Six years ago, Riyadh Ahmed, a 30-year-old individual, returned from Al-Bayda governorate, where he worked as a daily wage laborer in qat farms, to his village in the rural areas of Dhamar. This return followed a psychological shock that disrupted his normal life and led to a deterioration in his health condition.
Safiya, Riyadh's mother, narrates to "Khuyut" her arduous journey with her son's treatment, stating: "I sold everything I had for Riyadh's treatment, to the extent of selling the cow we subsisted on. I sent him with his younger brother and one of the neighbors to a center of one of the Quranic readers (for spiritual healing) in Ibb governorate, as advised by neighbors, believing that he might be afflicted by the evil eye or sorcery."
She continues: ''Riyadh returned just as he went, showing no improvement at all; instead, his condition worsened. Therefore, I was advised to take him to a psychiatric clinic in Sanaa for treatment. Indeed, my son went to the doctors, and they prescribed a lengthy treatment for him. He began to show slight improvement, but we couldn't afford the treatment costs, amounting to 30 thousand riyals monthly.''
Safiya no longer had another cow to sell, so she had to sell the last of her gold grams to afford the available treatment for her son in Sana’a. However, Riyadh stopped taking the medication, returning to chewing qat. Consequently, this further deteriorated his health, leading to the loss of his ability to work and support his family, consisting of his father, mother, wife, and two children.
Riyad's story is just one of hundreds of tragic stories widespread in rural Yemen, whose intensity and numbers have been exacerbated by the ongoing war that has been raging for over nine years.
Actually, individuals afflicted with mental health disorders in Yemen face difficulties and challenges in accessing or obtaining adequate healthcare services, including treatment, psychological support sessions, and diagnostic procedures. This predicament is particularly acute in rural areas situated far from urban centers and provincial healthcare facilities.
Likewise, Abdullah Mohammed, a 40-year-old citizen residing in a rural area devoid of a mental health treatment center, tells "Khuyut": "Regrettably, my married son was afflicted and diagnosed with a psychological illness. Then, unfortunately, I found myself unable to even cover the travel expenses to Sana’a, let alone the associated costs of treatment and the necessary transportation between different centers."
He further expresses his disappointment: "My hopes for my son's recovery have dissipated due to the delayed intervention since the onset of his illness. This is a consequence of the state of destitution and poverty that compelled him to endure years in a state of delirium, silence, and isolation from those around him in society."
With the hope pinned on the advancement of science and psychiatry to save millions of patients, the absence of health centers and psychological counseling facilities has had a profound impact on the regression and worsening conditions of psychiatric patients in the majority of Yemeni cities and villages. This is a result of not giving this crucial aspect the supposed and adequate importance and attention. Furthermore, the consequences of war have resulted in a lack of support for mental health programs at the primary healthcare level and the loss of specialized mental health services. Collectively, all these factors deprive many individuals of the opportunity to access psychological support and treatment, thereby contributing to the exacerbation of psychological issues for a considerable portion of the people.
“A study conducted by the Family Development and Guidance Foundation has pointed out that more than five and a half million citizens are afflicted with psychological disorders and their associated impacts. It revealed that the age group spanning from 16 to 30 years recorded a notable increase, reaching 80.5%. Moreover, the study also indicated that there is only one mental health professional (a psychiatrist) for every 600,000 individuals.”
Rising Affliction Rates and Lack of Facilities
The suffering of psychiatric patients in Yemen intensifies amidst the limited availability of mental health facilities, comprising departments and clinics within both public and private hospitals. The total number of these facilities is 13, in addition to 35 private clinics, most of which are located in the capital, Sana'a.
In the given context, a study conducted by the Family Development and Guidance Foundation regarding the evaluation of the prevalence of mental disorders among the population in Yemen has revealed that over five and a half million citizens are afflicted with psychological disorders and their consequential impacts. The study recorded a notable increase in the number of cases in the age group between 16 and 30 years, reaching 80.5% of the total cases outlined in the study. Furthermore, the study affirmed that Yemen faces a shortage of resources and essential prerequisites necessary for the provision of mental health services, emphasizing the critical imbalance with merely one mental health professional (a psychiatrist) available for every 600,000 individuals.
Stigma and Lack of Awareness
In addition to the obstacles and challenges faced by psychiatric patients in Yemen in general, and particularly in rural areas, due to the illness or mental disorder itself, they grapple with the repercussions of societal stigmatization. They are often perceived as mad or a threat to the community, reflecting a lack of awareness and education about the normalcy of these psychiatric conditions, which can affect individuals just like organic illnesses. Indeed, certain neurotransmitter imbalances in the brain (organic) can lead to the development of a mental illness or disorder, especially in the midst of challenging economic and social conditions.
According to a recent evaluative study conducted by the Ministry of Health in collaboration with the European Union and implemented in six governorates—namely, Amanat Al Asimah (the Capital), Sana'a governorate, Hodeidah, Taiz, Al Mahwit, and Hajjah—the number of mental health professionals (psychiatrists) in these governorates is 48, including 17 consultants, all of whom are male, and in addition to 30 specialist doctors, consisting of 24 male doctors and 6 female doctors.
According to the evaluation, the distribution of medical staff in the governorates was concentrated in the capital Sana'a by 80%, 13% in Hajjah and Al-Mahwit governorates, and 6% in Al-Hodeidah. The evaluation results further showed that 75% of the overall mental health doctors in Yemen work in only three governorates.
Alarming Surge
Based on a recent official statistic from the United Nations, there has been a frightening surge in the numbers of psychiatric patients in Yemen in recent years due to the repercussions of the ongoing war that has been raging in the country for several years.
Similarly, in accordance with a report from the World Health Organization, approximately eight million individuals in Yemen are facing psychiatric disorders and mental, psychological, or social issues.
The organization further stated in an official report that mental health disorders have become notably widespread and have emerged as one of the most prevalent health conditions in Yemen. This comes after a recent notable increase in the number of affected individuals, raising significant concerns.
