Even with the worst of Covid-19 well behind us, for many people around the world, life has scarcely become easier. Global economic slowdown, war, and the effects of climate change – most recently in Pakistan – make the world an uncertain place. The result, as the World Health Organisation pointed out earlier this year, is that we see higher baseline anxiety and depression levels since the beginning of the pandemic. Many residents of the UAE come from countries that have been affected by difficult circumstances. Ultimately, no one is immune to mental health challenges.
The good news is that mental health continues to be talked about more readily in a growing number of countries, including in the UAE. In the workplace, managers are more aware of specific needs of their employees; there are mental health days, which did not exist before. And in schools, well-being is talked about in a more structured manner. The message is that mental health issues can and will take a toll, and it is OK to take a step back when issues arise.
Though so much progress has been made in our understanding of this subject, there is still a discrepancy between awareness and the access to avail that care. Mental health care is still a luxury in all parts of the world rather than a basic form of primary health care. There continues to be a significant shortage of psychiatrists and psychologists, adding to costs and reducing access to treatments.
When dealing with mental health, delays of this nature can be detrimental. Every intervention prevents more complex conditions. Every second matters and patients cannot be left to wait as their issues could worsen. Moving forward, we must work to recognise – much more widely than presently – that mental health is a serious issue which must be discussed. We need to figure out how to meet the needs of people in the most cost-effective and timely manner possible. And this must be a holistic process that also asks what sort of lifestyles we need to stay as mentally well as possible.
Certain everyday activities are extremely beneficial for mental health – physical exercise, regular eating and regular and restorative sleep. We humans also need connection and a sense of belonging to feel emotionally stable. Spending time with people whose company we enjoy, friends, family or colleagues, is absolutely essential for good mental health, especially when we are unwell and feel like it’s draining to be around others. Helping others/ community service also positively influences mental health. It keeps us distracted from our own problems and makes us useful to others. And, of course, we need to have fun. We should foster playfulness throughout our lives, not just in childhood or adolescence. All such activities can cause a big improvement in how we feel.
When treating mild cases of anxiety and depression, I am often asked for my opinion about online counselling platforms and self-help wellness apps. My answer is simple: while nothing beats a one-to-one therapy session in person, any other form of therapy is better than no therapy – and it is often much cheaper and therefore more accessible. I would recommend well-reviewed and credible services and apps of this nature to anyone looking for support.
Here in Abu Dhabi, we are lucky to have some very good government-led initiatives. During the pandemic, Istijaba, a public hotline for Covid-19 symptoms, was established, which has since been converted to a free hotline for mental health support. This is a great initiative that speaks to the demand for such a service, and the government’s seriousness in providing affordable solutions.
A recently concluded mental health upskilling programme in Abu Dhabi aimed to train primary care nurses and doctors in the UAE to screen for basic mental health disorders such as depression, anxiety, eating disorders and substance abuse, and to treat cases that do not necessarily require psychiatrists or clinical psychologists.
In practical terms, this means that anybody who sees a family doctor can also get a basic level of mental health care included in their visit and can be screened for common mental health disorders, which is akin to all patients having their blood pressure taken when visiting their general practitioner.
The upskilling course was a collaboration between the Department of Health Abu Dhabi, Abu Dhabi Health Services Company (Seha), and NYU Abu Dhabi. It was an important step towards a larger goal. Most mild to moderate mental health disorders such as anxiety and depression can be successfully managed in primary care settings by upskilled health providers. And seeing as we do not have enough specialised clinicians in secondary care, it is vital that we unburden the ones we do have so they can deal with more severe and complex cases.
Utilising primary care is also more cost-effective and quicker because it avoids the need for referral and waiting times. Studies show that patients are more likely to return to their primary care providers rather than follow up with secondary care.
I am heartened by similar attempts in other countries and institutions to move toward integrated care. Our own NYU Abu Dhabi Health Centre operates a holistic healthcare delivery model that integrates specialised mental health care into primary care for students.
It is a model that works. Our job now is to roll it out to as many people in as many countries as possible and truly globalise and prioritise access to mental health care for all.
Istijaba call centre is available via the toll-free number 800 1717 or +971 800 1717 when calling from outside the UAE.
For more information on the Mental Health Upskilling Programme, write to mentalhealth@doh.gov.ae
