Yemen and Psychotherapy [Archives:2000/24/Health]

June 12 2000

Yasser M. Ahmed
Yemen Times
Human being is an aggregate of contradicting sentiments and feelings. The thought of mental health is just as important for him as that of water, food and medicine. Recent studies show that some of mental diseases were known since 5000 B.C.
Psychotherapy is a multifaceted field which was the result of the development of knowledge about mental health.
Islamic scholars were the first to classify diseases and human behavior according to their source, kind and degree. Avecena was considered to be a pioneer sergeant and psychologist. He described depression, worry and tensions and their effects on the body. Averroes had made a distinction between severe diseases and permanent mental diseases. The first sanitarium was established during the reign of Imamin. It is reported that after a few centuries Kerblin applied Muslims theories to the treatment of mental sickness.
Some of the outstanding scholars who contributed a lot to the science of psychotherapy are as follows:
a) Paracelus (1493-1541) who discarded astrology and concluded that there were some concrete, analyzable reasons behind mental diseases.
b) Charct and Askerol were some of the most famous psychiatrists. c) Pritchard, Sygan and others committed themselves to the study of psychology and excelled in it.
In our country we are in urgent need of further study in this science. We have to plan out and draw up strategies to start from the point others stopped at.
The spread of mental diseases in our country is quite discernible in the past few years. It is triggered by social and economic reasons such as family problems, migration, divorce, increase in the number of qat chewers, deplorable economic conditions, especially after the Gulf War, accentuated by the return of a large number of Yemenis.
One of the incentives that prompted me to conduct this survey is the First Mental Health Activities Meeting during (27-29) 2000 in which there were illuminating lecturers about the victims of obsessive compulsive disorders and their negative impact on the society.
Dr. Ahmad Maki, specialist in mental diseases, talked about the preliminary steps to develop the network of services in the area of mental health in our country since 1982 when a number of specialists graduated. The graduation ceremony was attended by an advisor from the International Mental Health Organization. It was held in the Southern governorates before the unification. Since then, mental health services began, though in a limited scale, in Taiz and Hodaidah. In the past the government used to send mental patients to be treated abroad which used to cost the exchanger huge sums of money. However, if mental health centers are available in the country, more patients will be better treated here, saving the precious foreign currency reserve of the country. Therefore, it is of prime importance to establish these centers, so as to treat these patients, the majority of whom are still occupying key posts in the country. This can make them valuable assets to the country rather than making them a burden on it.
The government has started giving more attention to psychiatric patients and a number of important decisions have been taken by the Cabinet to help them. The Cabinet also earmarked the funds for establishing a sanitarium for mental diseases in Al-Thawrah Hospital Sana’a. A short-term plan for 1984-1985 was also drafted, the objective of which was to create a central administration in the ministry of Health that would be responsible for developing facilities for treatment of cases related to psychiatry in different governorates of the Republic.
In December 1986 a seminar on obsessive compulsive disorders was organized in collaboration with the World Health Organization in Geneva and Alexandria. A Yemeni team with the members from the Ministry of Health and the university participated in it. In the seminar the participants discussed and outlined the agenda for treatment of the mental diseases. Yemen was the third country to present its action plan to the WHO.
Eventually, the then southern part of Yemen was making slow progress in the field of psychiatry. Regular treatment of patients started at the beginning of the 1960s by the British demonstration for the first time. That was in the central Prison of Aden. Then, Al-Salam sanitarium was established by the British government in Sheikh Othman in 1966 to quarantine the sick people and treat them in a far off place. Then there was a trend to establish such projects for ensuing the mental health of the people. In pursuance of this in 1985 the Educational Psychiatry Hospital was inaugurated in Aden. However, There was a marked focus on the educational side. The psychiatry program which was funded by the WHO ran a training program inside the hospital. Meritorious students were sent abroad for further studies.
After the unification efforts were further consolidated in the hospital. As Dr. Zaki Mubark Saeed, general manager of the hospital, said “The progress achieved so far in the psychiatry field is very important and essential for the society to protect it from different mental diseases.”
