Stigma Against Mental Illnesses in the Middle East

          Stigma is characterized as a stamp that signs to others that an individual has a trait that diminishes her or him from being an “entire” individual to a “tainted” one (Pescosolido, 2013). Mental health related stigma can be conceptualized into five areas: self-stigma, help-seeking stigma, associative stigma, public stigma, and anticipated stigma (Corrigan, 2004). It is prevalent in the MENA region and considered a barrier to mental health care. Mental illness related stigma has many reasons and outcomes.

          Self-stigma is a concept where an individual stigmatizes one’s self resulting in lower self-esteem and worth, and it occurs due to other people’s negative attitude (Corrigan, 2004). It is associated with the decreased probability of seeking mental health among adolescents with mental illnesses due to embarrassment and shame (Youssef & Deane, 2006). A survey shows that 28% of Emiratis avoid seeking help because of the stigma attached to it (Eapen and Ghubash 2004). Families also tend to hide the fact that one of the members is getting psychiatric help because they think that it will jeopardize their reputation and reduce a daughter’s prospects of marriage, which is one of the reasons by stigma differs between genders, appearing in females more particularly than in males (Al-Krenawi et al. 2009; Al-Samadi 1994). Furthermore, Arab males are expected to “man up” and not talk about their mental and emotional problems which result in the avoidance of seeking help.

       Additionally, stigma has negative results such as increased feelings of depression (Manos, Rüsch, Kanter, & Clifford, 2009), a negative disposition to treatment  (Conner et al., 2010), decreased acceptance of treatment (Fung & Tsang, 2010), and less eagerness to return for treatment (Wade, Post, Cornish, Vogel, and Tucker, 2011). It can also cause an underreporting of cases.

Kronfol (2012) discussed that people in the Arab world think that there is a lack of mental health problems, but the issue is more to do with stigma and ignorance.

          People have more acceptance to physical complaints than mental or emotional ones which can hence affect relationships, involvement, and social standing in the community, as well as limiting future options like employment or marital prospects (Al-Darmaki 2003; Al-Krenawi 1998; Al-Kre- nawi et al. 2009; Hijiawi et al. 2013; Sayed 2002).

          Another part of stigma in Arab countries is the religious, spiritual and cultural stigma. Those perspectives shape the way society views mental illnesses and how they care or seek health for their issues. In their mindset, the state of the person whether sick or healthy indicates their relationship with Allah because sickness and health come from him. So when someone experiences psychological symptoms, they are advised or urged to strengthen their faith by praying and reciting the Quran (Al- Darmaki 2011; Al-Riyami et al. 2009; Sayed et al. 1998). Emiratis assign mental illnesses to metaphysical forces such as the demon (jinns), evil eye (‘ayn), sorcery (sihr) or envy (hasad) (Al-Adawi et al. 2002; Al-Issa 2000; Al-Krenawi and Graham 2000; Al-Subaie and Alhamad 2000; Thomas et al. 2015). Therefore, it is not surprising that they seek help from ‘‘Muttawa’’ or ‘‘Imam’’ or ‘‘Sheikh’’ (religious figures), as they find it less stigmatized than actually seeking help from a professional specialist (Yous- sef and Deane 2006).

References

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Shaikha is an 18-year-old Zayed University student majoring in psychology, a feminist and a mental health advocate.

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