Advertisement

Child and adolescent psychiatry training and services in the Middle East region: a current status assessment

  • Carolyn E. ClausenEmail author
  • Khalid Bazaid
  • Muhammad Waqar Azeem
  • Fathelaliem Abdelrahim
  • Ahmed A. Abd Elgawad
  • Bibi Alamiri
  • Ahmed Malalla AlAnsari
  • Ali Alhamzawi
  • Ahmad Mohammed Al Mai
  • Aisha Motwakil Bakhiet
  • Mahmoud Bashtawi
  • Füsun Çuhadaroğlu
  • Mazen Hedar
  • Mohammad Holdar
  • Samah Jabr
  • Ather Sajjad Jafri
  • Amjad Jumaian
  • Suaad Moussa
  • Abdelgadir Hussein Osman
  • Katayoon Razjouyan
  • Eyad Yanes
  • Anthony Guerrero
  • Norbert Skokauskas
  • Consortium on Academic Child, Adolescent Psychiatry in the Middle East (CACAP ME)
Original Contribution
  • 145 Downloads

Abstract

Mental health is a key component of health, yet appropriate care is limited. Evidence concerning child and adolescent mental health has predominantly come from western countries, while the Middle East region, with a large youth population, has reported very little on it. This original, cross-sectional study of child and adolescent psychiatry in the Middle East provides an assessment of current postgraduate programs, services and what is needed to build workforce capacity. Academic psychiatrists from 16 Middle East countries were invited to form a Consortium to map current postgraduate training as one of the determinants of available child and adolescent psychiatry services, identify gaps in the distribution of child and adolescent psychiatrists, and propose potential steps to improve access to child and adolescent mental health care. The study collected data from 15 of the 16 countries invited (no data provided from Yemen). The study revealed underdeveloped child and adolescent psychiatry academic systems throughout the region. Despite recognition of the specialty in a majority of the countries (11/15), only six countries had established a designated child and adolescent psychiatry training program. The overall shortage of child and adolescent mental health specialists varied, yet all Consortium members reported a need for additional child and adolescent psychiatry specialists and allied professionals. Lack of child and adolescent psychiatry specialized programs in place throughout the region has evidently contributed to the shortage of qualified child and adolescent mental health workforce in the Middle East.

Keywords

Child and adolescent psychiatry (CAP) Postgraduate training Middle East (ME) Child and adolescent mental health 

Notes

Acknowledgements

We would like to thank all Consortium members who contributed to the collection of data and sharing of information for the successful completion of this study and advancement made towards the evidence-based knowledge surrounding child and adolescent psychiatry. A special thank you and acknowledgment to Dr. John Fayyad for his endless contributions to the field; his dedication and invaluable insight will be missed.

Compliance with ethical standards

Conflict of interest

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethical approval

No ethical approval was required for the information-gathering in this study, as it did not involve the collection of personal information or biological material, but the organization of generally publicly-available information that was known to the representative professionals as Consortium members.

