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the organization of mental health services


Academic year: 2022

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In the Name of God, the Compassionate, the Merciful

Address by




Ladies and Gentlemen,

It gives me great pleasure to participate in the first Gulf Conference on Mental Health. Mental health is a topic of prime importance in today’s fast changing world in which the factors affecting the mental health of both youth and adult populations are many and varied. I congratulate the Council of Health Ministers of the Gulf Cooperation Council for choosing mental health as a priority area for this year.

In 2001, the World Health Organization focused on mental health as the theme of World Health Day on 7 April and of The World Health Report 2001, released in October that year. These two events brought into focus the neglected needs of the mentally ill, as well as the understanding that has come in the past few decades and which offers new hope



to people suffering from mental disorders and to their families. At the time of the release of The World Health Report 2001, the Director-General presented the challenge as follows:

“We have the means and scientific knowledge to help people with mental and brain disorders. Governments have been remiss, as has been the public health community.”

Keeping in mind the goals of this Conference, I would like to share with you some of my thoughts on the growing mental health needs in WHO’s Eastern Mediterranean Region;

the organization of mental health services; specialized services; medical education; research and some of WHO’s activities in these areas.

There are three important mental health issues in the countries of the Region. The first relates to mental disorders and substance abuse. These conditions are important, not only because they result in significant disability but also because they are treatable and the burden is reducible. The problem of substance abuse is growing, particularly among youth, in all of the countries of the Region. This is a matter of great concern. The second issue relates to the role of behaviour in the causation, course and treatment outcome in all health conditions. There is growing evidence of the importance of individual behaviour as an important modifier of outcome in health matters. The third issue relates to the mental health needs of populations under severe stress as a result of conflict and disaster. Our Region has many countries experiencing this problem and that the needs are high can be readily understood from recent studies conducted in Palestine and Afghanistan. In Palestine, for example, nearly half of the schoolchildren were found to have psychological symptoms of sufficient seriousness to be called psychiatric problems. In Afghanistan, over 25% of the population was found to be suffering from depression while the number with severe anxiety symptoms was even higher.

Dear Colleagues,

A striking feature of the countries of the Region is the extremely limited mental health services. Even in countries like Bahrain, Kuwait, Saudi Arabia, United Arab Emirates and other economically rich countries where essential health services are well established and assured to the population, the development of mental health care is far from satisfactory.



Mental health care remains confined to a few big hospitals. The wide range of possibilities for community-based mental health services do not exist in any of the countries of the Region. This is in spite of the well recognized feasibility of integrating mental health care into general health services, and demonstration of the ability of the majority of mental health patients to live and work in the community. This treatment gap needs urgent attention from all of us, and it is gratifying to see some countries, such as Egypt, Islamic Republic of Iran and Pakistan, implementing mental health reforms and developing mental health care as part of general health services.

Another aspect of the mental health services of the Region is the clear lack of specialized services for children, for the elderly and for substance abusers. A recent study from the United Arab Emirates showed that 22% of the children in the community had an identifiable mental disorder but that not one of them was recognized as being ill, or had received psychiatric care. There is an urgent need to build school-based and home-based child psychiatric services. Similarly, there is a need for a full range of specialized services for those involved with different types of substance abuse. I am pleased that you will be discussing both of these topics in the round table sessions and workshops. In many countries of the Region the elderly population is increasing in proportion and this group needs special attention for both their physical and mental health needs.

Ladies and Gentlemen,

One of the important areas in which to bring about the changes that will address these needs is in medical education. The doctor of the future should be skilled not only in physical interventions but also in psychosocial and social interventions. Training in understanding of behaviour should become an important part of the overall training of doctors. This would mean recasting of the medical curriculum. I understand Pakistan has revised its medical curriculum to include behavioural sciences in the pre-clinical phase and an adequate amount of training in psychiatry, along with an independent paper on psychiatry in the final year. Such an approach will prepare a new type of doctor who is as skilled in mental as in physical health care. In addition to medical education reform, there is need for continuing medical education for the earlier generation of physicians, surgeons,



paediatricians, obstetric and gynaecological specialists. This integrated approach has the twin advantages of meeting the needs of all patients and of reducing the stigma of specialized mental health services. I urge mental health professionals to work with and write for other medical professionals as much as they would for their own professional group.

The need for local, regional and national level research to guide health services is an important need. International collaborative studies of schizophrenia, depression and drug abuse have all shown the importance of social factors in the presentation, response to treatment and outcome of these conditions. There is need to build a research culture in all of our health services. In addition, special training programmes in qualitative and quantitative research should be organized at national level. Researchers should be encouraged to choose to study local and national priorities, rather than repeating international studies.

Ladies and Gentlemen,

Following the focus on mental health in 2001, WHO both at the global level as well as at the regional level, has initiated measures to address the needs I have outlined. A major initiative of health and behaviour has been started in the Regional Office. The Regional Advisory Panel on the Impact of Drug Abuse (RAPID) was created, charged with the task of studying the growing problem of drug abuse and of developing interventions. A recently held meeting on the mental health needs of countries in conflict situations identified regional approaches to meet the needs of the population. In the coming months interventions suitable to the Region will be developed and applied to meet the needs of the population. It is planned that school-based preventive measures to promote mental health and prevent mental disorders will become a reality in all of the countries of the Region. In addition, countries with limited mental health resources will be supported to develop human resources and community-based care programmes.

I am delighted that the Health Ministers of the Gulf Cooperation Council have given such high priority to mental health. I commend you for that and my colleagues and I look forward to working with you to reach the goal of good mental health for all.


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