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Nour Elsawy

Grade 10

Research Paper
Topic:
The Egyptian community perception of mental illness
Introduction:
Mental health refers to our behavioral and emotional wellbeing, it is all about how we think,
feel, and behave. The term 'mental health' is sometimes used to mean an absence of a mental
disorder. One in every 4 people are affected by poor mental health at some points in their
lives and 7 % of Egyptians suffer from mental illness. So why don’t people feel comfortable
when discussing their mental condition? On the other hand how does the Egyptian
community perceive the mental illness.

Resources:
 http://ephase.org
 https://www.egypttoday.com/Article/6/30687/‘Break-the-Silence’-A-new-mental-
health-awareness-movement
 http://www.cairoscene.com/In-Depth/Mental-Health-in-Egypt-8-Stories-of-The-
Stigma-by-Patients-and-Professionals
 https://www.independent.co.uk/voices/world-mental-health-day-wellbeing-
depression-eating-disorders-recovery-anxiety-a7993031.html
 https://www.mentalhealth.org.uk/campaigns/mental-health-awareness-week
 http://education.qld.gov.au/health/healthpromotion/mental-health-awareness-
prog.html
 https://egyptianstreets.com/2016/12/13/are-psychiatric-hospitals-in-egypt-hurting-
mental-health-care/
 https://www.egypttoday.com/Article/1/48156/25-of-Egyptians-suffer-from-mental-
health-issues-survey
 https://www.researchgate.net/publication/7426670_Mental_health_in_Egypt
 https://bayanatbox.info/mental-health-egypt-challenges-progress/
 http://www.egyptindependent.com/7-of-egyptians-suffer-from-mental-illness-health-
ministry/
 https://www.ncbi.nlm.nih.gov/pubmed/16342608
 http://www.auccaravan.com/?p=4971

Outline:
 introduction
 2. Paragraph: common forms of mental illness
 3. Paragraph: stigma and wrong perception of mental illness
 4. Paragraph: effect of mental illness on personal level and community level
 5. Paragraph: raising awareness regarding the importance of mental health
 conclusion

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Grade 10

1. https://egyptianstreets.com/2016/12/13/are-psychiatric-hospitals-in-egypt-hurting-mental-
health-care/

Are Psychiatric Hospitals in Egypt Hurting Mental Health Care?

Community mental health approaches can tackle Egypt’s psychiatric problems, yet the reliance
on mental health hospitals is not only solidifying stigma but also hindering access to mental
health services.

On the 25th of January 2011, as Egyptian pro-democracy protestors marched towards Tahrir
Square hoping to incite political change, another extraordinary scene of communal resilience
was taking place elsewhere in the country. In the district of Kafr al Dawar, some 23
kilometers away from Alexandria, the local commune at the village of Kobania Abu Qir, had
gathered to inaugurate Egypt’s first and only mental health center.
“It was very special. This was the first time that those suffering from mental illness, their
families, and community leaders, including the governor, the church priest, the local imam,
the school headmaster and traditional healers had come together to decide and get involved
with how mental health care could be provided in the community,” says Dr. Eman Souror,
who has dedicated a lifetime towards working on alternative approaches to mental health care
in Egypt.
The former international officer at the Mental Health Secretariat and the lead psychiatrist
who launched the center as part of an Egyptian-Italian public initiative, Sorour was finally
able to witness Egypt taking its first step towards transferring mental health services from
mostly urban-based psychiatric hospitals to community-centered treatment.

Sahar, a 38-year-old single mother from Kafr al Dawar, suffers from acute depression. In
2011, she got divorced and had lost her minimum wage job at a textile factory. Having
moved back with her family with no prospects and a child to raise, Sahar started suffering
from extreme withdrawal and anxiety, causing physical inability to cope with her changed
circumstance – a time she remembers as the “darkest phase” of her life. Confused, she would
trap herself in her room and, spending days in isolation, would question her tormented mind.
While knowing her life had taken a turn for the worse, yet still unable to find the source of
her helplessness, she admitted herself to the Maamura psychiatric hospital in Alexandria.
Reluctant to get hospitalized, yet pressured by her family and deteriorating condition, she
checked in knowing that mental hospitals were considered to be only for the deranged.
“I was forced to take injections overnight and I suddenly found myself becoming delirious
and out of control,” she says, recalling her short stint at the hospital. “I became violent. I was
breaking things, screaming, and in an act of rage started pulling my hair out.”
Sahar had never suffered such extreme behavior before and realized that she could not be
cured in a hospital that relied solely on medication; the next morning, she insisted on being
checked out.
As one of the first patients to receive care at the community mental health center, today, she
realizes how beneficial her treatment plan is. It not only includes medication, but also group
therapy and individual counseling.