Aminah Rezk, chairperson of the educational and psychological guidance, Faculty of Education, Amran, said “Mental health is the overall outcome of all the psychological activities of the individual. It is a goal everyone seeks. However, the point is, do we have a qualified cadre of physicians who are able to render the necessary psychiatric services? We can take the Educational and Psychiatric Department in Amran as an example. The college was opened in 199596. The number of students who joined this department were 265. There was a continuous increase in the number of students joining this department. The department helps individuals of our society to overcome whatever mental problems they suffer from. These cadres help the Ministry of education, Ministry of Labor and technical training, Ministry of Interior and social affairs and Prisons’ Authority, Ministry of Health, etc.”Despite the sincere efforts of the government to train a qualified cadre, there are lots of obstacles that stand on our way to establish centers for mental health or psychiatry. Regarding these obstacles, Dr. Faraj Ba Saleh, specialist and chairman of the mental diseases, Avecena, Al-Mukala, said “Obstacles standing at establishing a prosperous mental health in Yemen are a lot which include the social beliefs, misunderstanding of some religious concepts, lack of trust in the psychiatrists, limited qualified staff, ignorance of the importance of this science not to include it in the schools’ curricula, attitude to the specialist in this field and the prevalence of conjurers.
The problem was aggravated by the absence of laws to regulate application of relevant rules.”
Dr. Abdul Rahman Salam, assistant professor, faculty of Medicine Sana’a University, said “There is also the problem of lack of cooperation on the part of our people. For example, some Yemenis have mental diseases. However, they do not consult a psychiatrist because the patient feels shy to reveal it resulting in the disease being serious. Of course, big families, strong faith help a lot to decrease the incidence of this disease. Other obstacles are the abnormal behavior of some patients which are not properly understood by the people around. Thus, the people should be aware how to differentiate between normal and sick behavior.”Dr. Mohammed Al-Tushi, faculty of Medicine, who is researching on some mental patients, said “I have made different studies on mental diseases. For example, the case of S.M.S who is 19 years. He is suffering from a mental problem due to which he commits adultery and thefts. After studying his case, I found that he has an anti-social personality. He was found to be suffering from some mental problems even before he was 15.
The mentally sick people suffering from schizophrenia are prone to lie, escape from home, steal, be skilled to insinuate others to commit illegal acts like cheating. If medicine is not timely used, there will also be greater possibility of committing suicide. You can not trust them for they may do things unaware of their results. Whatever the results, such patients are always indifferent.
Such cases should be carefully studied and be given the attention needed so as to give proper relief to their families and retrieve the situation before it is to late.”
Dr. Al-Tushi also recommended that specialists in psychiatry have to make researches about the mental disorders that youth may be exposed to due to the migration of youths. He appealed to all universities to invigorate intensify the researches on such phenomena as Qat chewing, carrying weapons and deteriorating family relations.
Another study was made by teacher Somiah Al-Tamimi. She reported that the obsessive compulsive disorders are prevalent more among adolescents. It affects their mental health and the harmony with their surroundings. This disorder has three parts:
1- Compulsive thoughts.
2- Compulsive rituals.
3- Compulsive thoughts and rituals.
Such thoughts and rituals are forcibly accepted by the patient despite his full realization of their inappropriateness. The study pointed to the conclusion that parental care with their children plays a vital role and that the parents’ strictness to make their children obey their orders leads to mental sickness in children. This creates an inner conflict inside the child between what he himself wants and what his parents want.
She added that treatment of such syndromes should be tempered with mercy and love.

There are many researches which highlight mental diseases. These suggest a number of remedies to lessen such diseases in the society. Anwar Al-Dhabhany, MA mental health, Mental Health Institute of the armed forces suggested building mental health service centers in the military cantonments, teaching basic psychiatry courses in schools, conducting field surveys and familiarizing the society members with elementary principles of mental health.
Dr. Faraj Basaleh thinks that remedies should arise from spreading the awareness about mental health among people through specific programs especially through, TV, seminars, mosques, etc.
Amat Al-Rahman Hameed and Zohrah Al-Nihari suggested building mental health centers to take care of those who suffer from mental problems and organize qualifying cadres working in the same domain. They said that the government should have statistics about the number of psychiatric patients in order to find the suitable solutions to the problem in a planned manner.
We hope that in days to come health psychology will be paid full attention to overcome all the difficulties specialists are faced with in their work.