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Overview of Mental Health and Stigma in Saudi Arabia: Issues of Disgrace and Social Distancing

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Introduction

The topic looks to find and understand the overall perception of communities towards individuals suffering from mental health disorders. This topic is of paramount importance in regard to literature to mental health in a conservative and developing middle-eastern country. This study aims to examine stigma behavior of Saudis and their attitudes towards members of the community suffering of mental illness. Furthermore, community demographics, culture, religion, ethnicity all play a decisive role in the full and positive integration of individuals suffering from mental disorders within the community.

Background

With limited literature and data available, as well as the conservative nature of the society this study is geared towards; conducting research and gathering as much information available as possible will benefit future regional progress. Also, large treatment gaps exist for mental health care in middle-eastern countries. With more healthcare expenditure for physical and treatment, rather than mental and prevention, with the majority of people with mental, neurological, illnesses obtaining no or insufficient care (Salman Alahmed, Irfan Anjumand Emad Masuadi, 2018). Healthcare systems allocation of funds is geared towards interventions and treatment and neglect has been set for mental health care. Often, cultural beliefs, norms, traditions, religion, ethnicity affect society’s stance toward mental illness and how to seek help. With almost an all Muslim society, Saudi Arabia and various countries within the region share a lot of the same norms and traditions. Belief in the supernatural and superstition is not uncommon. Some forms of segregation between men and women still exists in some work settings and public gatherings. Whether this can lead to extremely varying views on mental illness, in both social and biological aspects is relatively unknown. Research on how these beliefs and conditions can affect help-seeking in Saudi Arabia is extremely scarce (Salman Alahmed, 2018).

History

Mental health alludes to our intellectual, behavioral, and emotional wellbeing – it is about how we think, feel, and carry on. The term mental health is used to mean a nonappearance of a mental disorder. Mental health is a level of psychological well-being, or a nonattendance of mental illness. It is the psychological state of somebody who is working at an acceptable level of emotional and behavioral change. As per WHOs, mental health incorporates subjective well-being, saw self-adequacy, independence, capability, between generational reliance, and self-actualization of one’s scholarly and emotional potential, among others. The WHO additionally states that the well-being of an individual is incorporated in the acknowledgment of their capacities, adapting to typical worries of life, gainful work and commitment to their community. A generally acknowledged definition of health by mental health experts is psychoanalyst Sigmund Freud’s definition: the ability to work and to love (Thompson, 1993). The term mental illness alludes all in all to all diagnosable mental disorders health conditions portrayed by modifications in considering, state of mind, or behavior related with distress or hindered working.

Saudi Arabia and Mental Health:

For the previous three decades, Saudi Arabia had developed extensive healthcare facilities as well as the integration of mental health within the hospital setting (Carlisle J., 2018). By developing more legislation and promoting healthcare with WHO standards, taking social, cultural, and religious factors in dealing with the stigmatization of mental health disorders within individuals. However, dealing with a conservative and religious community can be very challenging. For example, %50 of Saudi patients will first seek treatment for psychological problems from faith healers (Tariq Alhabeeb, 2003). Almost all Muslims believe in “Jinn” which are spirits living amongst humans and watching them. Furthermore, this type of healing is very common, and may be more common within rural communities than urban ones. Although, scarcity in data about this particular piece of information currently unavailable due to the scarcity of data.

The first mental health hospital in Saudi Arabia is Shehar, founded in Taif in 1962. Although the region in general and Saudi Arabia in particular have a long way to go in terms of developing more psychological institutions, strong family ties and religious traditions have made halfway houses and day hospital unnecessary. (Alsubaie, 1989). As of recently, the Saudi Arabian government has launched the Mental Health Act (MHA) (Qureshi, N., Alhabeeb, A, & Koenig, H. G., 2013). This legislation aims at

  • Improving general access to mental health care
  • Ensuring least restrictive level of care
  • Preserving rights of patients, family, and caregivers
  • Streamlining competence, capacity, and guardianship issues
  • Ensuring facilities and professionals are accredited
  • Enforcing mental health laws and regulations
  • Establishing mechanisms to implement these provisions

The relationship between Mental Health and Our Communities:

Mental health illnesses are one of the stigmatized illnesses in many cultures around the world. Many individuals and societies consider mental health illness as a shortcoming. Like most illnesses; biological, psychological, and environmental factors can make a significant change in overall health of individual and influence health positively or negatively. More extreme examples of mental illnesses can be complications of other diseases such as Parkinson’s disease and schizophrenia. Relating to schizophrenia, a man’s activities are totally supported to themselves. Their disillusioned view of reality enables them to experience to a great degree of neurotic considerations. People suffering from these illnesses can sometimes lose control of rationale decision making and in times leads to crimes in the community. That is why dealing with a mentally unstable individual may lead to dire consequences., particularly when we consider the measurements of the odds of knowing a man that is somehow influenced by mental illness (Fieldhouse, 2012). It is crippling to think about the likelihood that one of our nearby buddies could endure peacefully out of dread for separation.

