The Reality of Mental Health Centers in Yemen: Limited Efforts Amidst Growing Mental Health Cases

Alia Mohammed – Sawt Al-Amal (Voice of Hope)

The conflict in Yemen and its repercussions have extended to numerous vital sectors of the country. The deterioration of economic, health, and social conditions has led to an increase in mental health cases among citizens. This situation necessitates a safe and supportive environment for children and youth affected by the conflict. Mental health support centers and psychiatric facilities are the ideal places to treat such mental health conditions. They provide psychological and emotional support to beneficiaries, offer necessary guidance and therapeutic services, and contribute to enhancing the mental well-being of society as a whole.

Mental health centers also work to raise community awareness about the importance of mental health and provide preventive programs that help reduce the spread of mental health problems. However, we must ask: What is the reality of the work of specialized centers providing mental health care in Yemen? Are they fulfilling their role in assisting with mental health cases?

To understand this, the report sheds light on the role of mental health centers and the challenges and difficulties they face in providing mental health care.

The Reality of Mental Health in Yemen

Mental health and psychosocial support consultant, Ridhwan Abdul-Wahid Al-Sharjabi, indicates that discussing mental health in Yemen cannot be separated from the social, economic, political, and cultural environment. Mental health is negatively and positively affected by these factors, leading to an increase in the rates of mental disorders and difficulties in recovery.

He explained that studies indicate that developing countries are the most vulnerable to the spread and increase of mental disorders. Many developing countries do not give sufficient importance to mental health, leading to the absence of national strategies to address mental health problems.

He added, “The cultural context plays a pivotal role in shaping the reality of mental health in Yemen. The cultural context is still reinforced by social stigma that refuses to acknowledge mental illness. This leads a large segment of those suffering from various mental health symptoms to refrain from disclosing their condition and seeking help from specialists, especially women and girls.”

He pointed out that the prevailing approach in dealing officially with mental health has not changed for decades. This approach treats mental health as a limited component within the public health system. Within mental health itself, levels of mental disorders are dealt with from a medical perspective that overlooks simple or complex disorders and focuses on severe or pathological cases.

He mentioned in his statement that Yemen is among the countries in the world where mental health has not received significant attention. In fact, for decades, mental health has been treated as a partial component within the components of public health. Specialized institutions for mental health that are responsible for policy-making, strategic planning, and keeping pace with scientific and technological advancements in the field of mental health have not been established.

Mental Health Centers in Yemen

In a 2014 report, the World Health Organization indicated data on the number of mental health workers in Yemen. It identified three mental health hospitals and one psychiatric unit in a general hospital. Meanwhile, the Ministry of Public Health and Population’s Mental Health Needs Response Plan 2020-2021 indicated the existence of four governmental mental hospitals in four governorates (Sana’a City, Taiz, Al-Hodeidah, and Aden), with one department in each hospital, and seven specialized mental health outpatient clinics.

Al-Sharjabi stated that the absence of mental health centers and the lack of attention given to them have negatively impacted the reality of mental health in Yemen. This is evident in the shortage of psychiatrists and mental health care institutions. Although there is a broad base of university graduates in various mental health fields and specializations, the majority of them turn to work in other fields required by the labor market, which are often far from social and psychological work. This leads to a significant loss of human resources and affects societal recognition of mental health as a whole.

He continues, “Comparing the number of mental hospitals to the number of governmental hospitals and health centers in the country reveals the discrepancy and the significant gap between the attention given to public health compared to the low level of attention given to mental health.”

He explained that in the main cities where mental hospitals were established (Sana’a – Aden), the services provided by these hospitals target patients with mental illnesses and do not provide psychosocial support to individuals who need psychological and social services, who constitute a large segment of society.

Al-Sharjabi also pointed out that the reality of mental health has been significantly affected in the past decade, which has been characterized by conflicts, disputes, and deteriorating social, economic, and developmental conditions. This has contributed to an increase in the proportion of the population suffering from mental disorders, especially among children, who have shown significant indicators of mental health issues such as post-traumatic stress disorder, depression, anxiety, and hysteria.

“I am exhausted by the illness… but my family does not agree that I should go to the clinic, and they reject the idea from the outset.” This is one of the many phrases that we hear as specialists in psychological treatment, after spending a lifetime studying, practicing, and developing it,” confirmed Abdul-Hafidh Al-Khamri, an expert in psychological training.

He says, “We hear these phrases a lot from many people, and they do not realize that psychological treatment is based on diagnosis, especially “dynamic” diagnosis, which tracks the disorder from its onset, its development, observing the factors that increase and decrease it, its progression and depth, its impact by multiple variables, leading to the current state, and even what its fate might be if left untreated.”

Challenges and Solutions

Munia Najib, a psychotherapist, stated that mental health treatment centers play a significant role in enhancing the mental health of community members by providing a variety of psychological treatments to help individuals cope with mental disorders such as anxiety and depression.

She added, “Mental health centers in Yemen are limited. Despite the establishment of some mental health centers and specialized clinics in recent years in many Yemeni governorates, the capacities and resources available to these centers remain limited. This is due to the current situation in the country, which has not been able to provide its mental health treatment services to a large proportion of the population. The role of these centers remains modest compared to the enormous needs.”

She pointed out in her statement that the most important challenges and difficulties facing mental health centers in Yemen are: limited government funding and international support for developing infrastructure and purchasing medical equipment, in addition to the shortage of specialized and equipped centers to provide mental health services, the lack of specialized personnel, and the lack of community awareness about the importance of mental health. This prevents many patients and their families from seeking mental health treatment due to the social stigma associated with psychological and mental problems, and traditional beliefs that favor religious and folk solutions over psychological treatment.

She stressed that addressing these challenges requires integrated efforts at the level of policies, human resources, and community awareness.

For his part, Al-Sharjabi said, “Despite the focus of community attention on the mental health of children and women through civil society institutions, and government interest in the framework of projects and programs funded by international donors, which are mostly in the form of family and community-based psychosocial support, these projects are limited in time and geographical scope, and lack sound planning based on studying community needs and prioritizing beneficiaries.”

He added, “At a time when mental hospitals have been affected by the lack of operating expenses and psychiatric medications, other hospitals have been unable to receive cases of mental illness, which has made the streets a refuge for them, sleeping on the ground.”

He explained that the National Mental Health Strategy in Yemen 2022-2026 addressed multiple aspects regarding mental health in Yemen. However, this strategy did not meet the level of ambition in improving the reality of mental health and the direction aimed at establishing mental health in Yemen.

He clarified that no working group for mental health includes both governmental and non-governmental components related to mental health. Instead, many parties are vying to claim responsibility for the mental health program, reducing the tasks of mental health to therapeutic interventions for severe mental disorders or mental illnesses, overlooking levels of psychosocial support and specialists in psychosocial support.