The Role of Official Institutions in Creating and Strengthening Mental Health Centers

Hanan Hussein – Sawt Al-Amal (Voice of Hope)

While there’s growing attention to public health and providing necessary services to meet citizens’ needs, mental health in Yemen remains largely neglected. It lacks community awareness and support. Despite efforts from some official institutions, it still faces many challenges that have relegated it to the lowest levels compared to the world.

Some of the challenges official institutions face in providing mental health services in Yemen include a lack of funding and support. Many specialized facilities and programs suffer from a severe lack of financial resources, a shortage of psychiatrists and psychotherapists, and weak infrastructure in healthcare facilities specializing in treating mental illnesses. The ongoing conflict has exacerbated mental health crises among citizens.

The role of official institutions in providing mental health services in Yemen includes setting policies and strategies that define clear measurable goals, timetables for achieving them, programs to promote the prevention of mental disorders, and facilitating access to mental health services. They need to provide financial and human resources to ensure adequate and free services for all Yemenis. They also need to train more specialists in mental health and build more specialized facilities to provide mental health services.

In addition, they need to raise awareness and disseminate information about the importance of mental health, break the social stigma associated with mental illnesses, and create partnerships and coordination with civil society organizations and international organizations to ensure comprehensive and effective mental health services.

Statistics and Reports

World Health Organization’s National Mental Health Strategy for Yemen 2022-2026 stated that the total number of government health facilities providing mental health services reached 0.07, meaning one facility per 1,500,000 people. There are 0.01 government psychiatric clinics, meaning one clinic for every 7,400,000 people, and 0.01 government psychiatric hospitals, meaning one government psychiatric hospital per 1,500,000 people.

According to Al-Sharq Al-Awsat newspaper, an international relief organization reported that Yemen suffers from a severe shortage of mental health doctors, with one doctor for every 700,000 people.

A 2023 report by the World Health Organization indicated that the organization provided life-saving medical and health services to 12.6 million Yemenis in 2022, representing 62% of the country’s humanitarian response plan.

In a 2024 report on the mental health crisis in Yemen, the organization pointed out that the number of people suffering from psychological trauma and stress caused by the ongoing conflict is estimated at 7 million, almost a quarter of Yemen’s population. All of them need mental health support.

The organization explained that only 120,000 people have been able to access continuous mental health services. Despite these significant challenges, the World Health Organization has made significant progress in improving mental health services in Yemen. Since 2021, more than 3,500 healthcare workers, first responders, frontline workers, school teachers, and managers dealing with gender-based violence and child protection, have been trained in providing mental health services and psychosocial support.

World Health Organization’s Mental Health Atlas statistics for 2011 indicated that there were only four psychiatric hospitals in Yemen. Comparing these figures to the population, we find that there are 0.21 psychiatrists and 0.17 psychologists per 100,000 Yemeni citizens.

Support, Guidance, and Funding

Mental health services in Yemen are facing huge challenges that are hindering their ability to provide adequate services to millions of Yemenis suffering from the effects of the ongoing conflict.

Dr. Salih Ali (a pseudonym for a psychiatrist) points out that there are major weaknesses in terms of guidance, support, and funding from relevant institutions. Funding from organizations is weak due to the conflict, and training for mental health professionals is weak or nonexistent because there are no incentives for them to work, including financial compensation.

Muhammad Omar Al-Rashid, a psychotherapist and behavior modifier, stresses the importance of the organized and purposeful role of relevant institutions in providing financial support and funding to mental health centers. Funding and support for establishing and operating health centers has become extremely important, especially at this stage.

He explains that the demands of this time, particularly with the ongoing conflict in Yemen, the lack of salaries, the scarcity of work, increasing unemployment, and the poor health situation, have put people under tremendous psychological pressure and have left them in a state of crisis. He demands that government institutions, supporting institutions, and charitable organizations provide financial support to establish and operate mental health centers.

On the other hand, Munira Al-Namir, a clinical psychologist, confirms that many institutions provide support to mental health centers. Many hospitals have opened recently, some in the private sector and others supported by organizations. She notes that in the past three or four years, there has been a huge surge in mental health care. It has become more well-known and widespread, and society is becoming aware of this aspect. Mental health has become more prevalent, so we are seeing support for mental health from organizations, both international and local.

