Crucial need for more psychiatric services
ABU DHABI // People with mental problems are caught in a “vicious cycle” that leads to isolation and unemployment because of the lack of psychiatric and rehabilitation services, health professionals say.
Sheikh Khalifa Medical City is the only government hospital in Abu Dhabi offering the services.
Its doctors also do rounds at Mafraq, Corniche and Al Rahba hospitals, and perform crisis interventions and home visits.
SKMC’s psychiatry centre had 41,000 outpatients last year, a number that is rising after the introduction of a rule by which patients have to pay 20 per cent of their insurance at private hospitals. Dr Abdulnaser Arida, who works at the American Centre of Psychiatry and Neurology – Abu Dhabi’s only private centre – said some patients in Al Gharbia drove three hours to see him.
“There are no psychiatrists in the Western Region, they all come to us,” Dr Arida said. “We also have patients from Al Ain.”
On average, he sees 25 patients a day, five of them new. Some are as young as 2. His eldest is 100, with dementia and depression.
Dubai has two public psychiatric centres but a lack of rehabilitation and support groups.
“As far as I know, there are no non-addiction support groups,” said Dr Motaz Al Shami, a psychiatrist at Dubai Hospital.
“Patients with mental illnesses are caught in a vicious cycle where they receive treatment but they find no support from the community, so many are isolated and put out of their jobs.”
The lack of psychiatric centres also strengthens the stigma attached to mental problems, Dr Arida said. “We have patients who are too scared to park their cars in front of the centre in fear that someone might recognise their plate number,” he said.
“If you have more clinics, then more patients will come forward and we will have less of a stigma.”
He said that many patients did not even know that there were clinics available.
“We want people to know that our services are available and 100 per cent confidential,” said Faisal Abdulla, of SKMC’s community psychiatry department.
“Many people still don’t know what our services are, which is why many people don’t seek help.
“Beyond the fact that we provide you with inpatient care and outpatient care, follow-up care and programmes like the daycare centre, but if you are unable to come to the hospital, we come to you.”
The hospital does up to 300 home visits every month for Emiratis, but the daycare centre’s vocational training is for locals and expatriates. SKMC is the only hospital in Abu Dhabi with inpatient psychiatric care. “We have 125 beds, which are mostly full, but we also have a high turnover,” Dr Abdulla said. “Inpatient care ranges from a few days to a maximum of 15 days.
“We keep patients until they are stable enough to go home. Institutionalising psychiatric patients is not in any shape or form beneficial for the patient.” SKMC’s main goal, he said, was “psycho-social rehabilitation. The idea is that if you have the most chronic and untreatable type of mental disorders, we still want you to be part of society, above all”.
But Dr Abdulla said there was a need for more decentralised psychiatric services. “Even though we offer comprehensive psycho- social rehabilitation services, I think it would help patients if we offered services closer to home,” he said.
Sara Sherbaji, a cognitive trainer at a Dubai disabilities training centre, wants to see a UAE-wide education campaign on mental health. Ms Sherbaji and a team of professionals are working on a 10-minute documentary on mental illness. “We want to do workshops and be engaging as much as we can,” she said.
“We would like there to be support communities for patients. “Everywhere in the world, there are different organisations and large, national campaigns dedicated to the reduction of stigmas, except here.”
At Dubai public hospitals, she said, it “takes a couple of months to get an appointment with a psychiatrist. The waiting list is quite long”.
“To close our resource gap, the number of psychiatrists should increase even more that tenfold in the UAE and must climb up to 10 psychiatrists for every 100,000 people,” Ms Sherbaji said. “Every community should have a local facility with psychiatric expertise and with a wider range.
“Every city should have several research institutes working on preventive measures,” Ms Sherbaji said.
There are 0.3 psychiatrists for every 100,000 people in the UAE, the World Health Organisation says, compared with 14.6 in the UK and 12.4 in the US.