Dubai's mental health strategy to remove stigma, empower patients

Asma Ali Zain/Dubai
Filed on May 12, 2018 | Last updated on May 12, 2018 at 06.16 am
The DHA strategy is underpinned by evidence-based research, best practices and the views of local subject matter experts in Dubai.
The DHA strategy is underpinned by evidence-based research, best practices and the views of local subject matter experts in Dubai.

The strategy titled 'Happy Lives, Healthy Communities' was launched in line with Dubai Health Strategy 2016-2021.

More than 450 million people suffer from mental disorders worldwide, and one in four people will develop a mental or behavioural disorder during their lifetime, according to the World Health Organisation (WHO).

Even in today's world of technology and instant communication, this topic is still taboo. Societal barriers and stigma often get in the way of patients seeking timely care. Which is why yearly campaigns, such as the ongoing global mental health awareness month, are important shed light on the issue and accord it the required treatment like any other illness. The stigma surrounding these conditions need to go, especially since patients are most in need of support, understanding and love.

To recognise the rising prevalence of mental health disorders, the Dubai Health Authority (DHA) has launched the first comprehensive mental health strategy for Dubai. The strategy titled 'Happy Lives, Healthy Communities' was launched in line with Dubai Health Strategy 2016-2021, to work towards successful implementation and active community participation to remove the stigma attached to it and empower the patient.

Dr Nadia Dabbagh, consultant child and adolescent psychiatrist at Rashid Hospital, and programme lead for the Mental Health Strategy at DHA, highlighted that the plan's implementation will be staggered based on priorities, needs and resources and according to the strategy's four pillars.

The pillars are: legislation and governance; promotion, prevention and early intervention; service delivery and recovery; and patient empowerment programmes. "Dubai's mental health strategy is underpinned by guiding principles that are based on international, evidence-based research and best practice, besides incorporating the views of local subject matter experts in Dubai," Dr Nadia said.

The strategy's key guiding principles include respect for the rights and needs of service users and their families; prevention and early intervention across the life span including vulnerable groups; and recognition of the spectrum of mental health difficulties, she noted. Many of these disorders include schizophrenia, bipolar affective disorder, depression, alcohol and other drug disorders and a range of anxiety disorders.

The prevalence of mental and behavioural disorders is about 10 per cent for the adult population worldwide. Twenty percent of the adolescents under the age of 18 suffer from developmental, emotional, or behavioural problems. Given the scale of the global prevalence of the illness, it should be a conversation that we can have without closing the doors, Dr Nadia pointed out.

Dr Khawla Ahmed Al Mer, acting head of psychiatry department at Rashid Hospital, said that stigma and lack of awareness are the main barriers that prevent early diagnosis and treatment. This often means patients and their family members ensure unnecessary suffering until they finally approach mental health professionals. This also means higher chances of prolonged treatment and a higher risk of complications.

She said that majority of patients at the hospital's psychology and psychiatry department receives come to the clinic only after their conditions have deteriorated significantly and rarely in the initial stages.  "With the new law and focus on early detection as well as continuum of care, things will change for the better and I reckon we will see more patients early on," she added.

Although there are effective treatments for depression, less than half of those affected (in some countries, fewer than 10 per cent) receive treatment, according to the WHO. Barriers to effective care include stigma, isolation and discrimination surrounding mental health issues. "Mental health is a disease like any other and if we learn to accept it, as we accept any other illness, we will be able to reduce the suffering of those afflicted," said Dr Khawla.

"We have a community mental health team at Rashid Hospital for patients with chronic mental health conditions for whom follow-up and regular treatment is a challenge. Our team visits their homes to provide medical, social and psychological support. This programme has helped chronic mental health patients lead a near normal life with many of them traveling again, going back to work or college."

Dr Samia Abul, consultant psychiatrist at Rashid Hospital, said one of the major reasons for depression and anxiety is stress that is not controlled. "Stress could be due to several reasons such as financial, emotional etc, but when that goes uncontrolled for a long time it can lead to depression," she said. "Depending on the number and severity of symptoms, a depressive episode can be categorised as mild, moderate or severe, and treatments are available to tackle all kinds of depression. The first line of treatment is not always medicine. It can simply be a few counselling sessions.  However, the point is that the patient and family members need to reach out in time to minimise the effects and complications of mental ill health," she added.

Dr Samia said studies have shown that stress often leads to a rise in depression levels. "Modern life often leads to depression. Today, people lead stressful lives and prolonged stress is known to trigger depression. Psychiatrists say that problems arise when a person's stress response does not switch off," she explained.

Today, many people suffer from learned helplessness, she said. "This means that some people carry a lot of burden and the pressures of daily life and they fail to switch off. However, it is important to understand that when stress-hormone levels stay high for too long, they can cause high blood pressure and suppress the immune system," she added.

This calls for intensive promotion of positive mental health and wellbeing at individual level and within families, organisations and communities. This means learning to relax and unwind, taking up more and regular leisure and pleasure activities, managing stress effectively and not stressing others by our behaviour.

She advised a four-step approach to help deal with stress: establishing routines, taking control of situations, finding coping mechanisms for situations outside of one's control and positive reaffirmations.

"The message is clear. In today's fast-paced world, we need to find some downtime. After all, your body is controlled by your mind," she said.

Signs of mental health issues

>Chronic anxiety

>Erratic thinking

>Withdrawal from friends and activities

>Eating disorders

>Changes in sleeping pattern

>Sudden weight loss or weight gain


>Unusual behaviour

>Mood swings