“My family at first did not understand my depression, mostly because I didn’t,” says Sahar.
Today, due to the services provided at the center, her family not only understands her illness

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but is also better equipped to manage her depressive episodes.
In 2012, the Ministry of Health and Population’s register for psychiatric services listed the
Franco Basaglia Center as Egypt’s first active mental health community center, which, until
today, is managed and staffed by publicly employed primary care physicians.
The facility, which is minutes away from her home, has a strong referral system linked with
psychologists from Maamura hospital that follow up with acute cases, hospitalizing patients
only if need be. The model is exceptional in bridging a treatment gap and helps Sahar access
mental health services while staying within her community. This model not only reduces
prospects of exclusion and isolation from society but also provides those who are mentally ill
with a safe space in which they are not “patients” but instead “members” of a center in charge
of providing mental health care.
In the first 15 months after its opening, 365 patients, along with Sahar, had benefited from the
community approach adopted in Kafr al Dawar. Unfortunately, despite the evident need of
such services, plans to expand and roll out the model in five other governorates have yet to be
implemented and there remains only one community mental health center of its kind in the
country.
This task shifting showed positive results, providing an effective response to the mismatch
between needs and resources that plagues access to mental healthcare in Egypt today.

Summary of the first recourse:


2011 in Kafr el Dawar there was built Egypt’s first and only mental health center. It was
something very special to treat the people suffering from mental illness. Sahar, a single
mother, had a very difficult life after her divorce and at the same time she suffered from
mental illness. She lost control of herself which led to depression and anxiety. Then she was
one of the very few who decided to be treated in Kafr el Dawar and she got successfully
recovered.

2. https://www.egypttoday.com/Article/1/48156/25-of-Egyptians-suffer-from-mental-
health-issues-survey

25% of Egyptians suffer from mental health issues: survey


By: Egypt Today staff Wed, Apr. 18, 2018

 

CAIRO – 18 April 2018: According to a nation-wide survey recently conducted by the
Ministry of Health, 25 percent of the population is found to be suffering from mental health-
related problems.

The study showed the prevalence of anxiety and depression disorders among that quarter of
the respondents, with approximately 43.7 percent suffering from anxiety disorders, while
30.1 percent are suffering from depression that is linked to substance abuse.

During the press conference held by the ministry to announce the findings of the random
sample of 22,000 families across the country, Mona Abdel Maksoud, director of the General
Secretariat of Mental Health, announced that the governorate of Minya has the highest
percentage of people suffering from anxiety.

The rural governorates had the highest rates of the depression and anxiety when compared to

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their urban counterparts, Abdel Maksoud added, emphasizing the ministry’s keenness to
develop more effective strategies to respond to mental health issues and to increase society’s
awareness of the importance of acknowledging such illnesses in order to put an end to the
stigma attached to them.

She added that the ministry is currently working on increasing the number of walk-in mental
clinics across Egypt.

“The findings of the survey confirm the dire need to be more focused on expanding mental
health services and awareness, especially in the underprivileged areas that have limited
access to services and treatment for mental issues,” Hisham Ramy, secretary-general of the
General Secretariat of Mental Health, said during the press conference.

The study also suggests that a family history rife with mental illness can be one of the main
contributors to the high chance of a person developing mental health issues, emphasizing the
importance of integrating diverse activities and sports into the daily routine of people, which
can significantly lead to a reduction of such issues.

3. https://www.ncbi.nlm.nih.gov/pubmed/16342608

2005;42(2):116-25.
Mental health in Egypt.
Okasha A1.
Author information

1
WHO Collaborating Center for Training and Research, Institute of Psychiatry, Ain Shams
University, Kasr El-Nil, Cairo, Egypt. aokasha@internetegypt.com
Abstract
The concepts and management of mental health in Egypt are presented from the Pharaonic
era through the Islamic Renaissance until today. Papyri from the Pharaonic period show that
Soma and Psyche were not differentiated and mental disorders were described as symptoms
of the heart and uterus. Although theories of causation were of a mystical nature, mental
disorders were treated on a somatic basis. In the Islamic era, mental patients were neither
maltreated nor tortured as a consequence of the belief that they may be possessed by a good
Moslem genie. In the 14th century mental disorders was one of the four departments in
Cairo's Kalawoon Hospital, a precursor of the place of psychiatry in general hospitals that
was accepted in Europe six centuries later.

