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Breaking the Silence: Tackling Mental Health Stigma and Challenges for Youth in Jordan

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By: Fabienne Rorke, Renaissance Strategic Center Assistant

Mental health challenges affect youth worldwide and Jordan is no exception. Yet stigma surrounding mental health remains a significant barrier, leaving many unable to access the support they need. Jordan’s mental health burden is significant, reporting 15,412 cases per every 100,000 people in 2021. Yet, its mental health services are ill-equipped to deal with such challenges (Institute for Health Metrics and Evaluation, n.d.). With research indicating that half of the global population will experience a mental health disorder in their lifetime, steps must be taken to improve mental health care in Jordan and work towards dismantling the prevailing stigma (QUEENSLAND BRAIN INSTITUTE, 2023).

This blog, inspired by conversations with young people and artists, delves into the state of mental health services in Jordan, highlighting the challenges of social stigma and gaps in support networks. It paves the way for a follow-up blog exploring the role of art in addressing these issues.

 

Addressing the Terms: Mental Health and Mental Wellbeing

Misunderstandings around the term “mental health” can exacerbate the prevailing stigma. Whilst some still consider it to be purely the absence of mental disease, mental health experts are moving away from this limiting definition and incorporating mental well-being into an understanding of the term. For example, the WHO defines mental health as a “state of well-being in which an individual realizes his or her abilities, can cope with the normal stresses of life, can work productively, and can make a contribution to his or her community” (World Health Organization, 2022).

Although mental health pertains specifically to the brain’s health and emotional stability, whereas mental well-being is broader and refers to our sense of self and the ability to live our lives the way we want to, the terms go hand-in-hand. Good mental well-being is crucial for achieving good mental health, as it reduces the likelihood of developing a mental illness.

Joud Al-Hadid, an art therapist based in Amman offers her definition, saying that mental health is “a foundation of how we think, how we act, how we feel, how we interact, how we react to everything happening around us. Plus, I found it’s about balance; balancing our strengths and our weaknesses and finding ways to cope with life challenges.”

 

Mental Health in Jordan: A Complex Reality

Jordan has made significant improvements to its mental healthcare system in recent years and was the first of six countries chosen to implement the WHO’s mental health action program (mhGAP) in 2008 (World Health Organization, n.d.). Despite this, many challenges still exist. Jordan lacks the resources to cater to mental health support with under 1 psychiatrist and 0.13 psychiatric nurses per 100,000 people, meaning that many are unable to access the care they need (Ministry of Health, 2021). The mental health care available is also limited in scope, with most funding directed towards psychiatric hospitals and related outpatient services, leaving little support for preventative care, community-based care and counseling services (World Health Organization, 2024).

Stigma exacerbates these issues, preventing many from accessing the support they need. Reports suggest that a staggering 41% of the total number of delayed visits to mental health services, cessation of visits, noncompliance, and delayed improvement was found to be due to stigma (Dr. Dmour, H., et al., 2020). With reports highlighting that the stigma surrounding mental health is partially due to individuals perceiving those with mental health illnesses as dangerous, there is a significant need for educational programs to tackle such misunderstandings. Even with an increase in mental health services, if individuals are not aware of the importance of mental health and mental well-being, they are unlikely to be willing to access them.

 

Youth-Specific Challenges: Unemployment, Substance Misuse, and Constraints on Expression

Young people in Jordan are particularly affected by mental health challenges. Research suggests that “more than 25% of Jordan’s population, mostly youth, still require appropriate psychological treatment due to various mental illnesses”, yet due to stigma and a lack of qualified mental health professionals, many do not receive the treatment they need (King Hussein Foundation, 2023). With the median age of the population in Jordan being 22.9 years old – meaning that half the population is under this age – youth mental health has a huge impact on Jordanian society (Higher Population Council, 2024).

