In 2021, I set out to address a critical but often overlooked challenge for the Arab world: access to affordable, credible and culturally-relevant mental health care for those who need it. That journey led me to the co-founding of Tuhoon, a mental health platform that offers self-help content and tools in the Arabic language.
Through my experience in the mental health space, I discovered that the problem lies not in demand, as I initially assumed, but in the inadequate supply of mental health services.
During my research, I encountered a striking statistic that captured my attention: searches for the phrase “how to improve my mental health” in Arabic have grown by 1,000 per cent in the Middle East and North Africa region over the past five years.
Additionally, the Arab Youth Survey reports that 56 per cent of people find it difficult to access quality mental health care.
The economic effect
Our youth are open to receiving mental health support, and it is crucial for both the private and public sectors to ensure they receive the necessary care. This promotes a happier and healthier society and also boosts economic productivity.
The World Health Organisation reveals that the GCC has 2.5 psychiatrists per 100,000 residents, significantly lower than the global average of 7 and the OECD (Organisation for Economic Co-operation and Development) average of 10+.
This shortage of mental health professionals hinders meeting the growing demand for quality therapy, which is a global issue.
The shortage is a global one. In the US, for example, 60 per cent of psychologists have no available slots for new patients and more than 40 per cent maintain wait-lists of 10 or more individuals. The leading cause of disability worldwide is depression. We need to think carefully and creatively about how to address this silent pandemic.
What is causing the growth in demand?
Several factors contribute to the exponential growth in demand for mental health services:
1. Increase in low-level mental health conditions: The prevalence of “low-level” mental health conditions, such as anxiety and depression, has risen by 25 per cent globally after the Covid-19 pandemic with no signs of subsiding. In Saudi Arabia, for example, a 2019 study revealed that 34 per cent of citizens meet the criteria for a mental health condition at some point in their lives.
2. Rise of teletherapy: Online therapy, facilitated by platforms like Labayh, O7 Therapy and Cura, has made mental health care more accessible. Teletherapy remains the largest use case for telehealth in the US and the region, matching therapists from the region with those looking for one.
3. Increased employer coverage: In 2020, about 41 million Americans utilised mental health support provided by their employers, compared to 35 million the previous year. Similarly, both public and private employers in the Mena region, such as Zain Group and Aramco, are offering subsidised therapy for their employees. A study conducted by Tuhoon in January 2023 found that 48 per cent of employers in Saudi Arabia provide some form of mental health support for their employees.
4. Normalisation of seeking care: Youth are not only experiencing higher levels of mental distress but are also more open to seeking care. According to the Arab Youth Survey, 49 per cent of youth have normalised seeking mental health support.
Challenges and economic potential
This surge in demand for mental health services presents significant structural and functional challenges. The shortage of quality therapists, coupled with the inelastic supply of mental health professionals, leads to inadequate care provision and exorbitant prices.
From training to licensure, it could take several years to produce new mental health professionals, contributing to the issue of supply and demand. This, in turn, creates financial barriers for individuals seeking care, reducing accessibility and affordability. Unfortunately, this causes people to use alternative, less reliable options that lack quality and credibility.
This shortage of credible professionals in the mental health industry generates increased prices for care. The scarcity allows existing mental health professionals to increase fees over rising demand (based on our research at Tuhoon, the average rate for a therapy session in Saudi Arabia is $70-$100 and $150-$175 in the UAE).
Addressing this gap in care provision within the GCC could generate economic opportunities exceeding $5 billion, creating 3,500 new jobs in psychiatry and 10,000 in therapy.
Assuming an average annual salary of $100,000 per professional, roughly $1 billion-1.5 billion in additional income could be generated for mental health professions.
By incorporating the estimated $4 billion in productivity enhancements associated with addressing mental health complications prevalent in the GCC, the additional value generated could reach at least $5 billion. This comprehensive sum embodies incomes for the new mental health professionals and the productivity gains derived from addressing mental health concerns.
Solutions and recommendations
Technology, such as artificial intelligence and wearable devices, can significantly enhance the quality, efficacy, and patient experience in mental health care.
Technological solutions that provide continuous care and remote patient monitoring will reduce burdens on health care professionals while integrating a patient’s treatment journey. For example, AI can assist with administrative tasks like insurance reimbursement, note-taking and progress tracking. It can also help standardise the supervision of trainees and increase patients’ adherence to behavioural changes and medication.
