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The Mental Health Crisis Facing the Men of Saudi Arabia

Research shows that nearly 1 out of every 2 Saudis is suffering from depression or anxiety

Less than a week ago, a French expatriate committed suicide at one of Islam’s most holy sites — the Grand Mosque in Mecca. The 26-year-old man, had been staying just a stone’s throw away from the Kaaba, Islam’s holiest building, and like the tens of thousands of Muslims around the world who had flown to the Holy City, he was said to have wanted to complete the second half of Ramadan. After news of his death spread across social media, Saudi police released a statement, simply saying: “A foreigner threw himself from the roof of the Grand Mosque in Mecca to the courtyard below, resulting in his instant death.”

It wasn’t the first time something like this happened. Last year, Saudi police stopped a national from setting himself on fire in front of the Kaaba, in what was considered to be an attempted suicide. Though some speculated the act was political — a form of protest mimicking self-immolation in Tunisia in 2011 that began the “Arab Spring,” Saudi police were quick to claim otherwise. “His actions show he’s mentally ill,” a spokesperson said. “Legal action will be taken against him.”

While these stories made headlines in the West, largely due to speculation about the men’s “religious” or geopolitical “motivations,” in Saudi Arabia itself, the acts didn’t come as that much of a shock. If anything, it was merely the latest (and saddest) example of the Kingdom’s mental health crisis — one that, according to some Saudi nationals, is growing substantially while the government turns a blind eye. A 2013 study from the Journal of Clinical Psychiatry estimated that around 7 percent of adults living in Saudi Arabia had some form of major depression. Another paper from BMC Psychiatry suggested that up to 46 percent of Saudi adults could be suffering from depression or anxiety generally, a condition that usually went unnoticed until they visited the hospital for other medical reasons.

So while the Kingdom has invested more heavily into mental health resources, researchers say the funding might have arrived too late. Worse yet, because mental health resources aren’t provided across the entirety of the Kingdom’s national health system, poorer citizens — including those who come from non-Arab backgrounds, or who are relatives of migrant workers — are usually unable to afford screening or treatment.

That was certainly the case for Moeen (a pseudonym), 24, who lived in Saudi Arabia until last year, when he moved to France with his sister Rayha for mental health treatment for his psychosis. “We noticed that there was something wrong when he was young,” Rayha tells me over Skype. “His personality would change quickly. He’d get angry frequently and would end up hurting himself as he was breaking things like glass and wood.” Rayha’s family, of Bangladeshi origin, tried to get help, but to no avail. “We didn’t come from a wealthy family,” she says. “My mom stayed at home to look after us as is customary in Saudi, so we relied on my father’s income as a laborer, which wasn’t very much. We could barely afford to buy school clothes, so medical things were out of the question unless it was urgent.”

Rayha also says that despite the investment into mental health in the Kingdom and some awareness campaigns being launched in the Saudi media, there was still “a stigma around those with mental health problems — they associate people who [suffer] from mental illness as being bad Muslims, or that they need to get closer to God in order to get better. We even had doctors tell us to go to the mosque and pray for my brother — that God would listen to our prayers. It made it difficult to be taken seriously.”

As in Moeen’s case, mental illness disproportionately affects men in Saudi Arabia. There’s little publicly available information, but according to a 2014 research paper looking at the metropolitan city of Dammam, out of 126 suicide cases in the city, 85 percent were carried out by men. More than half of these suicides involved non-Saudi citizens, usually of Indian descent and nearly all of whom suffered long-term illnesses that hadn’t been adequately treated.

“Saudi needs to be a place where people believe they can come, work and live a good life, regardless of who they are,” says Muhammad al-Ahwal, a Qatar-based psychiatrist who previously conducted research on depression rates in Saudi Arabia and now works as a clinician. al-Ahwal says that for the past five years, he’s received more patients coming into the clinic for mental health-related reasons than ever had before. Part of that, he says is because of awareness through social media. “Lots of young people here still watch American TV. They spend time on Facebook where people in the West talk openly about their mental health. So their language around mental illness is modeled on American understandings of it.”

While al-Ahwal welcomes this growing awareness, he says that so long as treatment isn’t spread more widely throughout the state health care system and afforded to those who don’t classify as naturalized citizens, acts like self-harm and suicide will continue to rise “astronomically.” “The people who will be most affected by this are immigrant workers and their relatives,” he explains. “They’re the ones without access to long-term medical care, who live in poorer conditions compared to wealthy Arabs and who are basically told by the state they’re second-class citizens. That affects their mental well-being, too.”

It’s a sentiment that Rayha can relate to, and ultimately, the reason why she and Moeen were sent to France to get medical treatment, and hopefully, continue his education. “For [Moeen] he faces so many challenges by living in Saudi,” she says. “He has a mental illness, which puts him at a disadvantage in [their] society. He isn’t wealthy, and he’s an immigrant with dark skin. So whatever changes about Saudi in the next 10, 100 years, he won’t benefit from it.”