Paraphrase of the third recourse:


Mental health in Egypt were represented from the era of the pharaohs to the Islamic era until
today. In the pharaonic era mental disorders were described as symptoms of the heart and the
uterus and they were treated on a somatic basis. In the Islamic era mental health patient were
neither maltreated nor tortured as a consequence of the belief that they may be possessed by a
good Moslem genie. In the 14th century mental health had its high point in Egypt. It was one
of the four departments in Cairo’s Hospital.

CARS:

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Nour Elsawy
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Credible:
-This text is written by an expert in the mental health field his name is Ahmed Okasha
-It is also .gov which means it was published by the Egyptian government
-this abstract is for mental health awareness and it explains mental heath throughout the
different eras
Accurate:
-this source gives a lot of clear information
-this source does not have a biography
Relevant:
-this abstract is connected to my research topic, because it explains the evolution of the
Egyptian society in mental health
Sufficient:
-this abstract does not answer my whole research question but if I combine it with other
sources it answers the question

4. http://www.auccaravan.com/?p=4971

EDITOR’S NOTE: MENTAL HEALTH AND SOCIAL STIGMA IN EGYPT


MAY 8, 2017 THE CARAVAN
Lives Unraveled, Lives Rebuilt
By: Mohamed Kouta
Editor-in-Chief
You turn on the news and hear that Prince Harry has been suffering from depression since the
death of his mother, Princess Diana.
So, you flip the channel after a couple of minutes and hear how they’re trying to
constitutionally impeach President Donald Trump on the grounds of mental incompetence.
And that’s all very dramatic so you then turn on Netflix, where Westworld and 13 Reasons
Why are now among the most-watched series of the day.
Or perhaps you’re not even home at all and instead driving on the roads. Some truck
overtakes you and as you honk at them, you make that tired gestures we all know and yell
“enta magnoun?” (are you crazy?) at them.
Or how about that one time that one professor failed you and you instead dismissed it
because “el set di las’a” (this woman is deranged)?
And so it’s clear that our days are charged and full to the brim with references to the state of
mind.
Yet despite a constant allusion to a person’s mental well being, there is a surprising lack of
awareness about mental health issues.
We hear others joke about all the time.
It’s become an eccentricity that makes movie characters and TV stars all the more interesting.
But rarely do we ever stop to engage with what these representations actually mean for us, for
those who actually do suffer from mental illness ,and for the society at large.
According to a study conducted for the National Survey of Prevalence of Mental Disorders in
Egypt in 2009, approximately 16.93 percent of the population suffers from a form of mental
disorder.
Published in the Eastern Mediterranean Health Journal, the study diagnosed 14,640 adults
aged 18-64 years across five regions in Egypt using a MINI-Plus methodology.
It was concluded that 6.43 percent of the studied population suffers from mood disorders,
4.75 percent from anxiety disorders and 4.72 percent from identity disorders.
Scott Stossel, the editor of The Atlantic, once said “to grapple with and understand anxiety is,
in some sense, to grapple with and understand the human condition.”
This existentialist view of anxiety has its roots in the father of psychoanalysis, Sigmund