References

  1. 1.
    World Health Organization (2016) mhGap intervention guide: for mental, neurological and substance use disorders in non-specialized health settings, Version 2.0. The World Health Organization, Geneva. https://www.who.int. Accessed Apr 2017
  2. 2.
    United Nations (2015) Transforming our world: the 2030 agenda for sustainable development. Department of Economic and Social Affairs; 2015. https://sustainabledevelopment.un.org/post2015/transformingourworld/publication. Accessed Apr 2017
  3. 3.
    United Nations (2018) UN data: a world of information [Internet]. United Nations, Department of Economic and Social Affairs: Statistics Division; 2018 [updated 2019]. https://unstats.un.org/home/. Cited Apr 2018
  4. 4.
    Sachs JD (2012) From millennium development goals to sustainable development goals. Lancet 379:2206–2211CrossRefGoogle Scholar
  5. 5.
    Patel V, Kieling C, Maulik PK, Divan G (2013) Improving access to care for children with mental disorders: a global perspective. Arch Dis Child. 98:323–327CrossRefGoogle Scholar
  6. 6.
    Erskine HE, Baxter AH, Patton G, Moffitt TE, Patel V, Whiteford HA et al (2017) The global coverage of prevalence data for mental disorders in children and adolescents. Epidemiol Psychiatr Sci. 26:395–402CrossRefGoogle Scholar
  7. 7.
    World Health Organization (2011) Regional Office for the Eastern Mediterranean. Atlas: child, adolescent and maternal mental health resources in the Eastern Mediterranean region. Geneva, Switzerland: World Health Organization. EMRO Technical Publication Series 39. https://www.who.int/iris/handle/10665/119949. Accessed Apr 2017
  8. 8.
    Wille N (2008) Risk and protective factors for children’s and adolescents’ mental health: results of the BELLA study. Eur Child Adolesc Psychiatry. 17(1):133–147CrossRefGoogle Scholar
  9. 9.
    McGorry PD, Purcell R, Goldstone S, Amminger PG (2011) Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Curr Opin Psychiatry. 24(4):301–306CrossRefGoogle Scholar
  10. 10.
    Kieling C, Baker- Henningham H, Belfer M, Conti G, Ertem I, Omigbodun O et al (2011) Child and adolescent mental health worldwide: Evidence for action. Lancet Glob Mental Health. 378(2):1515–1525Google Scholar
  11. 11.
    Kaushik A, Kostaki E, Kuriakopoulos M (2016) The stigma of mental illness in children and adolescents: a systematic review. Psychiatry Res. 243:469–494CrossRefGoogle Scholar
  12. 12.
    Patel V, Rahman A (2015) Editorial commentary: an agenda for global child mental health. Child Adolesc Ment Health. 20(1):3–4CrossRefGoogle Scholar
  13. 13.
    Leventhal BL (2015) Too little too late? The shortage of child and adolescent psychiatrists. WCAP. 8:3–6Google Scholar
  14. 14.
    Girolamo G, Dagani J, Signorini G (2014) Youth mental health: from continuity of psychopathology to continuity of care (STraMeHS): a European conference. Venice, 16–18 Dec 2014. WCAP. 6: pp 6–8Google Scholar
  15. 15.
    Malla A, Shah J, Iyer S, Boksa P, Joober R, Andersson N et al (2018) Youth mental health should be a top priority for health care in Canada. Can J Psychiatr. 63(4):216–222CrossRefGoogle Scholar
  16. 16.
    American Academy of Child and Adolescent Psychiatry (AACAP) (2018). American Academy of Child and Adolescent Psychiatry. https://dev.aacap.org/AACAP/copy_of_home.aspx. Cited Apr 2018
  17. 17.
    Leventhal BL (2016) Challenges and opportunities in the flattening world: growth of global child and adolescent psychiatry services and training. J Am Acad Child Adolesc Psychiatry. 55(105):S57CrossRefGoogle Scholar
  18. 18.