To improve mental health care, governments and regulators can take the following steps:
♦ Increase subsidies for training programmes to enhance the skills of junior therapists
♦ Roll out mental health screening programmes at primary care institutions, schools, and universities
♦ Train nurses and general practitioners to screen for mental health concerns during routine check-ups
♦ Equip and train nursing staff and coaches with evidence-based methods like Cognitive Behavioral Therapy to manage low-risk cases and reduce pressure on clinical staff.
♦ Follow the example of the US, where health and wellness coaching became integrated into the health care system through a national board-certified credential process, ensuring higher quality standards.
To further enhance the patient experience and improve treatment outcomes:
♦ Broaden the regulatory framework to include Digital Therapeutics (DTx), which utilises software-driven interventions to prevent, manage, or treat mental health disorders.
♦ Explore opportunities in the private sector, such as expanding care provision, introducing evidence-based treatments like Transcendental Magnetic Stimulation and Ketamine Therapy, and investing in rehabilitation and reintegration programmes.
By implementing these measures, both public and private sectors can achieve financial profitability while making a positive effect on societal well-being.
Prioritising mental health is crucial for a healthier and happier Arab world. By empowering existing programmes, implementing screening initiatives, and leveraging innovative solutions, we can make a significant difference in the lives of millions.
Society’s worth is only as good as the care for its most vulnerable population, and mental health ailments are challenging to address due to their “invisible” nature. I am certain our society can accomplish this.
Simple and cost-effective interventions can help us achieve these accomplishments.
For example, by supporting programmes like the Saudi National Center For Mental Health, which significantly impacts residents in the kingdom. Abu Dhabi has taken a positive step by mandating all health care professionals to carry out mental health screening during routine check-ups. These initiatives are commendable and move us in the right direction.
Fares Ghandour is co-founder of Tuhoon, a Saudi-based social enterprise in the mental health space. He is also partner at Wamda Capital, an early stage VC firm based in the UAE.
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Milestones on the road to union
1970
October 26: Bahrain withdraws from a proposal to create a federation of nine with the seven Trucial States and Qatar.
December: Ahmed Al Suwaidi visits New York to discuss potential UN membership.
1971
March 1: Alex Douglas Hume, Conservative foreign secretary confirms that Britain will leave the Gulf and “strongly supports” the creation of a Union of Arab Emirates.
July 12: Historic meeting at which Sheikh Zayed and Sheikh Rashid make a binding agreement to create what will become the UAE.
July 18: It is announced that the UAE will be formed from six emirates, with a proposed constitution signed. RAK is not yet part of the agreement.
August 6: The fifth anniversary of Sheikh Zayed becoming Ruler of Abu Dhabi, with official celebrations deferred until later in the year.
August 15: Bahrain becomes independent.
September 3: Qatar becomes independent.
November 23-25: Meeting with Sheikh Zayed and Sheikh Rashid and senior British officials to fix December 2 as date of creation of the UAE.
November 29: At 5.30pm Iranian forces seize the Greater and Lesser Tunbs by force.
November 30: Despite a power sharing agreement, Tehran takes full control of Abu Musa.
November 31: UK officials visit all six participating Emirates to formally end the Trucial States treaties
December 2: 11am, Dubai. New Supreme Council formally elects Sheikh Zayed as President. Treaty of Friendship signed with the UK. 11.30am. Flag raising ceremony at Union House and Al Manhal Palace in Abu Dhabi witnessed by Sheikh Khalifa, then Crown Prince of Abu Dhabi.
December 6: Arab League formally admits the UAE. The first British Ambassador presents his credentials to Sheikh Zayed.
December 9: UAE joins the United Nations.
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SECRET%20INVASION
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The specs
Engine: 2.0-litre 4-cylturbo
Transmission: seven-speed DSG automatic
Power: 242bhp
Torque: 370Nm
Price: Dh136,814
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
Wallabies
Updated team: 15-Israel Folau, 14-Dane Haylett-Petty, 13-Reece Hodge, 12-Matt Toomua, 11-Marika Koroibete, 10-Kurtley Beale, 9-Will Genia, 8-Pete Samu, 7-Michael Hooper (captain), 6-Lukhan Tui, 5-Adam Coleman, 4-Rory Arnold, 3-Allan Alaalatoa, 2-Tatafu Polota-Nau, 1-Scott Sio.
Replacements: 16-Folau Faingaa, 17-Tom Robertson, 18-Taniela Tupou, 19-Izack Rodda, 20-Ned Hanigan, 21-Joe Powell, 22-Bernard Foley, 23-Jack Maddocks.
