Mental health study in Dubai schools

DUBAI //Nearly one in five teenage schoolchildren in Dubai shows elevated symptoms of depression, the first study of its kind has found.

The figures are comparable to elsewhere in the world and the causes are similar, but experts have identified some factors that are unique to the UAE.

Expatriate children who are trying to acclimatise to a new country are among the groups affected, said Dr Veena Luthra, a consultant psychiatrist at the American Centre for Psychiatry and Neurology in Abu Dhabi.

The "nanny culture" is also a contributing factor. "A lot of kids here are raised by nannies and the nanny is the primary care giver," she said. "I don't know how much emotional support they're getting ... it's probably more like putting the child in front of the TV and giving them video games."

The study looked at 1,289 pupils aged 14 to 18 in 20 schools, 16 private and four public.

It is the first of its kind in the UAE covering mixed nationalities in both private and public schools, and found that 17.5 per cent of pupils were experiencing symptoms that were considered above normal.

Dr Raymond Hamden, a clinical psychologist and forensic with the Human Relations Institute, said another factor in Dubai was that some families had difficulty dealing with sudden wealth.

"Many of these families don't know how to 'behave rich', so they start to socialise at the expense of their family." They are concerned with material acquisitions, he said, and this "replaces some of the core values of life that keep the family together".

These misplaced values can result in children feeling disconnected from their families.

"There's nothing wrong with wealth, but it should not take the place of decorum and dignity," Dr Hamden said.

For the study, children were asked to fill out a socio-demographic questionnaire and an internationally recognised self-assessment report that evaluates the presence and severity of specific depressive symptoms in children.

Dr Sami Mana Ahmad bin Ahmad Ali, community medicine specialist registrar with Dubai Health Authority and author of the study, said that although it screens only for symptoms and does not provide a diagnosis, it can provide a basis for further investigation.

"Adolescent depression is a significant health problem which can lead to detrimental consequences in adolescents, their families and for their communities," he said. Those who have elevated symptoms are more likely to develop depression.

Literature reviews from the study show that a comparable rate worldwide is between 12 and 33 per cent of high school pupils.

A 2004 study published in the Archives of Pediatrics and Adolescent Medicine showed the above-average prevalence in the US was 18 per cent. In Oman, according to a 2006 study published in the Eastern Mediterranean Health Journal, it was 17 per cent.

The Dubai study shows eight main predictors of elevated depressive symptoms, including physical inactivity, absence of psychological support from families and colleagues, verbal bullying and school type.

Nearly half – 45.4 per cent – of the pupils surveyed were considered physically inactive, taking part in less than one hour of exercise a week. The study found that 23.2 per cent of students who were physically inactive had elevated symptoms compared with 13.7 per cent of those who were active.

Dr Bin Ahmad Ali said the findings were yet another reason why schools should push to improve their physical education programmes.

"Mental health is not only about depression, you have a lot of things such as anxiety and stress, a lot of problems and diseases," he said. "And some of the very important buffers inside the school are physical and extracurricular activities."

In 2010, the Ministry of Education increased the required amount of instruction for physical education. Children up to Grade 7 are required to take three 40-minute classes a week, and high school pupils take two. This is low compared with physical activity requirements at schools in Organisation for Economic Cooperation and Development countries.

Jamal Essa Al Midfa, head of instructor training in the physical education department at the ministry, said they were trying to push for more lessons but faced constraints because of the academic schedule.

"The workload for the morning sessions at schools makes adding more PE classes a challenge," he said. "So for now, I believe giving them two to three hour sessions is all that can be offered."

He said the ministry did provide the option of after-school athletics training and sport for interested pupils.

The Ministry of Education requires one social worker to be available at every government school. While most private schools have counsellors, they deal mostly with career guidance.

A community-wide health education programme is necessary, Dr Bin Ahmad Ali said. The next step is to assess the level of support available in schools. The researcher said he was sharing the results with the Ministry of Health, the Knowledge and Human Development Authority and the School Health Department at the DHA.

"We don't know the real status now. Some schools have counsellors, some don't," he said. "A health programme should be taking a role and dealing with the elevated depressive symptoms.

"Education and health is one. What is the result if you have a very educated student and he is diseased, either mentally or physically?"

mismail@thenational.ae

* Additional reporting by Afshan Ahmed