Collectively, the Middle East and North Africa (MENA) region forms the global hotspot for the proportion of mental health disorders as a share of the total disease burden. Although mental health is receiving more interest from policymakers, and there are clear signs of progress across the region, a number of longstanding barriers remain, including Insufficient human resources to meet mental health care needs, an outdated institutional focus that isolates mental health patients from the community and widespread mental health illiteracy and stigma.

Mental health in the Middle East - Measuring progress towards integrated, accessible and equitable mental health is an Economist Impact report sponsored by Janssen: Pharmaceutical Companies of Johnson & Johnson. As part of the research, Economist Impact developed a policy scorecard to illuminate the status and progress towards improving mental health integration in the MENA region. This scorecard allowed us to explore government commitment and accountability, efforts to reduce stigma and advance awareness of mental health, and the accessibility and affordability of mental health services. We also explore the burden of mental illness in the MENA region and critical barriers to the access and provision of mental health care.

The research focuses on six countries in the MENA region: Egypt, Jordan, Kuwait, Oman, Qatar and Saudi Arabia, providing a representative and diverse sample in terms of population size and income groups in the region.

Key takeaways from our research and scorecard analysis include:

• Although existing strategies and legislation are an essential start, officials in our scorecard countries need to enhance them to meet international best practice and human rights provisions.

• Suicide prevention needs urgent attention, including appropriate suicide prevention policies, the decriminalisation of suicide and expansion of mental health helplines to provide round the clock support.

• Policies and laws need funding to aid their implementation, as well as good data to support their ongoing improvement and any required adjustments.

• It is likely that improvements in mental health literacy and stigma stem in part from an increase in awareness and education efforts in the region.

• Healthcare systems need to draw on wider expertise from patients, service users and patient advocacy groups in order to provide care to individuals who have extensive multisectoral needs.

• More effort is required to respond to the specific needs of vulnerable groups such as refugees and low-income migrant workers.

• Although mental health services are fully or partially covered under the basic national insurance in all countries, coverage doesn’t necessarily translate into access.

• Health officials need to prioritise and commit resources to integrating mental health care delivery with primary care and the management of common co-morbid conditions. 

• As telehealth and digital tools become more mainstream, there is a need for integration within mental health policy and ongoing evaluation.