RESULTS
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Key products and UAE prices
iPhone XS
With a 5.8-inch screen, it will be an advance version of the iPhone X. It will be dual sim and comes with better battery life, a faster processor and better camera. A new gold colour will be available.
Price: Dh4,229
iPhone XS Max
It is expected to be a grander version of the iPhone X with a 6.5-inch screen; an inch bigger than the screen of the iPhone 8 Plus.
Price: Dh4,649
iPhone XR
A low-cost version of the iPhone X with a 6.1-inch screen, it is expected to attract mass attention. According to industry experts, it is likely to have aluminium edges instead of stainless steel.
Price: Dh3,179
Apple Watch Series 4
More comprehensive health device with edge-to-edge displays that are more than 30 per cent bigger than displays on current models.
Gender pay parity on track in the UAE
The UAE has a good record on gender pay parity, according to Mercer's Total Remuneration Study.
"In some of the lower levels of jobs women tend to be paid more than men, primarily because men are employed in blue collar jobs and women tend to be employed in white collar jobs which pay better," said Ted Raffoul, career products leader, Mena at Mercer. "I am yet to see a company in the UAE – particularly when you are looking at a blue chip multinationals or some of the bigger local companies – that actively discriminates when it comes to gender on pay."
Mr Raffoul said most gender issues are actually due to the cultural class, as the population is dominated by Asian and Arab cultures where men are generally expected to work and earn whereas women are meant to start a family.
"For that reason, we see a different gender gap. There are less women in senior roles because women tend to focus less on this but that’s not due to any companies having a policy penalising women for any reasons – it’s a cultural thing," he said.
As a result, Mr Raffoul said many companies in the UAE are coming up with benefit package programmes to help working mothers and the career development of women in general.
Abu Dhabi Sustainability Week
SUZUME
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Who has lived at The Bishops Avenue?
- George Sainsbury of the supermarket dynasty, sugar magnate William Park Lyle and actress Dame Gracie Fields were residents in the 1930s when the street was only known as ‘Millionaires’ Row’.
- Then came the international super rich, including the last king of Greece, Constantine II, the Sultan of Brunei and Indian steel magnate Lakshmi Mittal who was at one point ranked the third richest person in the world.
- Turkish tycoon Halis Torprak sold his mansion for £50m in 2008 after spending just two days there. The House of Saud sold 10 properties on the road in 2013 for almost £80m.
- Other residents have included Iraqi businessman Nemir Kirdar, singer Ariana Grande, holiday camp impresario Sir Billy Butlin, businessman Asil Nadir, Paul McCartney’s former wife Heather Mills.
Hunting park to luxury living
- Land was originally the Bishop of London's hunting park, hence the name
- The road was laid out in the mid 19th Century, meandering through woodland and farmland
- Its earliest houses at the turn of the 20th Century were substantial detached properties with extensive grounds
Dunki
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The Indoor Cricket World Cup
When: September 16-23
Where: Insportz, Dubai
Indoor cricket World Cup:
Insportz, Dubai, September 16-23
UAE fixtures:
Men
Saturday, September 16 – 1.45pm, v New Zealand
Sunday, September 17 – 10.30am, v Australia; 3.45pm, v South Africa
Monday, September 18 – 2pm, v England; 7.15pm, v India
Tuesday, September 19 – 12.15pm, v Singapore; 5.30pm, v Sri Lanka
Thursday, September 21 – 2pm v Malaysia
Friday, September 22 – 3.30pm, semi-final
Saturday, September 23 – 3pm, grand final
Women
Saturday, September 16 – 5.15pm, v Australia
Sunday, September 17 – 2pm, v South Africa; 7.15pm, v New Zealand
Monday, September 18 – 5.30pm, v England
Tuesday, September 19 – 10.30am, v New Zealand; 3.45pm, v South Africa
Thursday, September 21 – 12.15pm, v Australia
Friday, September 22 – 1.30pm, semi-final
Saturday, September 23 – 1pm, grand final
Profile Box
Company/date started: 2015
Founder/CEO: Mohammed Toraif
Based: Manama, Bahrain
Sector: Sales, Technology, Conservation
Size: (employees/revenue) 4/ 5,000 downloads
Stage: 1 ($100,000)
Investors: Two first-round investors including, 500 Startups, Fawaz Al Gosaibi Holding (Saudi Arabia)