This was first appeared on ESG mean.
ESG Mena spoke to Hamish Clark, Partner, Chief Wellness Officer, PwC, to get his insights into mental health in the MENA and the role that the public and private sector has in spreading awareness, normalising mental health discussions, and enhancing mental health services.
Hamish, what’s your understanding of the scale of the mental health crisis in the MENA?
In the GCC, the number of people living with a mental health disorder is slightly higher than the global figure, at 15%. Yet, the scale of the problem is likely to be larger as many never seek help from a qualified professional, partly due to continued stigma, minimal health insurance coverage, and a lack of mental health professionals in the region.
In Saudi Arabia, for example, 80% with severe mental disorders do not seek treatment. And the prevalence and impact of mental illness are unfortunately on the rise – according to the Global Burden of Disease study, the contribution of mental disorders to the total burden of disease ranged between 9% and 14% in the GCC, in comparison to 7% in high-income countries globally.
And how are the youth population, specifically, affected?
Unfortunately, no one is ‘immune’ from experiencing mental health disorders at some point in their life – even the youth population. A study in 2021 indicated that across the GCC, almost half (45%) of children and adolescents had experienced depressive symptoms, as measured by the International Depression, Anxiety, and Stress Scale (DASS). The same proportion (45%) had suffered from symptoms of anxiety, while more than a quarter (26%) had experienced stress.
What’s required to address the challenge of mental health in the MENA, and what are the barriers to realising this?
Early intervention, prevention, and effective treatment are key to addressing the challenge of mental health. However, patients struggle to gain access to mental healthcare treatment and support. In the GCC, there are just 2.85 psychiatrists per 100,000 population. This general shortage of qualified mental health professionals across the GCC is further exacerbated by the lack of relevant university-level degree programs in clinical psychology and psychiatry – there is almost no access to master’s or doctorate-level programs in these subjects. Compounding the problem, many qualified and competent mental health professionals in the UAE are unable to practice because of the slow licensing process, which is poorly aligned with internationally recognised licensing standards.
Although Governments are making some progress in measuring and tackling mental health initiatives across the region, such as KSA’s Saudi National Mental Health Survey and Qareebon app, Qatar’s Mental Health Attitudes and Awareness Index, and the UAE’s National Policy for the Promotion of Mental Health, more work and funding is needed.
Mental health is increasingly coming into focus in the workplace. How are you seeing the situation evolve there?
The workplace can be both protective and negative for mental health. There is strong evidence to suggest that work can offer purpose, social interaction, and a work-life balance will support mental health, but high-stress, unhealthy work will do the opposite.
Within the workplace, only 33% of employees feel that they receive support in managing their wellbeing in the Middle East, according to our Hopes and Fears report. A further survey conducted with 1,000 participants in the UAE found approximately 30% of participants were reluctant to seek help due to the fear of being judged by employers and harming their career progression.
And what role do leaders have to play in tackling stigma and promoting mental wellness?
Workplace interventions of improving access to exercise and psychological support have been shown to help reduce absenteeism and increase productivity, which currently contributes to a $1 trillion loss globally each year. Leadership in the workplace needs to lead by example to help dispel the pervasive taboos and stigmas that still exist in many MENA societies, despite recent progress in some countries.
Employers need to embrace initiatives that will help to promote their employees’ health and wellbeing, such as:
- Exploring hybrid-working arrangements,
- Investing in Mental Health First Aid training programmes to encourage peer-to-peer support, and
- Creating a board-appointed leadership role, such as Chief Wellbeing Officer, to champion the mental health and wellbeing agenda from the top down.
Increasing access to mental health professionals, whether through health insurance (in 2021, the Dubai Health Authority upgraded its essential benefits plan to include mental healthcare) and/or leveraging reputable, regulated technologies and advances in Digital Therapeutics (DTx), can also help to drive positive change.
Expanding on this, how do we create mentally resilient societies and what role does technology have to play?
The World Health Organisation (WHO) describes good mental health as not just the absence of a specific mental disorder but as a state of holistic wellbeing. It is worth noting that a lot of failures of ESG adherence result in negative health outcomes – and when communities are displaced, ravaged by climate-change-triggered disease, or failed by improper governance, this will inevitably make it much harder to achieve this state of holistic wellbeing, and sustain a mentally resilient society.
Building mentally resilient societies involves the equitable distribution of and access to resources, including healthcare. DTx, digital mental healthcare interventions (DMHIs) and virtual clinics can bring the healthcare environment from the clinics and hospitals into patients’ homes.
This simple paradigm shift immediately reduces energy consumption, waste and carbon emissions. During the COVID-19 pandemic, healthcare has had its own virtual revolution as many providers ramped up their use of telehealth. One of the largest health systems in the US, CommonSpirit, conducted 1.5 million virtual visits in 1 year between 2020-2021 and estimated that these virtual visits prevented 15K tons of CO2 from being released and saved patients an estimated $11 million by them no longer having to drive to appointments. Clearly, greater access to digital mental health care will have a profound impact not just on improving patient outcomes but also on their carbon footprints.
Additionally, improving awareness around mental health and promoting early psychological screening and intervention is key to building a more sustainable mental health ecosystem, avoiding chronic conditions that put further strain on resources, and even prevention. For example, school-based mental health initiatives are recommended by the WHO as a cost–effective mental health intervention initiative with an incremental cost-effectiveness ratio of $1000-5000 per healthy life year gained.
And how can mental health be prioritised in ESG strategies?
It is without question that mental health must be a priority factor in ESG metrics and subsequent strategies.
At a corporate level, business leaders need to ensure they have appropriate in-house expertise for ESG reporting across all operations in the workplace and embed employee wellbeing as a key KPI to continually measure, monitor and improve, setting meaningful goals and creating a supportive and equitable workplace wellbeing ecosystem for employees.
At a national level, governments need to collect and process more comprehensive, detailed data on mental healthcare and wellbeing, leveraging new technologies and data analytics. Once they fully understand this baseline, they need to increase funding for the recruitment, clinical training, and deployment of mental health professionals across the region and broaden access to digital mental healthcare, including DTx and DMHIs.
Only by working together to prioritise mental health and wellbeing across both the public and private sector ESG strategies will a holistic and sustainable impact be created.
