This article is part of a series on mental health in the Arab world, the impact of mental-health problems on Arab youth, and their access to treatment. See also the companion articles, Anxiety and Depression Often Shadow Arab Youth and Study To Map Mental-Health Needs of Lebanese Youth.
BEIRUT—Often, a university provides a rare chance for a young person to access mental-health care without judgment or fear of family members finding out.
“Depression and sexuality issues are common. We see a lot of families that are not accepting of these issues,” explains Joseph El-Khoury, assistant professor of psychiatry at the American University of Beirut and director of the Psychosis Recovery Outreach Program.
Some universities in the Arab region have begun to establish mental-health care services in recent years, but others offer no counseling to students at all.
“Over the last two to three years at Zayed University, we have put a pretty good system in place,” explains Justin Thomas, an associate professor in psychology at Zayed University in Abu Dhabi. “And it was born out of a need. Institutions without any mental-health systems are carrying a huge risk.”
Zayed University has trained Arabic-speaking counselors and made them available for students who need sympathetic ears and skilled guidance. “It’s really important to have care on campus in a context where the student might not be able to get help outside of the university for fear of their family finding out,” says Thomas.
Most of the Arab universities that have established procedures for responding to mental-health issues on campuse have looked to the West to build their models.
For example, the American University of Beirut has adopted a system that allows students with illnesses and disabilities—mental-health conditions included—to be afforded extra consideration from their professors and supervisors. Additionally, there is a counseling service that students can refer themselves to.
“We work closely with the counseling center to adapt a student’s academic work if needs be,” explains El-Khoury. “We’re completely confidential about their problem. We don’t involve families or make judgments.”
This system has been well received by those who argue that the Arab universities should take mental health more seriously.
“AUB is one of the first universities in the Middle East to do this, and it’s a model borrowed from the United States. It really helps people here,” says Hrag Vosgerichian, a master’s student in psychology at AUB and a mental-health advocate.
However, Vosgerichian says his university’s mental-health services need to be extended. “We need to increase the number of mental-health providers. The services are free, but they’re understaffed for a student population of 8,000. There’s a huge gap.” The counseling center has six staff, four of whom are psychologists.
Those who use the service acknowledge their good fortune that counselors are available, while also recognizing that more needs to be done.
“AUB is an outlier. We are so much more privileged than other universities,” says one student who asked to remain anonymous. He has suffered from depression and used the university’s mental-health care. “I think they’re doing the best they can to provide these services. The need is there but they’re clearly shorthanded.”
“Some providers overwork themselves, working the weekends,” adds the student. He said it was the “luck of the draw” whether a student got a clock watcher or someone with a high level of commitment.
Elsewhere in Lebanon, the picture varies considerably.
At the Lebanese University, the only public university in the country, there are no mental-health support services. “It is shameful and surprising,” says Ahmad Alamy, a professor of psychology there.
But other universities in Lebanon have recognized they have a significant demand for mental-health care within their student populations.
“The need for such services appeared very clearly after the Lebanese civil war,” says Myriam Ghosn, a social-services assistant at the Tripoli campus of Saint Joseph University of Beirut.
Ghosn points out that her university was the first in Lebanon to establish a support office to deal with student mental health. “Providing these services is no less important than providing a good education,” she says.
The Lebanese American University has four counselors spanning its Byblos and Beirut campuses. They provide one-on-one therapy with students and also collaborate with off-campus professionals like psychiatrists when needed.
“It’s all done with confidentiality and the student’s consent,” says Norma Moussally, the senior counselor on the Beirut campus. In the more severe cases, the dean of students will write to the student’s professors, who may then take steps such as rescheduling deadlines and exams, but those decisions are left to the discretion of the professors.
Meanwhile, the University of Balamand, near Tripoli, doesn’t have a special department dedicated to the mental health of its students. Instead the center that is tasked with welcoming new students and helping them get oriented is also responsible for the student body’s mental health. The center is run by Rola Jadayel, an assistant dean of student affairs and a mathematics professor.
“The center includes three people: myself, the social worker who follows up the cases, and the psychiatrist,” says Jadayel. With the lack of a specialized office, many students are reluctant to seek any kind of assistance for mental health, she adds.
Palestine: Greater Needs
In Palestine, far less support is available for students than in Lebanon—even though the need for mental health services in Gaza is the highest in the region, according to one study. (See a related article, “Anxiety and Depression Often Shadow Arab Youth.”)
The majority of Palestine’s close to 50 higher-education institutions have no independent department dedicated to the mental and psychological health of their 221,000 students.
Al-Quds University is the exception, with a soon-to-be created dedicated center.
“The university is launching a unit that is specialized in psychological and mental support” says Abd Al-Raouf Sanawi, the head of student affairs at Al-Quds. “It will officially start its work in 2018.”
Bethlehem University has a guidance office that provides assistance to disabled and special-needs students, with facilities like Braille books for the blind. This office also delivers “social and psychological guidance,” says Salbi Joqman, a social worker at the university.
Some students, however, find those services inadequate.
“They don’t care about the psychological aspects that students can face,” laments Haneen Himdeat, a third-year social-studies student at Bethlehem University. “I am aware of the importance of having a complete independent center, but having an office is not really enough for academic institutions.”
The lack of dedicated facilities in Palestine is mainly due to financing, say experts. “We have been promised [these centers] multiple times, but funding has always preventing us from doing so,” says Amal Dahidel, a psychological advisor at Birzeit University.
Tunisia: A Central Approach
In Tunisia, mental-health care for university students is delivered centrally by the ministry for higher education and not on a university-by-university basis. Students at universities without any on-campus psychiatric care can be referred to centers at other universities. Some services, meanwhile, are performed by mobile units of counselors that move between universities.
Each psychologist covers a student population of between 2,000 and 3,000. Siham Bin Nasr, a psychologist and the ministry’s director of social work, guidance and psychological support for students, says that is a good ratio.
She adds that the ministry expects to recruit more psychologists in a drive to improve access.
But students say things got worse after the 2011 revolution. “I think there is a shortage of psychiatric clinics after the revolution. We used to have a psychologist or psychiatrist in each faculty,” says Ahmed al-Thawadi, an activist in the General Union of Students in Tunisia. “But the number of clinics has been shrinking considerably for the last five years.”
Egypt: Help on Campuses
In Egypt there are counseling centers on campuses, delivering services in ways similar to those in Lebanon or the United Arab Emirates.
Assiut University offers psychological support through a specialized center, which also trains students and teachers in how to handle these cases. Mohamad Riyad, a psychology professor and former dean of the faculty of education, however, was unable to say how many students are using the services and whether the need is being met.
The American University in Cairo provides weekly therapy sessions to students who need it, although—like the University of Balamand in Lebanon—this is not done through a specialized, dedicated center.
“The Office of Student Orientation provides students with individual counseling, which aims to help students work through their personal and social difficulties,” says Mona Amer, an associate professor of psychology at the American University in Cairo.
Both Ain Shams University and Helwan University have separate and independent counseling centers.
Student access to mental-health care in the Arab world is far from universal and depends largely on individual universities’ choices about the type and level of support they will provide. While many universities have made concerted efforts in recent years to deliver services where they previously offered none, there are still students who do not have the benefit of on-campus mental-health care should they need it.