People with mental disorders are susceptible to a wide range of human rights violations. They not only deal with a complicated condition, they must also face society. Indivviduals suffering from a mental illness are often ostracized from their society, and are subject to different types of neglect and abuse (Alsubaie, 1989).

Methodology

The primary focus of this review is gather enough information about mental health and culture and religion is Saudi Arabia. First, literature about history and origins of mental health comprehension and facilities aimed at treating mental health illnesses. After that, focus was more about how religion and culture influence on mental health and how mental health is perceived. Furthermore, data was within the last 30 years which is also very limited given the young age of the country Saudi Arabia, and how within the 80s more progress and funding was allocated towards education and health care.

Google scholar was the only resource used, because most literature was available and enough to make an overview and overall assessment of mental health in Saudi Arabia. Inclusion and exclusion criteria involved, location; Saudi Arabia, perception and stigmatization of mental health. Moreover, substitutes to mental health treatment exist, but causes may differ. This is why it was important to find articles highlighting mental health treatments and study history of mental health within the region. Conservative countries within the region in general, and Gulf countries in particular, attribute many everyday tasks to religion and culture. This is an accumulation over hundreds of years, to the point where mental health issues and disorders may be attributed to “jinn” which is something considered supernatural and unscientific. With countries in the Gulf having a homogenous society, which is very culturally composed, religion plays a major role. Going to a sheik to “cast out devils” is not uncommon. This however, is not an exclusively Islamic ritual. Other Abrahamic religions, such as Christianity, have rituals very similar to those in Islam in dealing with this phenomenon.

Saudi Arabia is heading to a region wide shift and vision, called “Vision 2030”. This vision has many primary targets in its agenda such as; a balance in society by empowering women and providing equal opportunities/rights, using innovative teaching techniques and adapting efficient learning curriculum, inclusion of mandatory second languages within educational k12 system, efficient healthcare and a priority in public health and social awareness. With this information and trend in Saudi Arabia, healthcare is given the proper funding to raise awareness about mental health illnesses and their complications. Also, this will help erase stigmatization and ultimately decrease complications of mental health disorders.

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Different types of literature were reviewed: mostly peer-reviewed published articles. Using keywords like; mental health, Saudi Arabia, prevention, community, problem, depression, mental-illness, and using search engines, Google Scholar, we were able to determine a sum of data all within a short period of time. Relevant sections within selected literature was re-read focusing on planning and implementation used.

In Saudi communities, the common perception about mental health is that it is a mental health can be defined as status or condition of emotions, behaviors and moods of people that are linked with specific sorts of problems and stress factors. It is also referred as the reactions of people/individuals toward the anxiety or depression. Recent researches about Saudi communities described that in Saudi Arabia, the mental health is linked with social, economical, emotional as well as physical health of individuals (Fieldhouse et al., 2012). Normal state of social, emotional and behavioral maturity and absence of mental or behavioral disorders is also called as mental health in Saudi communities. In a Saudi community, a person is considered as mentally perfect if he/she has the ability of enjoying every moment of his/her life (Carlisle, 2018). Data from researches conducted under supervision of World Health Organization show that more than 52% of the Saudi’s population is the victim of different sorts of mental disorders or mental diseases (Carlisle, 2018). Good mental health in societies is very important for personal growth and development of individuals as well as growth and development of Saudi communities.

Anxiety, anger, depression, ADHD, Autism and Bipolar disorders are most common types of mental disorders in Saudi population. More than 47% of Saudi population faces the issue of depression (low or high level of depressions). Occurrence of depression related disorders is common in adults as compared to the teenagers (Carlisle, 2018). Recent researches also revealed that about 40-45% of adults in United States are having the ADHD disorder. One out of five Saudi adults and 2 out of 15 Saudi teenagers live with some sort of mental illness (Alahmed et al., 2018). The problematic issue in this regard is that only half or less than half of population has mental disorders receive proper treatments, which is causing many types of social and economical problems in Saudi societies including issues of harassments, sexual abuse, racism, poverty and increase in suicide rates (Alahmed et al., 2018).

