behavioral and Mental Health in Saudi Arabia

behavioral and Mental Health in Saudi Arabia

Layla AL-Darwish

HCM 500

Saudi Electronic University



Evolution of Mental Illness

Lack of Psychiatric hospitals

Two psychiatric hospitals by


Lack of psychiatric research

Lack of psychiatrists

Treatment through religious faith healing

(Koenig et al., 2014).

Up until 1950s, there were psychiatric hospitals in the kingdom of Saudi Arabia. Considerably, this was rooted t the fact that the country had established itself from the nomadic societies whereby it was barely 20 years old (Koenig et al., 2014). The first psychiatric hospital was the Taif Mental Hospital in Sahar which was an hour drive from mecca, the cradle of Islam. By 1980, two psychiatric hospitals were built to serve an estimated [population of 6-8 million people (Koenig et al., 2014). Significantly, psychiatric research was underdeveloped as no institution sought to ascertain how the Islamic pilgrimage affected the mental state of both the visitors and the residents of KSA. Additionally, U.S trained psychiatrists had to be recruited to improve the quality of mental health primary care in the country. During this time, the treatment of those with mental illness particularly those diagnosed with the condition in the rural areas entailed religious faith healing (Koenig et al., 2014).


Evolution of Mental Illness (cont.)

Increasing psychiatric

disorders amongst women

Modification of primary

care approaches

Impact of legal issues

Over filled hospitals

(Koenig et al., 2014).

Notably, psychological conditions for women was increasing relative to that of men. Varying factors were cited including probable conflict with the western culture and the fact that women were more willing to seek psychiatric care compared to men thus the perception that this gender had a high prevalence of the condition. Additionally, professions highlighted the need for modifying the western methods of primary care delivery as it was not effective in this country (Koenig et al., 2014). Considerably, legal issues impacted how psychiatric care was practiced whereby psychiatrists would be punished if they released a psychotic patient early from the hospital only to end up causing assaults. Therefore, the psychiatrists were reluctant to release patients resulting in over filled hospitals, especially those with long term chronic conditions (Koenig et al., 2014).


Evolution of Mental Illness (cont.)

Use of medication and lack of psychotherapy

Underdeveloped educational institutions

No Electroconvulsive Therapy (ECT)

Prevalence of mental health problems today

Availability of healthcare providers

(Koenig et al., 2014)

Considerably, anti-psychotic drugs were often used this time. However, the psychiatrists did not use psychotherapy even to the chronically ill mental health patients. Additionally, the educational institutions were underdeveloped as they only taught few lecture on organic brain syndrome and depression (Koenig et al., 2014). Significantly, there was No Electroconvulsive Therapy primarily because most of the professionals were not well-trained in psychiatry. Significantly, mental health problems are highly prevalent in KSA today thus heightening the need for healthcare services development and reforms. Unlike the past, mental health services and facilities are available in the country, an aspect that signifies their dedication to combat the problem (Koenig et al., 2014).


Structure of Care and Access

MOH is the major government provider of healthcare

244 hospitals, 2037 primary healthcare centers


Referral hospitals

Security forces medical hospitals

National guard health affairs

(Almalki, Fitzgerald & Clark, 2011)

Under the Saudi Arabia healthcare system, the government is the major provider of healthcare services in the country. The ministry of health is the major healthcare provider whereby it comprises of 244 hospitals and 2037 primary healthcare centers (Almalki, Fitzgerald & Clark, 2011). The MOH has all levels of healthcare thus addressing patient’s needs (Almalki, Fitzgerald & Clark, 2011). Under the government are additional agencies such as the referral hospitals and Security forces medical hospitals that provide healthcare services to defined populations such as their employees and the dependents. Additionally, the agencies provide healthcare needs during emergencies or disasters.


Structure of Care and Access (cont.)

The Private sector

All levels of healthcare

Accounts for 21.2% of

healthcare services.

Enhanced access of

healthcare services

(Almalki, Fitzgerald & Clark, 2011).

Figure1: Saudi health care system design and functioning

Source: (Almalki et al 2011)

The private sector contributes to the provision of healthcare services in KSA whereby it accounts for 21.2% of the primary care services provided in the country (Almalki, Fitzgerald & Clark, 2011). The existence of both public and private heath sector highlights that the population has a greater access to health care services in the country. Primarily this is due to the advancement of healthcare services together with other factors such as accessible public education, better life conditions, increased health awareness within the community and significant improvements in health indicators (Almalki, Fitzgerald & Clark, 2011).