The unique pressures faced by youth groups in Jordan exacerbate mental health challenges. Factors include high unemployment, substance misuse, academic pressure, regional conflict, and a lack of avenues to express themselves. In Jordan, the unemployment rate stood at 21.5% in the third quarter of 2024, reaching 40.8% amongst youth groups in 2023 (Trading Economic, n.d.). Refugee youth, in particular, face additional challenges due to their inability to work legally, compounding the pressures they face. With research suggesting that unemployment is associated with substantially greater depression and anxiety, unemployment is a major mental health concern in Jordan (Arena, A.F et. al, 2023).

Substance abuse is another growing concern. Globally, substance abuse has been linked to mental health challenges, with youth particularly at risk as substance use can interfere with brain development (National Institute of Mental Health n.d.). Drugs like Captagon are linked to severe long-term health consequences, including depression, anxiety, and self-harm (Steenkamp, 2024). With the Public Security Directorate reporting about 18.3 thousand crimes in 2022, between drug use, possession, and trafficking – including the consumption of Captagon – drug awareness campaigns should be implemented to address this issue (Jordan Strategy Forum, 2023). The compounding effects of drugs on mental health highlights the need to address the factors driving mental health disorders and focus on preventative mental health care models.

The lack of preventative health care models is reflected in youth groups expressing limited room for self-expression. When interviewing young artists on what they thought were the main contributing factors towards mental health challenges, this was one factor that frequently came up. One interview participant said that youth are constrained from expressing themselves, limiting their potential for success. Another highlighted that there is little space for her to express herself, especially when it comes to artistic expression. Limiting spaces where youth feel free to express themselves leads to feelings of isolation which could, in turn, lead to substance misuse and mental health disorders. This further points to the need for preventative care, which could come in the form of community spaces, where youth can meet and discuss ways to enhance mental well-being, thus breaking the silence around mental health through active engagement.

 

Gaps in Current Mental Health Support and Ways Forward

A notable setback within Jordan’s mental healthcare landscape, is that they are currently facing a significant gap in mental health programs, particularly community-based services at primary care level. To bridge this gap international donors and NGO’s including ARDD provide psychosocial support to refugees and vulnerable Jordanians but with services so heavily dependent on international aid, these efforts are unsustainable in the long-term (World Health Organization, 2024). As such, the Jordanian Ministry of Health needs to focus more attention on community-based support to prevent a rise in mental health disorders and address the stigma surrounding mental health.

Breaking the stigma is essential; youth need spaces where they can talk openly about mental health. Expanding counselling services and community-based support can encourage open-dialogue and prevent the need for psychiatric care in the future. To delve further into this topic, an upcoming blog will explore how art and community-arts projects can help relieve the stigma surrounding mental health and open up avenues for youth to express themselves – a vital step we must take together.

 

Recommendations

  • Increased funding towards preventative and community-based mental health services, including therapy and counselling services and community-based projects.

With only 1 psychiatrist and 0.13 psychiatric nurses per 100,000 people, it is critical that efforts are taken to increase the mental health services available and offer mental health support at affordable prices. Although psychiatric facilities are important, there needs to be a greater focus on preventative and community-based care, which can limit the need for psychiatric care in the future.

  • Advocacy campaigns to tackle the stigma surrounding mental health in Jordan

Stigma is currently one of the main contributing factors for youth groups in Jordan not accessing the mental health support they need. Advocacy campaigns should be implemented to educate youth groups on mental health, including guidance on how to improve mental wellbeing.

  • Open up spaces throughout the city, where youth feel free to express themselves

With interview participants expressing that there is limited space for self-expression in Jordan, spaces – including arts spaces – should be opened up throughout the city where youth groups can come together to discuss topics that are relevant to their own lived experiences.

  • Heightened focus on drug awareness campaigns

As drug and alcohol abuse can lead to heightened levels of mental health disorders, drug and alcohol awareness campaigns must be implemented to educate youth of the dangers of substance abuse.

 


References

Arena A.F, Sophia Mobbs, Samineh Sanatkar, Douglas Williams, Daniel Collins, Marnie Harris, Samuel B. Harvey, Mark Deady. “Mental health and unemployment: A systematic review and meta-analysis of interventions to improve depression and anxiety outcomes”, Journal of Affective Disorders, Volume 335. 2023. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0165032723006638

ARDD. 2023. PSS Support Group Sessions. Accessed December 12, 2024. Available at: https://ardd-jo.org/wp-content/uploads/2023/03/PSS-Support-Group-Sessions-English.pdf.

