In her first years as a medical resident, psychiatrist Sally Toma stumbled upon a woman from Upper Egypt who was getting her son checked up for depression, never using the actual word.
“He gets thoughts,” she said.
To this day and age in Egypt, epilepsy is mistaken for the need for an “exorcism”, and other psychological health disorders are simply brushed under the rug, or worse.
One out of four people worldwide experience some psychological condition in their lifetime. Yet the complex and resilient stigma attached to it continued to discourage people from seeking help.
“Even a psychiatrist is not spared from stigma,” Toma stated.
There are no updated national statistical studies on the prevalence of mental illness in Egypt. However, a 2009 national survey estimated that 16.9% of the adult population suffer from mental health disorders.
Médecins du Monde (MdM), an international organisation providing medical care to vulnerable populations, organised a conference on 7 April, bringing together representatives of government health services, along with national and international civil society organisations.
“This event is held for a dialogue that needs to be fuelled,” said Clara Di Dio, MdM’s general coordinator in Egypt.
The current state of mental health
Egyptians have numerous obstacles to overcome, on top of which is social shaming. Families who have at least one member diagnosed with a mental illness suffer from discrimination, MdM states. Women face the harshest forms of stigma and marginalisation. Conditions for “minorities at risk”, such as female victims of violence or children who have left home, are worse off as they face a double stigma.
“All my years studying medicine, there was a focus on only the physical, and never the mental, wellbeing of patients,” said Wesam El-Beih, the Egypt director of a Swiss organisation named Drosos. “Mental illness is placed as a third rate sickness.”
Another major issue hindering progress is the fact that mental health expenditures in Egypt amounts to no more than 2% of total government expenditure on health. As such, pressure mounts on the brimming public psychiatric facilities. In addition, such facilities mainly serve urban areas.
According to Sohair Wilson, assistant director of the Health Ministry’s primary health unit, 5,300 medical units are available in Egypt. Yet, Amal Atta, the executive manager of Basmet Amal NGO, argued that “we cannot feel their presence”.
The way forward
El-Beih specified three targets to improve psychiatric healthcare in Egypt: changing policies, providing both more services and accessible services, and changing the perception of society towards the psychologically ill. The doctor highlighted the media’s role in shaping public opinion.
MdM specified coherent steps to enhance psychiatric healthcare in the country, including introducing a coherent referral system, allocating adequate resources, and introducing psychiatric healthcare as part of the family health model in primary health centres, and equipping and/or renovating existing consultations rooms in these centres.
“Egyptians need to overcome taboos attached to mental illness, a common human experience,” Di Dio said.