High costs a barrier to mental health support in UAE, report finds

A comprehensive assessment of mental health care around the world highlighted the high cost and relative scarcity of practitioners in the UAE, while also noting that digital access to mental health support was among the best in surveyed countries.

According to a Mental Health Price Index compiled by German market analysts Kenkou, at an average of $163 for a one-hour therapy session, the UAE was the second most expensive behind Switzerland, where counsellors charge $206 per session on average.

Mental health provision was assessed in 50 nations around the world in compiling the index.

With 0.77 psychologists per 100,000 people, the Emirates had the fifth lowest number of experts among the 50 surveyed nations. Japan, the Czech Republic and Finland had the best physical access to mental health care, while Bangladesh, Mexico and India were least accessible.

Progress with online services and new centres

The UAE scored well on providing digital access to mental health support, scoring fourth on a global list of 50 nations behind Denmark, Norway and Sweden.

Experts in the UAE said mental health care was an evolving service that had made recent progress, but more insurance cover was needed.

A new Priory Wellbeing Centre opened in Abu Dhabi in March, the company’s second facility in the UAE, offering specialist mental health support.

Consultant psychiatrist Dr Waleed Ahmed at The Priory Group UAE, said treatments were not always covered by insurers.

“I find myself often having difficult conversations with patients and families about their worries regarding certain mental health conditions and treatments not being covered by their otherwise generous health insurance packages, and having to pay themselves,” he said.

“Others are having to choose between an evidence-based psychotherapy session and a session with the doctor to discuss prescribed medications.

“This is especially true for our children’s services, where important diagnostic and therapeutic developmental assessments that also take considerable clinician time, are not routinely covered by insurance.

"Unfortunately, stigma persists in the field of mental health and there is still some way to go globally for it to be seen on an equal footing to physical health.”

Free support on offer

Free services in the UAE provided by the the National Programme for Happiness and Wellbeing include a mental health support phone line, where trained counsellors offer advice to callers.

Under the Emirates Foundation, the 800 HOPE number was established at the onset of Covid-19 to offer safe and confidential mental support to individuals affected by the pandemic, and continues to provide help.

The Kenkou analysis of mental health services in the UAE assessed data to understand costs entailed in global care.

It investigated the cost of care and medicines, the prevalence of conditions and access and quality of care.

Analysts researched fees for therapy and mental health hospital admissions, as well as the average cost for a month-long addiction treatment.

They also evaluated the price of medicines by collating data via local pharmacies in each country for the most common mental health conditions; these were depression, anxiety, bipolar disorder, schizophrenia, post-traumatic stress disorder and stress.

Varying degrees of pharmaceutical regulation were considered by checking generic and branded versions of the most typical drugs prescribed.

The national affordability of mental health care was then assessed in each country against the global average, using the combined cost of medicines and care.

Marie Byrne is a professional counsellor who runs the Wellness Clinic in Jumeirah and volunteers for the Emirates Foundation offering free mental health support.

“In terms of what help is available for mental illness, counselling is just one aspect,” she said.

“The costs per hour in the report are more reflective of the general cost of living in the UAE, and you would find a similar pattern if you compared fees of a solicitor, doctor or other professional."

The quality and availability of professionals can also affect costs, she said.

“There is not a scarcity in Dubai, but it could be an issue in other areas of the UAE.”

Mental health drive 'still developing'

The Emirates Foundation offers support in Arabic and English.

While the crisis line operates only between 8am and 8pm, it is expected to operate until midnight during Ramadan.

Ms Byrne’s rates are below the national average per session quoted in the report, and she offers free introductory sessions.

“Restoring someone’s mental health and well-being is a relatively new concept globally,” said Ms Byrne, who is from Ireland.

“It is a developing area, insurance companies and health care in general still do not see it in the same way as physical health.

“There is still some stigma and people don’t always want to claim on their insurance for mental health care.

“Insurance companies are more aligned with clinical psychologists, where medication is offered as part of the solution, rather than just routine counselling and therapy.”

Employers urged to offer assistance

According to the Kenkou index, the cost of mental health care in the UAE is 201 per cent more expensive than the global average.

It found stress as the most common mental health issue, followed by depression, anxiety, bipolar disorder and schizophrenia.

Stephen Maclaren, a health insurance specialist with Seven Insurance Brokers in Dubai, said mental health cover was becoming more common, but often resulted in higher premiums for employers.

“Insurance for mental health is there, you just have to pay for it,” he said.

“Employers need to understand the need for this kind of cover and some don’t want to pay for it.

“It can be expensive but there are ways around it, such as an employee assistance programme where employers can pay about $30 (Dh110) a year per employee.

“That entitles them to five sessions of in-person counselling per condition, and access to unlimited telephone support – it is not enough but there are ways of getting more cover.”