Abstract
Background
Most mental health disorders begin to develop in adolescence and early adulthood. These disorders account for a significant portion of hospitalization and other societal costs. The United Arab Emirates (UAE) has a rapidly growing population, one-third of which is below 25 years of age. The UAE government has pointed at mental health as one of the areas requiring attention and has approved a strategic plan supporting mental health research, education and promotion with a specific focus on youth (Dubai Mental Health Strategy 2021). The current study represents the first investigation aimed at characterizing youth who access mental health services in the UAE (specifically Dubai).
Methods
Data was collected retrospectively from child psychiatry case records of inpatients who accessed the Mental Health Clinic at Rashid Hospital between 2011–2016. Patients who received a diagnosis of schizophrenia spectrum disorders, bipolar and related disorders, depressive disorders or anxiety disorders were included. From patients’ records, information collected included demographics, life stressors (related to family, friends, health, academic performance, or religion), duration of untreated illness (DUI), family history of mental illness, parents’ age and education, main diagnosis, presence/absence of psychotic features. Demographic information and family history had been acquired from patients and family members at the time of intake.
Results
The final sample (N=99; Age 12–19) included 47.5% local (UAE national) and 52.5% non-local patients. The frequency of life stressors did not differ across ethnic groups except for relationships with friends, which were less likely to be reported as a source of stress among UAE nationals (χ2=4.35; p=0.04) compared to other nationalities. Suicidal thoughts were less common in patients with psychotic features compared to patients without psychotic features (χ2=4.64; p=0.03). A diagnosis of Depression was more common in females than males (χ2=3.93; p<.05) and was associated with more frequent suicidal thoughts (χ2=23.81; p<0.001) and self-harm behavior (χ2=16.20; p<0.001). Separate ANOVAs were conducted to explore the effect of different variables on DUI: results showed that presence of Psychotic features was associated with shorter DUI (F (1,55) =4.37; p<0.05) while Self-harm was associated with longer DUI (F (1,70) =5.82; p<0.05).
Discussion
To our knowledge, this is the first study attempting to describe youth who access mental health services in the urban multi-cultural context of Dubai. A number of interesting findings were highlighted. Relationships with friends were more likely to represent a source of stress for non-local than local patients, suggesting a possible role of adjustment and social stress in migrant/expatriate youth. Suicidal thoughts were more common in patients diagnosed with depressive disorders (somewhat expected) but less common in patients presenting psychotic features. Patients experiencing psychotic symptoms were accessing mental health services sooner (shorter DUI) compared to patients who did not experience psychotic symptoms, in line with previous literature. Interestingly, patients reporting self-harm behaviors had longer DUI. Several interpretations can be proposed, for example, it is possible that self-harm represented a copying strategy to temporarily “handle” mental illness and delay help seeking in our sample. Studies in support of this and alternative explanations will be discussed. Taken together, our study can be a useful start point to open prevention-focused mental health discussions in the UAE and lead to improved national policies to promote youth wellbeing in the region.
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