    World Health Organization (2018) Mental health atlas 2017. Geneva: World Health Organization. https://www.who.int/mental_health/evidence/atlas/mental_health_atlas_2017/en/. Cited Apr 2017
  19. 19.
    Hirota T, Guerrero A, Sartorius N, Fung D, Leventhal B, Ong SH et al (2015) Child and adolescent psychiatry in the Far East. Psychiatry Clin Neurosci. 69:171–177CrossRefGoogle Scholar
  20. 20.
    El-Gilany A, Amr M (2010) Child and adolescent mental health in the Middle East: an overview. Middle East J Family Med. 8(8):12–18Google Scholar
  21. 21.
    Dimitry L (2011) A systematic review on the mental health of children and adolescents in areas of armed conflict in the Middle East. Child Car Health Dev. 38(2):153–161CrossRefGoogle Scholar
  22. 22.
    World Bank, Data Bank (2018) World Development Indicators. 2018. [updated 2019 Mar 21]. https://www.worldbank.org/. Cited Apr 2018
  23. 23.
    Assaad R, Roudi-Fahimi F (2007) Youth in the Middle East and North Africa: demographic opportunity or challenge? Population Reference Bureau, pp 1–8. https://www.prb.org/wp-content/uploads/2007/04/YouthinMENA.pdf. Accessed May 2018
  24. 24.
    Unicef (2015) Fact sheet: a summary of the rights under the convention on the rights of the child. [updated 2014 Aug 7]. https://www.unicef.org/crc/files/Rights_overview.pdf. Cited Apr 2017
  25. 25.
    World Health Organization (2016) Global Health Observatory data. World health statistics 2016: monitoring health for the SDGs [Internet]. Geneva, Switzerland: World Health Organization; 2016 [2017 Apr]. https://www.who.int/gho/publications/world_health_statistics/2016/en/. Accessed Apr 2017
  26. 26.
    Tol WA, Song S, Jordans MJD (2013) Annual research review: resilience and mental health in children and adolescents living in areas armed conflict – a systematic review of findings low-and middle-income countries. J Child Psychol Psychiatr. 54(4):445–460CrossRefGoogle Scholar
  27. 27.
    Thabet AAM, Abed Y, Vostanis P (2004) Comorbidity of PTSD and depression among refugee children during war conflict. J Child Psychol Psychiatr. 3(45):533–542CrossRefGoogle Scholar
  28. 28.
    Polanczyk GV (2016) Development of national capabilities in low-and middle-income countries for research in child mental health. Eur Child Adolesc Psychiatry. 25:123–125CrossRefGoogle Scholar
  29. 29.
    Watson D, Cheney K, Ezzat HR (2015) Children and young people in times of conflict and change: child rights in the Middle East and North Africa. Glob Stud Child. 5(2):115–121CrossRefGoogle Scholar
  30. 30.
    Endrawes G, O’Brien L, Wilkes L (2007) Mental illness and Egyptian families. Int J Ment Health Nurs. 16:178–187CrossRefGoogle Scholar
  31. 31.
    Sewilam AM, Watson AMM, Kassem AM, Clifton S, McDonald MC, Lipski R et al (2015) Suggested avenue to reduce the stigma of mental illness in the Middle East. Int J Soc Psychiatry. 61(2):111–120CrossRefGoogle Scholar
  32. 32.
    Ciftci A, Jones N, Corrigan PW (2013) Mental health stigma in the Muslim Community. J Muslim Ment Health. 7(1):17–32CrossRefGoogle Scholar
  33. 33.
    Skokauskas N, Fung D, Flaherty LT, Klitzing K, Pūras D, Servili C et al (2019) Shaping the future of child and adolescent psychiatry. Child Adolesc Psychiatry Ment Health. 13:19CrossRefGoogle Scholar
  34. 34.
    Collins PY, Insel TR, Chockalingam A, Daar A, Maddox YT (2013) Grand challenges in global mental health: integration in research, policy, and practice. PLoS Med. 10(4):e1001434CrossRefGoogle Scholar
  35. 35.
    Simmons M, Barrett E, Wilkinson P, Pacherova L (2012) Trainee experiences of child and adolescent psychiatry (CAP) training in Europe: 2010–2011 survey of the European federation of psychiatric trainees (EFPT) CAP working group. Eur Child Adolesc Psychiatry. 21:433–442CrossRefGoogle Scholar
