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.
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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.
