In October 2024, the Global Congress on Population, Health and Human Development (PHDC) convened industry leaders, healthcare professionals, academics, and government officials to exchange insights on prioritising human development through a specific focus on education, economic opportunity, social welfare, and overall well-being. Economist Impact moderated a panel discussion on advancing mental health in Egypt, based on country-specific insights from our 2023 white paper Mental health in the Middle East, Measuring progress towards integrated, accessible and equitable mental health.
Here we reflect on that discussion and a follow-up interview with Dr Menan Rabie, Head of the General Secretariat of Mental Health and Addiction Treatment (GSMHAT).
Changing attitudes and challenging stigma nationally
Stigma towards mental health is prevalent globally. Negative social attitudes to mental health conditions can come with social isolation, disruption in education, and unemployment.1
The panel acknowledged the importance of changing attitudes and approaches to promote and protect mental health.2 Awareness-raising policies and practices were specifically discussed as an area of improvement by experts.
The Egyptian General Secretariat of Mental Health (GSMHAT) has led several mental health campaigns over the past decade to raise awareness of key mental health conditions and tackle misconceptions. These campaigns leverage actors outside of the health sector such as education, workplaces, faith-based organisations and community groups to improve awareness with the goal of ultimately altering basic societal understanding.3
“The importance of Mental Health on the quality of life” Dr Menan Rabie, Head of the General Secretariat of Mental Health and Addiction Treatment (GSMHAT)
The panellists emphasised the importance of political will and government accountability in driving and achieving progress in mental health policy and services. Political agreement upon global targets for mental health can strengthen systems, improve access, shift cultural stigmas and ensure accountability and monitoring.4
Comprehensive strategies as a tool for advancing mental health
The World Health Organisation (WHO) highlights the need for comprehensive strategies that address the wide range of factors that can negatively impact our mental health, including socioeconomic status, education, and community support, to create more effective interventions.5,6
In addition to comprehensive strategies, the panellists emphasised the need for clear policy directives that effectively leverage financial resources and establish accountability mechanisms to enhance mental health outcomes. Dr Menan shared how, through national surveys, the GSMHAT has been able to gather data on “current needs and obstacles in mental healthcare to advocate and lobby for necessary improvements” in an evidence-driven way.
“The significance of integrating mental health initiatives into the '100 Million Healthy Lives' campaign” Dr Menan Rabie
The Egyptian government launched its 100 Million Healthy Lives campaign in 2018, to tackle Hepatitis C.7 Over the course of six years the campaign has led to the effective elimination of the disease.8 Dr Menan described how the campaign has been extended to include mental health, presenting a great opportunity to achieve progress on tackling mental health in Egypt and reflecting the continued commitment of the government to address it.
Ultimately, financing is the mechanism that allows for plans and policies to be translated into action through effective resource allocation.9 There is a need for political will to make financing happen, this is where Dr Menan believes that “His Excellency the Deputy Prime Minister, Minister of Health & Population’s vision of the significance of Mental Health on the quality of life and the importance of mental illness prevention” has been so critical in translating plans into action through resource reallocation to mental health.
Addressing workforce challenges through prevention and community care
2023 Economist Impact research found that there was a decline in the mental health workforce across the region and Egypt is no exception.10 In Egypt this workforce shortage has resulted in long waiting lists and limited access to care for both public and private patients in Egypt, with in-patient facilities described as “overcrowded.”11 Integrating mental health promotion, prevention and treatment into primary care was an area where the panel identified progress had been made in Egypt.
“While challenges remain, including limited resources and the need for more comprehensive system integration, Egypt is actively working to bridge the mental health treatment gap by bringing these services closer to communities.” Dr Menan Rabie
In Egypt, the concept of mental health is still generally viewed as an acute issue that is managed in hospitals. Dr Menan shared how the GSMHAT is making progress in integrating mental health services into primary healthcare through its mhGAP (Mental Health Global Action Programme.12 This includes training for primary healthcare providers to ensure they can provide mental health support to patients within their setting. MhGAP focuses on training primary healthcare providers on early detection, available treatments and referral systems. In the background it also works on strengthening the systems that underpin these processes, including electronic health records.
Dr Menan described an on-going pilot project integrating 230 counselling services in primary care centres across the country, resulting in over 40,000 people receiving guidance, support and appropriate referrals since April 2024.
