As far back as the ninth century, Islamic societies based in Baghdad and Cairo boasted institutions that afforded care for people with mental health concerns. At a time when systematic access to healthcare was not widespread, these early hospitals in the Muslim world – known as dar al shifa or places of healing – tended to the physically ill while also providing humanistic care to those facing psychiatric issues. Their inclusiveness towards people with diseases of the mind thus shows an early awareness of mental illness.
It’s essential to acknowledge that the global understanding of psychological health has progressed significantly since then. In today's world, we witness significant advances; from corporate mental wellness days to celebrities speaking openly about their own struggles, there is widespread acceptance that psychological complaints can no longer be ignored.
Nevertheless, many countries across the globe are still falling behind in devoting enough attention to mental health, including in regions like the Middle East that once housed bastions of healthcare progress in Cairo and Baghdad.
A recent whitepaper developed by the Economist, titled Mental Health in the Middle East: Measuring Progress Towards Integrated, Accessible and Equitable Mental Health Care, has revealed that mental health conditions are increasing as a share of the total disease burden, even as their prevalence rates appear to remain relatively consistent. In fact, in Jordan, Oman, Kuwait and Qatar, the share of mental health conditions as a share of the total disease burden is over double the global average of 5 per cent.
In the coming years, this burden may be further exacerbated as a natural consequence of the region’s young population, and its high burden of non-communicable diseases like diabetes and cardiovascular illness.
Of the Middle East and North Africa’s population of 679 million, 60 per cent are estimated to be below the age of 30, and we know that younger people are more vulnerable to mental health problems. According to the WHO, 50 per cent of mental health problems start by age 14, and 75 per cent of them present by age 24. Mental health conditions are also similarly linked to major non-communicable diseases: a WHO study on the comorbidity between mental health disorders and major non-communicable diseases found that depression is two to three times more common in those with diabetes than those without.
There are also external factors compounding the prevalence of mental health concerns in the region: the displacement of various peoples, as well as the large proportion of migrant workers, create additional needs for adequate psychological healthcare provisions.
It is clear, then, that the burden of mental illness in the region is now too big to ignore. In 2022, PwC, the professional services firm, estimated that the GCC loses at least 37.5 million productive days every year due to mental illness, equivalent to $3.5 billion. This figure does not account for the health-related and social impacts of untreated mental illness on patients and their caregivers.
Policymakers are indeed aware of these costs, and many countries in the region do include formal legislation. Some nations even include a degree of coverage for mental health under basic national insurance. But this has not translated into access, especially given the high demand, and a shortage in the number of mental health workers.
At Janssen, one of the pharmaceutical companies of Johnson & Johnson, we believe that this problem needs a shared solution. Our goal has always been to reduce the burden, disability and devastation caused by neuropsychiatric and neurodegenerative diseases, and we seek not to just improve – but to transform – the lives of people facing mental health conditions.
To that end, it is essential that we promote and enable collaboration between all stakeholders to enhance mental health strategies and policies.
Decision makers, leaders, relatives, patients, professionals, and civil societies must all work collaboratively towards achieving a shared future vision in which individuals can experience good mental health and well-being.
Such an ecosystem must include access to mental health services as part of basic insurance coverage, and individuals must be able to access it without any deterrent from insurance providers. In the absence of this, other policies fall short, and those needing care remain untreated and often unrecognised.
Countries like Qatar, Saudi Arabia and the UAE are making significant strides into integrating mental health into their primary care models, and studies have revealed that this kind of integration can provide the best and most cost-effective opportunity to cover entire populations, including those that are hardest to reach. When realised, integration into primary care would make quality mental health services available and accessible to all, while also reducing the cost and stigma associated with seeking psychiatric treatment. We recognise and welcome these efforts, and call for greater action and will continue until measurable impacts are achieved.
Janssen remains committed to fostering innovation in the field of mental health through its Patient Affordability Programmes. These initiatives aim to assist eligible who lack comprehensive insurance coverage by providing them with medications as patient support by Johnson & Johnson companies. The programme is an integral component of Janssen's enduring dedication to addressing mental health as a vital aspect of overall well-being and aligns with our ongoing commitment to advancing the field of neuroscience.
Janssen continues to make a difference in ensuring access and advancing healthcare for the most vulnerable patients globally. As part of its ongoing efforts, Janssen signed a Memorandum of Understanding (MoU) with the Ministry of Health and Prevention (MoHAP) and Axios, a global healthcare consulting firm, to expand the Hand in Hand patient support programme. The Hand in Hand (HIH) initiative aims to provide medicines to uninsured and low-income expat patients or those whose insurance does not cover the cost of treating mental health disorders.
We at Janssen urge greater collaboration and initiative among all stakeholders in the Middle East and North Africa until effective systems actually provide insurance coverage and financial assistance to patients in need.
Real action and empathy to tackle the region’s mental health burden are not only timely but imperative.
– The writer is the General Manager of Janssen Gulf