628896 letter2016

ISP0010.1177/0020764016628896International Journal of Social PsychiatryAlamri

E CAMDEN SCHIZOPH

Letter to the Editor

Mental illness in Saudi Arabia: Stigma and acceptability

International Journal of Social Psychiatry 1­–2 © The Author(s) 2016 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/0020764016628896 isp.sagepub.com

Yassar Alamri1,2,3

Mental health disorders are very prevalent in Saudi Arabia, present in almost one-fifth of primary-care clinic attendees (Al-Khathami & Ogbeide, 2002), and reportedly reaching rates as high as 48% in certain populations (Almutairi, 2015). Despite these alarming figures, however, social stigma (Alnamlah, 2006) and doubts towards the legitimacy of mental illnesses (Al-Habeeb, 2003; Hussein, 1991) still persist in the Saudi society. Almost all of the published literature pertinent to the subject in Saudi Arabia comes from hospital audits (AbuMadini & Rahim, 2002; Alnamlah, 2006) or attitudes of health care workers (El-Gilany, Amr, & Iqbal, 2010, Shahrour & Rehmani, 2009). The attitudes of health care workers are not necessarily representative. Because of their direct interaction with mental illness patients, health care workers are often found to be accepting (Corrigan et al., 2001) and caring (Shahrour & Rehmani, 2009). Literature on the attitudes towards mental health from the wider population is still lacking. The only available data on the acceptability of mental health come from a large study on anxiety and depression in Saudi patients (Alamri, unpublished). This study involved administering the Arabic Hospital Anxiety and Depression Scale (HADS) to a sample of 237 outpatients in a tertiary neurology clinic and their family members. A cut-off score of 11 on either sub-scale (anxiety or depression) was the threshold to suggest referral to mental health services for further assessment. A total of 34 patients (14.3%), who were excluded from the study, were surveyed. Fifteen patients refused to complete the HADS once they learned it was investigating anxiety and depression, while the other 19 patients initially agreed to the study, but declined to continue once mental health input was suggested. These patients were not different to patients included in the study in their sex (male, 61% vs 56%, p = .64), age group (

Mental illness in Saudi Arabia: Stigma and acceptability.

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