Engaging a broader range of stakeholders to address population mental health
Engaging a broad range of stakeholders is crucial to effectively address mental health care. The panel at PHDC included policymakers from Egypt and Spain, industry representatives and a representative from FAHIM - an Egyptian mental health advocacy group that aims to address mental health stigma.13,14 FAHIM works closely with the Egyptian government to ensure long-term commitment to population mental health.15
Successful design and implementation of mental health policy requires policymakers, care providers, service users, and communities.16,17 The panel emphasised the need for diverse stakeholder engagement and specifically cross-ministerial collaboration to reflect that the causes of and solution to mental health conditions go beyond the health sector.18,19
“Prioritization of mental health support and engagement of all stakeholders, particularly with strong political will and leadership placing mental health in line within the Sustainable Development Goals for 2030 and WHO recommendations emphasizing mental health as an integral part in the overall well-being.” Dr Menan Rabie
Research and innovation as tools for advancing mental health
Research drives innovation. As such, it is a key tool to advance population mental health, as highlighted by the PHDC panel. Ultimately, mental health research drives the development and evaluation of innovative therapies, providing insight on their efficacy and use.20 Innovations in mental health create a range of opportunities to make resources more accessible and streamline care pathways.21,22 A lot of mental health research is generated in North America and Western Europe, so it may not reflect the specific context of the Middle East region (including Egypt).23 This is where networks that can connect mental health researchers in Egypt are valuable to enable in-country, culturally relevant research and insights.24,25
Celebrating progress while acknowledging more work is still needed
Egypt has made great strides in addressing mental health in a more holistic way that is driven by the needs of its population. However, significant challenges still exist. Dr Menan described the presidential initiative for mental health launched on November 10th 2024 by His Excellency Deputy Prime Minister, Minister of Health & Population Prof Khaled Abdelghaffar as highlighting the political commitment to prioritising mental health. Furthermore, Dr Menan called out mental health problems among older people and women as priorities for future work, as well as a focus specifically on major depressive disorder. Addressing these challenges will only happen through continued comprehensive action that is bolstered by political buy-in and commitment at the highest level.
References
[1] https://iris.who.int/bitstream/handle/10665/356119/9789240049338-eng.pdf?sequence=1
[2] Ibid
[3] https://impact.economist.com/perspectives/sites/default/files/janssen-measuring_mental_health_integration_in_the_middle_east-report-a4-v4.pdf
[4] https://iris.who.int/bitstream/handle/10665/345946/9789240036703-eng.pdf
[5] https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
[6] Ibid
[7] https://www.worldbank.org/en/news/feature/2024/04/05/how-egypt-won-its-battle-against-hepatitis-c
[8] Ibid
[9] https://www.who.int/publications/i/item/9241545933
[10] https://impact.economist.com/perspectives/sites/default/files/janssen-measuring_mental_health_integration_in_the_middle_east-report-a4-v4.pdf
[11] Ibid
[12] https://www.emro.who.int/ar/mnh/mental-health-gap-action-programme/index.html
[13] https://www.facebook.com/Fahim.Foundation
[14] https://egyptianstreets.com/2023/01/29/new-egyptian-fahim-foundation-emphasizes-role-of-family-in-mental-health-treatment/
[15] https://nmec.gov.eg/nmec-events/fahim-foundation-for-psychological-support
[16] https://ijmhs.biomedcentral.com/articles/10.1186/s13033-021-00458-y
[17] https://www.nimh.nih.gov/get-involved/public-involvement
[18] https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response
[19] https://ijmhs.biomedcentral.com/articles/10.1186/s13033-021-00458-y
[20] https://www.nihr.ac.uk/blog/mental-health-research-goals
[21] https://www.nimh.nih.gov/health/topics/technology-and-the-future-of-mental-health-treatment
[22] https://digital.nhs.uk/blog/transformation-blog/2018/the-past-present-and-future-of-innovation-in-mental-health
[23] https://www.aljazeera.com/features/2022/3/18/egypts-forgotten-mental-health-crisis
[24] https://www.mhinnovation.net/organisations/mental-health-research-network-egypt
[25] https://unitedgmh.org/the-global-advocate/why-local-insights-are-vital-for-funding-youth-mental-health-innovation/