There are also many types of stigma perception of Saudi communities toward the mental illnesses or mental disorders that contribute fall in physical health as well as fall or disturbance in individual’s social, psychological, emotional and physical well being in (Palinkas et al., 2009). There are different sorts of biological, psychological and environmental causes of mental illness or mental disorders in Saudi communities (Fieldhouse et al., 2012). Biological factors are the factors that cause mental disorders because of certain inactivity or problems in functions of different biological processes or organs such as damage in nerve cells or brain cells can cause mental illness and mental disorders (Fieldhouse et al., 2012). Other sorts of biological factors that cause different mental disorders among Saudi population include heredity (transfer of mental illness causing genes from parents to next generation), injuries or traumas at time of birth, bacterial or viral infections and poor nutrition. Attitude of Saudi communities towards biological reasons of mental illness show variable results because of difference in the level of education and knowledge about mental illness. More than 42% Saudi individuals having college education believe that biological factors could be a reason for mental illness in public. More than 78% uneducated individuals do not believe that biological factors could cause mental illness in their family members or in other individuals of their communities (Palinkas et al., 2009).

Psychological factors also play important roles toward occurrence of mental illness in Saudi individuals. Common psychological factors responsible for mental illness and mental disorders among Saudi teens and adults are loss faced by kids (death of parent), racial issues, sexual harassment, and lack of abilities to contact and interact with others. Stigma of Saudi communities about the psychological reasons of mental illness is somewhat different from that of biological reasons of mental illness among Saudi individuals (Al-Krenawi, 1999). 12% Saudi individuals believe that racial discrimination could cause mental illness in their community members while 67% Saudi individuals believe that loss of beloved one is a main reason for mental illness (Palinkas et al., 2009). Sexual harassment and lack of abilities to contact with others are least acceptable reasons for mental illness among Saudi population because only 2-3% Saudi individuals believe that these could be a reason of mental illness among their community members (Choudhry et al., 2016). Drug addiction is also an important reason of mental disorders among Saudi population but it is not much intensive as compared to other reasons because Saudi government has very strict rules and regulations against drug usage and smuggling of drugs (Alahmed et al., 2018).

With the increase in intensity of mental health issues in Saudi communities, stigma about mental illnesses is also hanging with the passage of time. Stigma and mental illness are interlinked with each other in regard of the community health of Saudi Arabia. Isolation from close relationship because of mental illness is common stigma in Saudi societies. This isolation caused many sorts of barriers in follow up the treatment of mental illness as well as participation in psycho-education (Pridmore and Pasha, 2004). In Saudi societies, mentally ill people are considered as “different” from other individuals and are commonly rejected with negative behaviors. In Saudi Arabia, larger part of individuals holds negative attitudes and generalizations towards individuals with mental illness (Palinkas et al., 2009). Since early on kids will allude to others as ‘insane’ or ‘strange’; these terms are utilized usually all through adulthood of Saudi Arabia also. Regularly the negative generalizations include observations that individuals with mental illness are perilous. This observation is filled by Saudi media stories that paint violent culprits as ‘mentally sick’ without giving the setting of the expansive range of mental illness (Dardas & Simmons, 2015). This bias isn’t constrained to Saudi individuals who are either clueless or detached from individuals with mental illness; in reality health care suppliers and even some mental health professionals in Saudi Arabia hold these exceptionally same generalizations (Palinkas et al., 2009).

These negative attitudes regularly show as social distancing as for individuals with mental illness in Saudi Arabia. Specifically, when Saudi people feel that a person with mental illness is hazardous, that outcomes in dread and expanded social separation. This social distancing result in the experience of social confinement or dejection with respect to individuals with mental illness and is getting progressively normal in less taught social orders of Saudi Arabia. In Saudi Arabia, the disgrace and social distancing can possibly intensify the prosperity of individuals with mental illness in a few different ways (Choudhry et al., 2016). In the first place, the experience of social rejection and disengagement that originates from disgrace has the potential for direct hurtful impacts (Fieldhouse et al., 2012). It has for quite some time been comprehended that social confinement in Saudi Arabia is related with poor mental and physical health results and even early mortality the lethality of dejection. Further, social segregation in Saudi people group predicts handicap among people with mental illness.

In Saudi Arabia, individual with mental health issues perceive and disguise this shame to build up a solid self-disgrace. This self-disgrace among Saudi patients regularly undermine self-viability, bringing about a why attempt attitude that exacerbate prospects of recuperation. Further, as Saudi patients start to encounter side effects of their mental health conditions, for example, anxiety or discouragement, disgrace because some “Saudi patients to attempt to maintain a strategic distance from, separate from or smother these emotions, all of which have been connected to the declining of prosperity” (Palinkas et al., 2009). This shame doesn’t simply intensify results on an individual dimension, yet additionally convolutes the care and assets accessible to individuals with mental illness in Saudi Arabia. In Saudi people group, the shame can result in a lower prioritization of open assets and less fortunate nature of care. “Disgrace and embarrassment are the top reasons why individuals with mental illness did not take part in drug adherence in Saudi Arabia” (Choudhry et al., 2016). The impacts of shame work both ways – mental health conditions are not commonly screened in most health care settings, losing an imperative open door for care in Saudi Arabia. In Saudi Arabia, individuals with mental illness are multiple times bound to be in prison than in psychiatric offices, driving some to call prisons. Over 45% Saudi people think about this as a human rights infringement that adds to the cycle of prison, destitution and vagrancy for some mentally sick individuals in Saudi Arabia (Thompson et al., 1993).