Continuous Encouragement

In terms of encouragement policies to activate the role of official institutions, Al-Rashid emphasizes the importance of support and encouragement to activate the role of official institutions in the field of mental health. This comes from television, radio, old and new media, and community awareness through mosque sermons. It also includes visiting mental health institutions to explore the circumstances that citizens live in and their needs.

He also notes that diversifying the services provided by official institutions should not be limited to mental health care only but should also include mental rehabilitation programs for victims with psychological sessions, as well as educating the community about mental health through social media, encouraging therapists to open channels on social media, and developing programs through official and private channels to explain the psychological needs of individuals in the community.

Munira Al-Namir adds that the media plays a role in mitigating the intensity of the social stigma that patients who suffer from mental illnesses face. Media plays a role in conveying positive experiences to other people in society. Al-Namir compares the topic of mental health to a “snowball” and says, “The more this ball rolls, the bigger it gets.” This means that the more people share their experiences with mental health, the more they encourage others to seek treatment and benefit from it.

She points out the importance of conducting a systematic study of mental health centers and working on attaching a mental health department to all government and private institutions and hospitals, such as internal medicine departments, pediatrics departments, and others, that contain a comprehensive mental health care unit staffed by a physician, a mental health specialist, and a social worker to provide the necessary support to patients.

Collaboration from Various Parties

Munira emphasizes the importance of working together with different organizations in Yemen to promote mental health. They’ve been making progress, collaborating with relevant groups and international organizations to strengthen mental health centers.

As a result, more mental health centers have opened, training sessions have been held, and testing tools have been developed and distributed by organizations. Mental health professionals have received training in using these tools.

Muhammad Al-Rashid stresses the need for government institutions to work together, providing spacious and supportive environments for mental health facilities. He emphasizes that these facilities shouldn’t feel like prisons, with more space for activities, playgrounds, and gardens.

He suggests raising awareness about mental health among students, incorporating mental health topics into school curricula, and incorporating these topics into subjects like Islamic education or Arabic language. This will help encourage positive energy in students.

Training, Development, and Qualification

Regarding training and development for mental health professionals, Al-Rashid points out that there are no programs for education and awareness in this area. He stresses the urgent need to spread awareness in various sectors, including private and public medical schools, to strengthen curricula, open a psychological nursing department alongside the psychiatric department, and qualify specialists in psychological treatment. This will help them understand the importance of psychological treatment alongside medication. These steps are crucial for developing psychiatry in Yemen.

Al-Rashid also emphasizes the need for strict oversight from relevant authorities to ensure mental health centers, clinics, and hospitals meet the necessary standards for patients.

Munira Al-Namir confirms that there have been significant efforts in training programs recently. These programs target nurses in urban and rural areas, and mental health therapists in various governorates. The goal is to train staff to provide a range of mental health services, including telephone counseling in emergencies and conflicts, referrals for psychological treatment, and mental health care.

She adds that general practitioners and medical doctors have been trained on aspects of mental health, including how to refer cases to specialists, treatment, and dealing with psychological trauma.

There’s been a push to train, qualify, and develop general mental health staff over the past three or four years through local and international organizations that have supported this training and equipped mental health centers with psychological testing tools.

Al-Namir acknowledges a significant shortage of psychiatrists, but the number of mental health trainers and therapists has been increasing over the years.

Treatments and Suggestions

Munira says, “The role of the relevant parties in mental health in Yemen is still weak and doesn’t match the importance mental health deserves. We urgently need to change this situation and integrate mental health into the overall health care system.”

Munira offers several suggestions to make the relevant parties more active and developed in this field. These include raising awareness about the meaning of mental health, mental well-being, and the nervous system, as well as how external events affect individuals, and how mental health affects thinking and daily problems.

She continues by saying that the relevant parties must work to combat the social stigma associated with mental illnesses and convince society that mental illness is like any other disease. Seeking treatment is not a shame, but the shame is waiting until the condition worsens and becomes a burden on the patient and those around them.

Munira concludes her conversation with an optimistic view of the future of mental health, saying, “Although we are still at the beginning of our journey and taking our first steps, we definitely need to monitor the performance of mental health centers and the results of mental health programs in the field. The relevant parties should work to transfer experience and skills from trainers to others so they can be applied to patients.”

Munira affirms that these steps are crucial for raising the level of mental health services in Yemen and making them compatible with developments in this field across the Arab world.