Dubai: As an Egyptian living and working in the UAE, I can easily see the difference between how mental health is perceived here versus there. In the UAE, although not as openly discussed as physical wellbeing, it is starting to take a front-row seat.
The UAE government itself has a National Policy for the Promotion of Mental Health, a list of services that address mental health issues and even offers free psychology sessions for citizens who are struggling.
Additionally, the UAE is also home to hundreds of psychology and psychiatry centres that are covered by health insurance and can give you talk therapy sessions as well as psychiatric medication for more serious cases. Your mental health matters here.
Things in Egypt, however, are a little bit different
Gulf News spoke to Yasmin Magdy, a Clinical Psychologist, Marriage Therapist and an addiction counsellor based in Cairo, to tell us about her experience as a psychologist in Egypt and the Middle East. She has lived all over the Middle East and practised as a professional psychologist in the UAE, Bahrain, Saudi Arabia and currently owns her own practice in Egypt, called Gaia. She is also the owner of the American Center for Psychiatry and Psychology in Cairo.
We also spoke to Ally Salama, a 23-year-old Egyptian mental health ambassador, who is mentored by Dr Nasser Loza, a World Health Organisation and EMRO Consultant and the President of the World Federation for Mental Health. Ally is the host of a mental health podcast called Asrar El Nafs, on which Egyptian celebrities including actors, singers and even football players guest-star, as a means of raising awareness and normalising the conversation about mental health in the region.
Life in Egypt is a whole other level of tough
When Gulf News asked Dr Yasmin to pinpoint the mental health issue that she has come across the most in Egypt the answer was “If I had to choose the most prevalent mental health issues in the country, they would be anxiety and depression. Life, in general, is hard. Dealing with people is difficult, but life in Egypt is at a whole other level of tough.
"You don’t really understand it until you actually live through it. But it is very difficult living here. From the small stuff like traffic jams or getting your ID renewed to bigger issues such as social pressures, marriage and family obligations. It’s almost impossible to find space in life to do anything self-care-wise.”
The ones who struggle the most with these mental illnesses are Egyptian women.
“They aren’t properly supported, both emotionally as well as by the government. One of my specialties is couples therapy, so I work a lot with women who are going through divorce. This means that I sometimes go to the courts with them. This experience continually opens my eyes to the unfair justice system in Egypt. It truly shows me how little women have in terms of rights in the country. As a result, many of them stay in bad marriages and take the beatings and swear words and the terrible treatment, just so they don’t have to deal with the government.”
Things have gotten worse during COVID-19. Although Egyptians aren’t exactly “rule followers, which meant that many of them were still out and about during the pandemic, some members of the large population did stay home out of fear. As a result, it has caused a surge in rates of domestic violence.
“Unfortunately, there isn’t much research or data or data on the subject, but let’s put it this way, as a therapist, I definitely noticed more domestic violence and crimes against women in the last few months.”
In addition to domestic violence, Ally has noticed that the usually high levels of anxiety within many young Egyptians is on the rise during the pandemic. “Unfortunately while data is still not available, my statements are only based on qualitative data from conversations with professionals. Employment is linked with greater mental wellbeing. With job losses being quite high during COVID, I am seeing that stress related diseases will be more common now. Again, I am just an advocate and by no means am I a professional, but this is what I am hearing from Egyptian youth.”
I also hope that the Egyptian government will be forced to invest into a greater mental health infrastructure after the COVID era. A study from the Mental Health Commission of Canada and Deloitte shows a 400 per cent return on investment (ROI) generated over time because into mental health initiatives within a sample of top tier companies in Canada, so the same could be applied in Egypt.”
The bigger issue is the negative stigma
We will only see the government implement initiatives to tackle mental health once we can heavily reduced the stigma around it.
“I have been practising all over the Middle East, including in Bahrain, Saudi Arabia, the UAE and Cairo, over the last 15 years,” Dr Yasmin told Gulf News. “The largest issue - bigger than any disease - is the negative stigma surrounding mental health. The fact that it is seen as a form of weakness. Because it’s an intangible issue, it’s very easy for people to dismiss it. People just say, “Oh get over it”. Others will tell their kids to read some more Quran. Or to “go pray and it will make things better. As a result, people just live with that anxiety and depression inside them and it’s untreated and it festers into something worse.”
Mental illnesses just aren’t a common topic of discussion in Egypt. “I grew up in Cairo, but now I live in Toronto,” Ally said to Gulf News. “As someone who got to experience both cultures, and see the difference of life in Canada in comparison to Cairo, I couldn't believe just how easy it was to openly talk about mental health issues in Canada. It also showed me that in Egypt, there wasn’t any culturally relevant mental health information accessible to the public.”
“I feel like mental health is such an undiscussed topic in the Middle East because of fear. People fear what is invisible to the naked eye. While mental health isn’t pseudoscience, it’s fact-based science, there seems to be a huge stigma around what the naked eye cannot see.
"I also believe that mental health is heavily underrepresented due to the stigma around it amongst men. Traditionally speaking, men, like myself, occupy the majority of leadership positions in publications and companies in Egypt. Unfortunately, due to the lack of education on the topic, it’s still seen as a weakness, even though many know it’s a medical condition. This unbalanced power dynamic affects the region's mental health."
"A common aspect you may notice is that people of countries with female leaders will typically have more tolerance for mental health. There also aren’t many TV shows, magazines or podcasts on the subject. It is hardly addressed in the mainstream. So I decided to start my own thing. My mental health magazine, EMPWR, and the podcast was born out of frustration and a desire to spread the word.” Ally’s work has been recognised by the World Health Organisation and numerous global mental health professionals.
Therapists in Egypt
Another major concern is that Egypt does not have any data to back up any claims that psychologists make. In fact, the stakeholders in this piece, were speaking out of direct qualitative data points and out of experience and their interactions with other professionals in the region.
“Because we don’t have an official board of psychology in Egypt, this has left a lot of room for unethical therapists,” Dr Yasmin told Gulf News. “We have had a terrible reputation over the years. No one really understood what we do, and many therapists in Egypt, who do not have the proper education, are treating patients in a very wrong way. People come to therapy not knowing what they are here for.”
However, over the last 15 years, Dr Yasmin has seen a vast improvement on how the population views therapy in Egypt and in the region. “I have noticed that the perception of going to therapy is more positive than ever before. People are more open about the idea and more educated, so I noticed that more prospective patients are asking for accreditation, which makes me very happy.
"At the moment, divorce rates in Egypt are incredibly high, so couples therapy has become quite popular. Not just with newlyweds, but I was pleasantly surprised to see older couples booking appointments with me. I have gotten couples in their 40s, 50s and 60s. But of course, there is always room for improvement.
"TV in Egypt is huge. We need more people to talk about their own experiences with therapy and traumas. Celebrities opening up would change the game. Hearing people talk about their real-life traumas is way more influential than just reading about psychology. Word of mouth is huge in Egypt. It is such a powerful tool. If the media gave us a bit more attention, we would definitely be in a different place in the community," Dr Yasmin said.