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Yemenis on the brink of mental health crisis

 

A health and psychological crisis in Yemen due to social stigma and the absence of specialists and medicines.

Saturday 10/15-2022

The continuous fighting for years and the economic crises that pushed Yemenis into the dark tunnel of poverty and also plunged them into depression, exacerbated by the absence of psychiatrists and medicines, as well as the fear of social stigma associated with resorting to treatment, which led some to commit suicide.

 

In Yemen, which is engulfed in a brutal war, the phenomenon of mental disorders is exacerbating, while the health sector is witnessing a collapse due to the eight-year fighting that has plunged Yemenis into depression and pushed others to commit suicide.

Doctors and psychologists say that Yemen, with a population of 30 million people, is currently experiencing a mental health “crisis” due to the absence of psychiatrists and medicines, as well as the fear of social stigma associated with resorting to psychological treatment.

According to the Ministry of Health, the number of psychiatrists in 2020 reached 59, which means that there is one psychiatrist for every half a million people. The average number of health workers specialized in mental health (doctors, nurses, and therapists) is estimated at about 300, or at a rate of one specialist for every 100,000 people.

The number of beds designated for mental health in Yemen does not exceed 990, while the Ministry of Health estimates the number of public and private mental health hospitals at seven, ie an average of one hospital for every 4.25 million Yemenis.

According to the Yemeni Family Development and Counseling Foundation, which specializes in psychological counseling, about 19.5 percent of the Yemeni population were suffering from psychological disorders in 2017, according to a study published that year.

Families often tie their patients, sometimes using fixed chains, rather than giving them access to hospital treatment

But the United Nations warned in reports published this year that “this number may be higher now due to the Corona epidemic and the continuation of the conflict.” There are no recent studies on the number of patients with mental disorders.

The war caused the death of more than 377,000 people directly or indirectly, according to a United Nations report at the end of last year, meaning that they died either in bombing and fighting, or as a result of indirect consequences such as starvation, disease and lack of drinking water.

The country is now at risk of escalating violence after the collapse of a half-year truce this month.

According to the Development and Extension Foundation, the causes of unrest in the population are mainly the result of “food insecurity, unemployment, cholera, arbitrary detention, torture, indiscriminate attacks, air strikes, or poor basic public services.”

In Taiz (southwest), one of the cities most affected by the war, mental health patients are crowded into a hospital that is no longer able to receive more due to its inability to provide medicines, food and treatment for all patients.

The director of the Psychiatric Hospital in Taiz, Dr. Adel Mulhi, explains that “the number of psychiatric patients is increasing as a result of the conditions in the country and the tragedies caused by the war and the current political situation.”

“We try to provide treatment, but we cannot provide it for all of them,” he explains. We receive large numbers (…) We are hardly able to provide the service because of what we have.”

 

Few hospitals
Few hospitals

 

With a capacity of 200 patients, the hospital does not have enough beds for everyone who knocks on its doors. The hospital receives government funding that covers 25 percent of its needs and receives some donations, according to its director.

In addition to the killing and destruction, Yemen is suffering from the worst humanitarian crisis in the world, according to the United Nations, with about 80 percent of the population of the neighboring country of some of the world’s richest countries, relying on humanitarian aid to survive.

In Hajjah, northwest of Sana’a, Médecins Sans Frontières runs a psychiatric clinic dealing with war-traumatized residents.

Ora Ramirez Barrios, director of mental health at the organization, confirms that 70 to 80 percent of patients in this clinic suffer from “psychosis, depression, bipolar disorders and post-traumatic stress disorder”.

“We have many people who have lost family members and homes and are experiencing displacement,” she said. Because of all these losses, grief is a common factor.”

But even with the clinic providing its services for free, some residents have difficulty accessing the center or accepting the idea of ​​obtaining psychological treatment. sick for days or weeks.

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When the parents were asked about the reason for resorting to these methods, they explained clearly that they do not know how to deal with patients in moments of aggression and moments of intense emotions, especially since patients pose a danger to those around them while they are in this situation, which motivates them to take these measures.

Ramirez Barrios explains that “patients’ families were ashamed to come earlier,” especially women, because they “need permission from their families or husbands and are afraid of not being committed to confidentiality” after talking about their situation.

She notes that many people come too late “when patients attempt suicide or symptoms such as severe hallucinations or delirium appear.”

She adds, “Many patients come to us after attempting suicide, whose causes vary according to the circumstances. The severe symptoms of psychosis can appear in the form of auditory hallucinations asking the patient to self-harm, or they can be caused by the patient suffering from severe depression. In the case of psychosis, it is important to understand the subjective experience of the individual, because hallucinations may seem very real and may be associated with a great deal of suffering.”

Yemeni media reports that a person commits suicide every two days, a number that cannot be confirmed by other parties.

Despite the difficulties, the official says, “This is not a hopeless place. People believe in us even when they have chronic diseases and think this is a safe place.”

 

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