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Freud, who said that the ‘riddle of anxiety’ is central to the human condition, and that our
mental life is characterized by psychic conflict.
Anxiety, in turn, is a signal that our unconscious drives are in conflict; the ego is repressing a
libidinal impulse we are not even aware of. All we are aware of is this anxiety itself.
The pervasiveness of anxiety disorders is considered in Students Increasingly Deal with
Anxiety, below.
This article explores both the individual and structural factors that contribute to the
prevalence of anxiety on campus.
Far From Home probes into the issue of international students on campus and how separation
from their home country can create long-lasting and severe bouts of anxiety and depression.
Globally, about 450 million people suffer from mental or behavior disorders, and most
studies seem to conclude that the figure is likely to increase in the near future.
In both Egypt and abroad, it seems that though there is indeed a genetic tendency to develop
certain mental disorders, these are exacerbated by existing socio-demographic factors.
In fact, in Egypt, the primary factor triggering the onset of mental and behavior disorders is
“being female.”
And so, it is clear now that mental health is not just a question of individual behavior but that
of a systematic and structural social flaw.
Nearly all societies, despite any claim to their progress on gender rights, inevitably
disempower women or otherwise place them at the end of the social ladder.
Mental health also appears to be a question of class: different disorders are more prevalent in
different levels of society.
Malak Saad’s article In Search of Ballerina Bodies features a study in which it was found that
eating disorders in Egypt are more common in urban areas than they are in rural
communities.
Alternately, it is also apparent that individuals in rural communities develop disorders that
have their roots in exposure to violence.
But violence is not confined to the lower and middle classes. In fact, it is a pervasive social
phenomenon that plagues homes across all economic classes.
The two articles on page four explore how patterns of violence can have discursive effects
both within and beyond the household they occur in.
Exposure to physical violence understandably carries significant psychological and
developmental after-effects that can severely impair the wellness of both the parties involved
and their children.
Egypt is a signatory to the Convention on the Rights of the Child, Article 19, which mandates
States Parties to “take all appropriate legislative, administrative, social an educational
measures to protect the child from all forms of physical or mental violence.”
And the country has indeed incorporated this provision within its domestic legislation. The
Child Law (No. 12 of 1996) was amended by Law No. 126 of 2008.
Article 3(a) of the law reflects the obligation under Article 19 of the Convention on the
Rights of the Child. But Its enforcement is lacking and domestic violence persists on a wide
scale.
The United Nations International Children’s Emergency Fund conducted a study in 2015,
revealing that 61 percent of children in Cairo suffer from physical abuse, compared to 65
percent in Alexandria and 67 percent in Assiut.
A report commissioned by Amnesty International in 2015 includes a survey conducted by the
Ministry of Health, which reveals that approximately half of all Egyptian women suffer from
spousal violence.
Almost equally as destructive is the widespread substance abuse endemic across Egypt.
Again, substance abuse is more common among the poor and in the rural areas. The most

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common drug of intake is Tramadol, which Egypt’s United Nations Office on Drugs and
Crime (UNODC) says is the cheapest and most easily available on the streets.
However, the dangers of substance abuse do not stop at addiction.
As explored through anecdotal accounts in Danah Al Ansari’s The Chains of Addiction, the
prevailing social stigma regarding substance abuse has drastically blocked efforts at
reintegration.
In fact, social stigma has contributed to the aggravation of various mental disorders.
These forms of exclusion can be found on the macro level, and are primarily directed against
distinct social groups.
Aside from women and children, homosexuals are perhaps among the most aggressively
discriminated against in Egypt.
However, the criminalization of homosexual behavior is still rooted in a perception that it
constitutes a medical anomaly.
First published in 1968 by the American Psychiatric Association (APA), the Diagnostic and
Statistical Manual of Mental Disorders (DSM) did indeed list homosexuality as a mental
disorder.
But that view has long since been abandoned. The APA delisted homosexuality as a mental
disorder in 1987, followed by the World Health Organization in 1992.
Yet, what LGBT in Egypt reveals is that many still operate under this logic. Many are still
being ‘treated’ by psychiatrists and psychologists for their homosexuality.
Those struggling with these disorders often have their lives made more difficult due to the
social stigma surrounding mental health.
Egyptian society still views mental illness as an aberration, as something left in the shadows,
something to be kept under wraps.
Sadly, the conventional wisdom here is that seeking help is an admission of weakness, as
something that brings shame and dishonor to the family.
But until we stop and reconsider the effects of this stigma on compounding mental illnesses,
we cannot expect the situation to get any better.

CARS:
Credible:
-This text is not written by an expert in the mental health field his name is Mohamed Kouta it
is his own opinion about mental health
-It is also .com which means it was published by the Egyptian community
-this abstract is for mental health awareness and it explains mental heath throughout our daily
lives and the media
Accurate:
-this source gives a lot of clear information
-this source does not have a biography
Relevant:
-this abstract is connected to my research topic, because it explains how the Egyptian
community perceive the mental health illness.
Sufficient:
-this abstract does answer m research question