As well as the raised levels of stress and anxiety associated with a global pandemic, measures taken to manage it have required major changes in work practices and lifestyles, leading to loneliness and depression. Zafar Raja, CEO of CareTech MENA, the largest private sector provider of mental health and well-being support services in the UAE, has seen Covid-19’s impact on the region’s mental health first hand. Yet, he sees reasons for optimism as the country returns to some semblance of normality.
The Covid-19 pandemic has undoubtedly brought about unprecedented challenges to people’s lives including those based in the United Arab Emirates (UAE).
Like most countries, the UAE took very pro-active steps to minimise the impact of the virus on its population’s health and wellbeing. And while attention, understandably, may have fallen on the nation’s physical health, the fall-out from the virus has also presented a real opportunity to address a traditionally sensitive and stigmatised area of healthcare, mental health.
In recent years, the UAE has focused its healthcare policies and initiatives towards the physical health of its population, targeting rising cases of obesity, diabetes, and hypertension. The country can now showcase a world class healthcare infrastructure and the clinicians to support it.
What has been increasingly evident during the pandemic is that traditional attitudes towards mental health are changing and there is greater awareness of the impact of mental health on individuals, the community, businesses, and a there is dialogue about new ways to deliver mental health support.
The UAE’s first case of Covid-19 was reported in January 2020 and by March a countrywide lockdown had been imposed. That remained in place until the end of July.
As well as border closures and the suspension of flights seen globally, the UAE also introduced a coordinated national programme of measures in its efforts to contain the virus. People were advised to stay at home, non-essential businesses were closed and there was a wholesale move towards remote working and distance learning. Streets and cities became the target of a night-time sanitisation exercise.
It had some relatively good success. As at mid-June 2021, the number of reported cases of Covid-19 had risen to just under 600,000 and Covid-19 related fatalities stood at 1,726.
Yet, even as the country began to return to normal after July 2020, it was inevitable there would be both social and psychological ramifications from the lockdown to the community as a whole.
Bridging the gaps
Based on a 2010 Global Burden of Disease study, we know that the UAE has a rate of depression higher than the global average.
The onset of the pandemic has prompted a number of surveys being commissioned from the government, academic institutions and the private sector and the results from these surveys have helped highlight some of the effects the pandemic has had on mental health. More importantly they have raised awareness of mental health more generally and contributed to the development of support programmes for people suffering mental health issues.
An academic led trans-emirate study involving over 4,400 people found that more than a third of those asked felt their mental health had deteriorated during the pandemic. This group reported increased stress due to work, home and financial matters. Psychological evaluation was completed via a series of questions assessing the impact of the pandemic and the perceived support available.
It’s not just academia that is raising awareness of mental health issues in the UAE. A number of private sector studies have also focused on the impact on mental health of changes in the workplace, and the move to working remotely or from home.
While many employees across the Emirates have welcomed an end to the long office commute, a more sedentary lifestyle has raised the risks of a range of health-related issues.
Surveys show that 44% of remote workers cited weight gain as the major concern of home working and a further 34% of home-based employees worried about muscular skeletal conditions. When it came to mental health, a study in the UAE showed that 77% of workers felt working from home had negatively impacted their performance. This echoes studies conducted elsewhere in the world over the past year which have shown an increase in mental health issues linked to remote working.
In fact, the World Economic Forum found a particularly strong link between loneliness during the pandemic and a high risk of anxiety, depression and sleep disruption.
Increased awareness of mental health issues has resulted in really positive action. Organisations have increased support to employees with both new and revised Employee Health and Wellness packages. And the disruption to normal learning in the education sector has ensured that mental health is no longer a conversation limited to the adult population.
Many schools have strengthened their mental health and well-being programmes by giving students a voice and that is something to be warmly welcomed. Indeed, the implementation of well-being programmes is now part of official school ratings for education providers. The voice of the younger generation is being heard and it will become a very vocal advocate in the promotion of mental health topics in the future.
Dedicated mental support
The government has not only played an important part in containing the virus through lockdown and an extremely efficient and effective vaccination programme, it has also addressed mental health support through a dedicated mental support hotline, dedicated counselling hotlines and the Hayat support programme for Federal employees. Wider support for the community has been instigated through The National Campaign for Mental Support. It is bringing the subject of mental health into the mainstream conversation.
CareTech MENA specialist clinical staff through our Maudsley Health and American Centre for Psychiatry and Neurology (ACPN) brands have seen an increase in requests from employers to help employees cope with the pressures of remote working while supporting children at home.
Front line health care workers have needed support in dealing with stress and long working hours and grieving families who have lost loved ones due to Covid-19 are turning to our community-focused teams. Our children’s services are supporting the younger population overcome anxiety and helping them settle into new routines at home.
Operationally, there has been a need to adapt delivery to meet the growing demand for consultations via tele-health. The importance of this trend in mental health was highlighted in a recent study of outpatient services at the leading psychiatric hospital in Abu Dhabi. The study showed a 90% drop in the number of visits to out-patient clinics compared to the same period pre-pandemic.
While this drop can be attributed to a number of pandemic-related factors – avoidance of hospitals, capacity constraints, curfews and quarantine – it also illustrates the rising importance of tele-health in the provision of mental health services.
Over 60% of new clinical interactions are now conducted via tele-health. This transition is part of a wider change in the way people think about accessing healthcare and support. A study in the UAE last year found that 66% of employee’s believe their employer can help them manage their mental health better through technology.
Keep open and focused
The pandemic is not over yet and some restrictive measures still apply in the UAE.
While the long-term effects of the pandemic are very difficult to predict, the emerging trends from some of the very early surveys bode well for a better understanding of mental health issues in the UAE and an increasing level of maturity in attitudes towards it.
In a recent address during the Mohamed Bin Zayed Majlis for Future Generations, Minister of Foreign Affairs and International Co-operation, Sheikh Abdullah bin Zayed encouraged more openness in mental health discussions to rid the associated stigma from society. Sheikh Abdullah said the only shame connected to mental health was in avoiding its discussion.
These are indeed extremely well founded and thoughtful directions from the leaders of the country.
Despite the extreme hardships created by the pandemic, the focus on mental health in the UAE is now moving forward with new momentum.
There is a sense of real opportunity for all stakeholders, policymakers, operators, health insurance companies and the not-for-profit sector to seize the opportunity to pay more attention to the mental health of the nation.
Grasping the opportunity will not only be doing a service to the population but it will facilitate the development of the country as a whole.