The first report into mental health provision for children in Dubai has found many youngsters are not receiving help early enough to give them the best chance of living a normal life.
With no comprehensive figures on mental health available, experts from Dubai Health Authority surveyed those working in the profession, and checked local and international surveys to paint a picture of mental health requirements for young people.
The findings of the first needs assessment for mental health in Dubai were discussed during the Public Health Forum of Arab Health 2018, and the data has been condensed into a single document to help monitor trends and develop services.
The study will serve as a baseline for future work, and be repeated within four years to assess the effectiveness of new measures to help children and parents facing mental health issues.
Eating disorders were the most common mental health issue in young girls, whilst boys were more likely to have autism or attention deficit hyperactivity disorder.
“As there is no registry, we are not able to get a clear figure to help the authorities plan the services that are needed, so we did some modelling and came up with an estimation based in surveys performed here and internationally,” said Dr Kadhim Alabady, senior specialist at the public health and safety department at Dubai Health Authority.
“This study has looked at all of the issues around mental health in Dubai, but we have also done the first study to focus on children.”
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Mental health is defined by the World Health Organisation as a state of well-being in which every individual realizes their potential, can cope with the normal stresses of life and can work productively.
Attention deficit hyperactivity disorder (ADHD) and eating disorders were the most common in children, with experts spoken to in the survey estimating between 1-2 per cent of children have ADHD.
Experts said the figure could be as high as 5 per cent in some communities.
Although there are no official UAE figures, health experts said children were being wrongly branded as ‘naughty’ and are at risk of being expelled, instead of being treated for a psychological disorder.
Dubai Autism Centre told the survey that autism was the most common Pervasive Development Disorder, affecting one in every 146 births.
A focus group within the private sector identified that a child with Autism Spectrum Disorder (ASD) is seen and diagnosed by psychiatrists for the first time aged 12-13, following a request from the child’s school.
There are just 18 children, a rate of 12.4 per cent, with ASD at Dubai Rehabilitation for Disabilities Centre, whilst Dubai Autism Centre (DAC) catered for 53 children with ASD.
The experts said just 16.4 per cent of children aged 6-18 were referred for help through their families.
Between 2014-2015, 152 children received treatment at DAC, with 129 boys.
Researchers found eating disorders were more common in girls aged 13-19, but also found they were being well cared for by their GP.
An assessment of eating disorders to find out how common the condition is is being made with help from a study with Al Ain University that estimated about 1.8 per cent of girls aged 13-19 were affected.
“We’ve met with psychiatrists, psychologists, social workers and managers to gather different views on mental health provision,” said Dr Alabady.
“In the interviews, we asked how many people were receiving treatment, and for which kinds of depression.
“It was clear not everyone with a mental health issue is reporting when they have a problem, because of a lack of awareness and the stigma that is attached in some cases,” he said.
Dr Nayla Daou, clinical psychologist at ClearMinds Centre for Emotional Health said the transitory nature of Dubai also made it harder for mental health issues to be reported since children struggle to confide in others.
“Families come and go, making it difficult for many children and teens to adjust socially.
“Many children fear getting close to others because they worry those children many end up leaving.”
She said children protect themselves by keeping distant but this can greatly contribute to their sense of loneliness and isolation.
Dr Alabady said the study highlighted the importance of helping these children earlier.
“It is not just a case of offering medication or surgery, these children need a lot of help and support to improve their quality of life.
“There is a huge gap in the continuum of care in terms of education, employment and housing,” he said.
“When the child reaches adulthood, there is a great strain on families, particularly in Dubai.”
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FlyDubai flies direct from Dubai to Skopje in five hours from Dh1,314 return including taxes. Hourly buses from Skopje to Ohrid take three hours.
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English-speaking guided tours of Ohrid town and the surrounding area are organised by Cultura 365; these cost €90 (Dh386) for a one-day trip including driver and guide and €100 a day (Dh429) for two people.
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Villa St Sofija in the old town of Ohrid, twin room from $54 (Dh198) a night.
St Naum Monastery, on the lake 30km south of Ohrid town, has updated its pilgrims' quarters into a modern 3-star hotel, with rooms overlooking the monastery courtyard and lake. Double room from $60 (Dh 220) a night.
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Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