  36. 36.
    Turkish Journal of Child and Adolescent Mental Health (Cocuk ve Genclik Ruh Sagligi Dergisi). 2019. https://www.ejmanager.com/my/cgrsd/. Accessed Mar 2019
  37. 37.
    European Society for Child and Adolescent Psychiatry (ESCAP). Eur Child Adolesc Psychiatry. 2018. [updated 2019]. https://www.escap.eu/. Cited Apr 2018
  38. 38.
    Orlowski S, Lawn S, Matthews B, Venning A, Wyld K, Jones G et al (2016) The promise and the reality: a mental health workforce perspective on technology-enhanced youth mental health service delivery. BMC Health Serv Res. 16(562):1–12Google Scholar
  39. 39.
    Azeem MW (2016) This issue: child and adolescent psychiatry. Psychiatr Ann. 46(1):20–23CrossRefGoogle Scholar
  40. 40.
    Bazaid KA (2013) The first review course in child and adolescent psychiatry in the Kingdom of Saudi Arabia, the Gulf States, and the Middle East. World Child Adolesc Psychiatry. 5:19–20Google Scholar
  41. 41.
    Mowafi H (2011) Conflict, displacement and health in the Middle East. Glob Public Health. 6(5):472–487CrossRefGoogle Scholar
  42. 42.
    Hirota T, Guerrero A, Fung D, Leventhal B, Ong SH, Kaneko H et al (2019) Child and adolescent psychiatry in the Far East: a 5-year follow up on the consortium on academic child and adolescent psychiatry in the Far East (CACAP-FE) study. Psychiatry Clin Neurosci. 73(2):84–89CrossRefGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Carolyn E. Clausen
    • 1
    Email author
  • Khalid Bazaid
    • 2
  • Muhammad Waqar Azeem
    • 3
  • Fathelaliem Abdelrahim
    • 4
  • Ahmed A. Abd Elgawad
    • 5
  • Bibi Alamiri
    • 6
  • Ahmed Malalla AlAnsari
    • 7
  • Ali Alhamzawi
    • 8
  • Ahmad Mohammed Al Mai
    • 9
  • Aisha Motwakil Bakhiet
    • 10
  • Mahmoud Bashtawi
    • 11
  • Füsun Çuhadaroğlu
    • 12
  • Mazen Hedar
    • 13
  • Mohammad Holdar
    • 14
  • Samah Jabr
    • 15
  • Ather Sajjad Jafri
    • 16
  • Amjad Jumaian
    • 17
  • Suaad Moussa
    • 18
  • Abdelgadir Hussein Osman
    • 4
  • Katayoon Razjouyan
    • 19
  • Eyad Yanes
    • 13
  • Anthony Guerrero
    • 20
  • Norbert Skokauskas
    • 1
  • Consortium on Academic Child, Adolescent Psychiatry in the Middle East (CACAP ME)
  1. 1.Norwegian University of Science and TechnologyTrondheimNorway
  2. 2.Royal Ottawa Mental Health CentreUniversity of OttawaOttawaCanada
  3. 3.Sidra Medicine /Weill Cornell MedicineDohaQatar
  4. 4.University of Medical Sciences and Technology, KhartoumKhartoumSudan
  5. 5.Institute of Psychiatry, Faculty of MedicineAin Shams UniversityCairoEgypt
  6. 6.Alamanra Kuwait Center for Mental HealthKuwait CityKuwait
  7. 7.College of Medicine and Medical SciencesArabian Gulf UniversityManamaKingdom of Bahrain
  8. 8.College of MedicineAl-Qadisiyah UniversityAl-DiwaniyaIraq
  9. 9.Sheikh Khalifa Medical CityAbu DhabiUnited Arab Emirates
  10. 10.University of KhartoumKhartoumSudan
  11. 11.Jordan University of Science and Technology, King Abdullah University HospitalIrbidJordan
  12. 12.Faculty of MedicineHacettepe UniversityAnkaraTurkey
  13. 13.World Health OrganizationDamascusSyria
  14. 14.College of MedicineImam Abdulrahman Bin Faisal UniversityKhobarSaudi Arabia
  15. 15.Mental Health UnitMinistry of HealthRamallahPalestine
  16. 16.Sultan Qaboos University HospitalMuscatSultanate of Oman
  17. 17.The Royal Medical Services of Jordan, King Hussein Medical CityAmmanJordan
  18. 18.Kasr Al Ainy Faculty of MedicineCairo UniversityCairoEgypt
  19. 19.Shahid Beheshti University of Medical SciencesTehranIran
  20. 20.University of Hawai’i John A. Burns School of MedicineHonoluluUSA

Personalised recommendations