Changes in Saudi Arabian mental health care framework have been emotional in the course of the last 30 years. In 1989, Saudi Arabia built up primary health care (PHC) focuses all through the nation so as to improve the conclusion and treatment of medical issues in the network. All Saudis presently get their medical care in these focuses. So as to improve the discovery and treatment of mental health issues, the WHO in 2000 urged nations to make PHC focuses the purpose of first contact for those with mental disorders. In circumstances where PHC physicians can’t deal with these patients, the suggestion was to allude to psychiatrists by and large emergency clinics, and in the event that psychiatrists in those settings couldn’t oversee patients, at that point they were to refer to strength psychiatric medical clinics or to showing clinics (Qureshi et al., 2013). Since most people first observe their medical specialist for health issues, and psychiatric and medical sickness frequently exist together, the WHO saw this framework as the most ideal approach to recognize and treat those with mental health issues. In Saudi Arabia, which has pursued the WHO proposal, this procedure has worked sensibly well covering most of the populace with mental health needs (Koenig et al., 2014). Patients in Saudi Arabia can likewise go legitimately without referral to see psychiatrists at claim to fame psychiatric medical clinics, and a few patients look for help through emergency administrations at either broad clinics or psychiatric emergency clinics without a referral. At long last, there is a private mental health care framework in Saudi Arabia, where patients are seen for an expense, not at all like the open framework which is government-supported. Notwithstanding unsupported private psychiatric clinics, there are more than 136 private general emergency clinics, numerous with private psychiatric clinics associated with them (Qureshi et al., 2013). As a result of the disgrace of mental sickness and the straightforward entry to administrations, the individuals who have the monetary assets regularly like to counsel private clinics and pay out of pocket. Private clinics offer psychotherapy, psychotropic medications, fixation administrations, language training, and restoration administrations to youngsters, youths, grown-ups, and more established grown-ups (Qureshi et al., 2013).

Saudi community is very diverse in regard of educational level, social status and impact of westernization on Saudi’s culture, believes and traditions. Limited studies have been conducted to analyze the stigma of Saudi communities in regard of their educational level and social status towards mental illness. That is why; less literature review studies were available for this research to analyze the facts. Furthermore less number of researches has been made to analyze the role of drugs and ethnicity in stigma behavior of Saudi individuals toward the mental illness. This also limits this study to analyze these facts on small scale. Although Saudi Arabia is making progress towards the issue of mental illness in all parts of its communities but many things needed to be done on broader way. Systematic approaches to understand the solution of mental illness as well as community’s behaviors toward mentally ill people are needed. This is possible with conductance of future researches with the spectrum of religion, ethnicity and drug role in causing changes in behavior of communities towards mental illnesses. Future researches with this spectrum will open new ways to overcome the challenges associated with mental illness in Saudi communities.

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Overview of Mental Health and Stigma in Saudi Arabia: Issues of Disgrace and Social Distancing. (2022, August 12). Edubirdie. Retrieved December 8, 2022, from https://edubirdie.com/examples/overview-of-mental-health-and-stigma-in-saudi-arabia-issues-of-disgrace-and-social-distancing/
“Overview of Mental Health and Stigma in Saudi Arabia: Issues of Disgrace and Social Distancing.” Edubirdie, 12 Aug. 2022, edubirdie.com/examples/overview-of-mental-health-and-stigma-in-saudi-arabia-issues-of-disgrace-and-social-distancing/
Overview of Mental Health and Stigma in Saudi Arabia: Issues of Disgrace and Social Distancing. [online]. Available at: <https://edubirdie.com/examples/overview-of-mental-health-and-stigma-in-saudi-arabia-issues-of-disgrace-and-social-distancing/> [Accessed 8 Dec. 2022].
Overview of Mental Health and Stigma in Saudi Arabia: Issues of Disgrace and Social Distancing [Internet]. Edubirdie. 2022 Aug 12 [cited 2022 Dec 8]. Available from: https://edubirdie.com/examples/overview-of-mental-health-and-stigma-in-saudi-arabia-issues-of-disgrace-and-social-distancing/
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