Dr. Hussein H. Dmour MD, Dr. Muath F. Marashdeh MD, Dr. Arfat k. Al-Zubi MD, Dr. Maxim A. Obaisat MD, Dr. Malik M. Al-Alwan MD. “Stigma of Mental Illness in Jordan”. April 2020. Journal of the Royal Medical Services. Vol. 27. Available at: http://rmsjournal.org/Articles/637272936889767110.pdf

Higher Population Council. 2024. Jordan Demographic Indicators Sheet 2024. Accessed January 14, 2025. Available at: https://www.hpc.org.jo/sites/default/files/jordan_demographic_indicators_sheet_2024.pdf

Institute for Health Metrics and Evaluation. n.d. “Mental Health Research Library.” Accessed December 12, 2024. Available at:  https://www.healthdata.org/research-analysis/health-risks-issues/mental-health-research-library

Jordan Strategy Forum. 2023. The Reality of Drug Crimes in Jordan. Accessed December 12, 2024. Available at: https://www.jsf.org/uploads/2023/06/25/The%20Reality%20of%20Drug%20Crimes%20in%20Jordan-1687702165.pdf

King Hussein Foundation, Information and Research Centre. “Traumatized Youth and MHPSS Health Seeking Behaviour in Jordan”. (May, 2023). English version. Available at:  https://haqqi.s3.eu-north-1.amazonaws.com/2023-10/Traumatized%20youth%20and%20MHPSS%20health%20seeking%20behaviour%20in%20Jordan%20English%20version.pdf

Ministry of Health. 2021. National Mental Health and Substance Use Action Plan 2022–2026. Accessed January 13, 2025. Available at: https://www.moh.gov.jo/ebv4.0/root_storage/en/eb_list_page/national_mhsu_action_plan_2022-2026_(english)_(2)-0.pdf.

National Institute of Mental Health. n.d. “Substance Use and Mental Health.” Accessed December 12, 2024. Available at: https://www.nimh.nih.gov/health/topics/substance-use-and-mental-health

QUEENSLAND BRAIN INSTITUTE, “Half of World’s Population Will Experience Mental Health Disorder.” Harvard Medical School, July 31, 2023. https://hms.harvard.edu/news/half-worlds-population-will-experience-mental-health-disorder

Shukla A, Choudhari SG, Gaidhane AM, Quazi Syed Z. 2022. “Role of Art Therapy in the Promotion of Mental Health: A Critical Review”. Cureus. Available at:  https://pmc.ncbi.nlm.nih.gov/articles/PMC9472646/

Steenkamp, Christina. 2024. “Captagon and Conflict: Drugs and War on the Border between Jordan and Syria.” Mediterranean Politics, January, 1–25. Available at: https://www.tandfonline.com/doi/citedby/10.1080/13629395.2023.2297121?scroll=top&needAccess=true

Trading Economics. N.d. “Jordan Unemployment Rate.” Accessed January 13, 2025. Available at: https://tradingeconomics.com/jordan/unemployment-rate

World Bank. 2023. “Unemployment, Youth Total (% of Total Labor Force Ages 15-24) (Modeled ILO Estimate).” DataBank. Accessed January 14, 2025. Available at: https://data.worldbank.org/indicator/SL.UEM.1524.ZS?end=2023&start=2020.

World Health Organization. “Mental Health in Jordan.” Last modified 2022. Accessed January 13, 2025. Available at:  https://www.emro.who.int/jor/jordan-news/mental-health-in-jordan.html.

World Health Organization. “Mental Health: Strengthening Our Response.” Last modified June 17, 2022. Accessed January 13, 2025. Available at: https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response

World Health Organization. WHO Special Initiative for Mental Health: Jordan Design Summary. November 2022. Accessed January 13, 2025. Available at: https://cdn.who.int/media/docs/default-source/mental-health/special-initiative/simh-design-summary-jordan-11_2022.pdf?sfvrsn=d0729c6f_1

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