Saudi Human Rights Commission detects issues in mental health care services


Abu Dhabi: The Saudi Human Rights Commission has monitored a number of observations during its inspection teams’ visits to the various mental health complexes across the kingdom, which included discrepancy in the general condition of buildings, inadequate level of hygiene and maintenance in some of them, and shortage in equipment and specialised medical professionals.

The Saudi watchdog also reviewed the services provided to home care to the beneficiaries, and the number of inpatients and the estimated capacity of complexes, application of diets, and the appropriateness of the meals provided.

The watchdog said it will work with the relevant authorities to address the shortcomings.

Today, most patients with serious mental health problems in Saudi Arabia are treated in psychiatric hospitals that provide in-patient and outpatient services, according to a study by Open Journal psychiatry, published in 2014.

The study says patients with chronic mental disorder continue to be hospitalised for pro-longed periods. Reasons for long-term stays included refusal by family to care for them, active psychiatric symptoms, need for rehabilitation, relative lack of community services, absence of halfway homes, and the legal issues related to premature discharge, which make psychiatrists reluctant to release them. Although the number of psychiatric outpatient clinics associated with general and specialty hospitals had expanded to nearly four dozen by 2006, a well-developed community mental health system (CMHS) still does not exist in Saudi Arabia.

It argues until that system develops, most mental health needs of those living in the community will continue to be met by primary care physicians at the 1900 PHC centers in the country. Efforts are now being made to improve the training of medical practitioners to help them recognise and treat psychiatric problems, as well as train psychologists and social workers to screen for mental and emotional illness in these settings.

It says there are also plans to develop more consultation-liaison services in tertiary care hospitals and to establish more psy-chiatric inpatient services in general hospitals. Finally, pharmacists are being trained to monitor psycho-tropic drug use and educate patients about these drugs, since research has shown that such education improves drug adherence by 15 per cent to 27 per cent. While there has been progress in training of primary care physicians (PCPs) to identify mental health problems in PHC centers, detection rates remain low.

Earlier research reported that Saudi PCPs missed up to 90 per cent of patients with psychiatric problems. More recent research indicates improvement, although PCPs in the Kingdom still miss more than half of those with psychiatric disorder. While detect mental health problem by PCPs remains a problem in Saudi Arabia, detection rates in US primary care settings are not much better. Research has shown that Saudi PCPs can be trained to recognise mental disorders in medical patients.

Improved detection rates have been documented after only a 3 or 4-day course of didactic lectures with a clinical practice component, although this also depends to some degree on exposure to psychiatric training in medical school. There are many barriers that need to be overcome to increase the detection and treatment of mental health problems in KSA primary care settings, the study says.

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