Financing of Mental Healthcare

Financed by the government

4% of the healthcare budget

is for use in mental health services

78% of mental health expenditure

goes to health institutions

Free access to psychotropic medications and non-drug psychological services

(Qureshi, AlHabeeb & Koenig, 2013).

Mental health financing is a powerful tool as this shapes the quality of primary care provision in the country. Mental health care in KSA is financed by the government whereby 4% of the healthcare budget of the MOH is directed to the use f mental health care (Qureshi, AlHabeeb & Koenig, 2013). Additionally, 78% of mental health expenditure is directed to mental health hospitals. Through this, the public has free access to psychotropic medications and other non-drug psychological and social services (Qureshi, AlHabeeb & Koenig, 2013).


Intervention through Policy and Research

Implementation of the Mental Health Act

Streamline the delivery of mental health care services

Implementation of the MHA after research on what other countries offer

Establishment of policies and procedures

(Qureshi, AlHabeeb & Koenig, 2013)

Recently, the KSA government enacted the mental health act to address key areas including improving access to mental health care, ensuring less restrictive level of care, preservation of the patients rights, streamlining competence, ensuring accreditation of facilities and professionals, enforcing mental health laws and establishment of mechanists for enactment of these provisions (Qureshi, AlHabeeb & Koenig, 2013). Notably, the MHA was implemented after reviewing what other countries were dong globally.


Preventative Measures Enacted By Governmental And Nongovernmental Entities

Health educations,

Increase awareness

Managing the burden

of the condition

Continuous professional


Development of community

health facilities

(Qureshi, AlHabeeb & Koenig, 2013).

The high prevalence of mental health In KSA requires robust preventive strategies to increase awareness about the condition. Heath education is often used to increase awareness at the community level thereby urging members to seek primary care at the health institutions (Qureshi, AlHabeeb & Koenig, 2013). This enhances ease in managing the condition at the community (Almutairi, 2015). additionally, the government is seeking to develop community mental health facilities to enhance accessibility of care. Significantly, both the government and NGOs have embarked on continuous professional development for nurses, social workers, psychology staff and other psychiatric professionals t improve their knowledge and skills.


Preventative Measures Enacted By Governmental And Nongovernmental Entities (cont.)

Changing negative attitudes

Increasing attention on human rights

Empowering mental health services

Implementation of community care

Implementation of the MHA

(Qureshi, AlHabeeb & Koenig, 2013).

WHO has proposed varying measures for the prevention and management f mental health care in KSA (Qureshi, AlHabeeb & Koenig, 2013). Primarily, this entails changing negative attitude by increasing awareness of the condition, in creasing attention on human rights to avoid violation of patients, empowering the mental health services through the adoption f effective strategies and implementation of community care to replace the outdated inpatient psychiatric hospitalization (Qureshi, AlHabeeb & Koenig, 2013). Additionally, the mental heath act emphasizes the provision of quality care to enhance effective management of patients (Almutairi, 2015).



Underdeveloped health system in the past

High prevalence of mental health illness

Increased access to primary care services

Financial support to enhance access of care

Prevention measures

(Koenig et al., 2014).

Initially, KSA had an underdeveloped health care system as the country originated from nomadic societies. The high prevalence of mental health illness in the community heightened the need for developing a robust health care system. Currently, the government finances the health care sector thereby resulting in increased access to primary care services. Additionally, the government and NGOs have embarked on implementing preventive ,erasures such as health education and continual development of professional skills to promote healthcare regulation (Koenig et al., 2014).



Almalki, M., Fitzgerald, G., & Clark, M. (2011). Health Care System In Saudi Arabia: An Overview. Eastern Mediterranean Health Journal, 17(10), 784-793. Http://Dx.Doi.Org/10.26719/2011.17.10.784

Almutairi, A. (2015). Mental Illness In Saudi Arabia: An Overview. Psychology Research And Behavior Management, 47. Http://Dx.Doi.Org/10.2147/Prbm.S79268

Koenig, H., Al Zaben, F., Sehlo, M., Khalifa, D., Al Ahwal, M., Qureshi, N., & Al-habeeb, A. (2014). Mental Health Care In Saudi Arabia: Past, Present And Future. Open Journal Of Psychiatry, 04(02), 113-130. Http://Dx.Doi.Org/10.4236/Ojpsych.2014.42016

Qureshi, N., Alhabeeb, & Koenig, H. (2013). Mental Health System In Saudi Arabia: An Overview. Neuropsychiatric Disease And Treatment, 1121. Http://Dx.Doi.Org/10.2147/Ndt.S48782


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