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

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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.

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References

  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. 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. 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. Sachs JD (2012) From millennium development goals to sustainable development goals. Lancet 379:2206–2211

    Article  PubMed  Google Scholar 

  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. 98:323–327

    Article  PubMed  PubMed Central  Google Scholar 

  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. 26:395–402

    Article  CAS  PubMed  Google Scholar 

  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. 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):133–147

    Article  PubMed  Google Scholar 

  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):301–306

    Article  PubMed  Google Scholar 

  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):1515–1525

    Google Scholar 

  11. Kaushik A, Kostaki E, Kuriakopoulos M (2016) The stigma of mental illness in children and adolescents: a systematic review. Psychiatry Res. 243:469–494

    Article  PubMed  Google Scholar 

  12. Patel V, Rahman A (2015) Editorial commentary: an agenda for global child mental health. Child Adolesc Ment Health. 20(1):3–4

    Article  Google Scholar 

  13. Leventhal BL (2015) Too little too late? The shortage of child and adolescent psychiatrists. WCAP. 8:3–6

    Google Scholar 

  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 6–8

  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):216–222

    Article  Google Scholar 

  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. 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):S57

    Article  Google Scholar 

  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. 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. 69:171–177

    Article  PubMed  Google Scholar 

  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):12–18

    Google Scholar 

  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):153–161

    Article  Google Scholar 

  22. World Bank, Data Bank (2018) World Development Indicators. 2018. [updated 2019 Mar 21]. https://www.worldbank.org/. Cited Apr 2018

  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. 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. 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. 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):445–460

    Article  Google Scholar 

  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):533–542

    Article  Google Scholar 

  28. Polanczyk GV (2016) Development of national capabilities in low-and middle-income countries for research in child mental health. Eur Child Adolesc Psychiatry. 25:123–125

    Article  PubMed  Google Scholar 

  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):115–121

    Article  Google Scholar 

  30. Endrawes G, O’Brien L, Wilkes L (2007) Mental illness and Egyptian families. Int J Ment Health Nurs. 16:178–187

    Article  PubMed  Google Scholar 

  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):111–120

    Article  PubMed  Google Scholar 

  32. Ciftci A, Jones N, Corrigan PW (2013) Mental health stigma in the Muslim Community. J Muslim Ment Health. 7(1):17–32

    Article  Google Scholar 

  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. 13:19

    Article  PubMed  PubMed Central  Google Scholar 

  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):e1001434

    Article  PubMed  PubMed Central  Google Scholar 

  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. 21:433–442

    Article  PubMed  Google Scholar 

  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. European Society for Child and Adolescent Psychiatry (ESCAP). Eur Child Adolesc Psychiatry. 2018. [updated 2019]. https://www.escap.eu/. Cited Apr 2018

  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):1–12

    Google Scholar 

  39. Azeem MW (2016) This issue: child and adolescent psychiatry. Psychiatr Ann. 46(1):20–23

    Article  Google Scholar 

  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. 5:19–20

    Google Scholar 

  41. Mowafi H (2011) Conflict, displacement and health in the Middle East. Glob Public Health. 6(5):472–487

    Article  PubMed  Google Scholar 

  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):84–89

    Article  PubMed  Google Scholar 

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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.

Author information

Authors and Affiliations

  1. Norwegian University of Science and Technology, Trondheim, Norway

    Carolyn E. Clausen & Norbert Skokauskas

  2. Royal Ottawa Mental Health Centre, University of Ottawa, Ottawa, ON, Canada

    Khalid Bazaid

  3. Sidra Medicine /Weill Cornell Medicine, Doha, Qatar

    Muhammad Waqar Azeem

  4. University of Medical Sciences and Technology, Khartoum, Khartoum, Sudan

    Fathelaliem Abdelrahim & Abdelgadir Hussein Osman

  5. Institute of Psychiatry, Faculty of Medicine, Ain Shams University, Cairo, Egypt

    Ahmed A. Abd Elgawad

  6. Alamanra Kuwait Center for Mental Health, Kuwait City, Kuwait

    Bibi Alamiri

  7. College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain

    Ahmed Malalla AlAnsari

  8. College of Medicine, Al-Qadisiyah University, Al-Diwaniya, Iraq

    Ali Alhamzawi

  9. Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates

    Ahmad Mohammed Al Mai

  10. University of Khartoum, Khartoum, Sudan

    Aisha Motwakil Bakhiet

  11. Jordan University of Science and Technology, King Abdullah University Hospital, Irbid, Jordan

    Mahmoud Bashtawi

  12. Faculty of Medicine, Hacettepe University, Ankara, Turkey

    Füsun Çuhadaroğlu

  13. World Health Organization, Damascus, Syria

    Mazen Hedar & Eyad Yanes

  14. College of Medicine, Imam Abdulrahman Bin Faisal University, Khobar, Saudi Arabia

    Mohammad Holdar

  15. Mental Health Unit, Ministry of Health, Ramallah, Palestine

    Samah Jabr

  16. Sultan Qaboos University Hospital, Muscat, Sultanate of Oman

    Ather Sajjad Jafri

  17. The Royal Medical Services of Jordan, King Hussein Medical City, Amman, Jordan

    Amjad Jumaian

  18. Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt

    Suaad Moussa

  19. Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Katayoon Razjouyan

  20. University of Hawai’i John A. Burns School of Medicine, Honolulu, HI, USA

    Anthony Guerrero

Authors
  1. Carolyn E. Clausen
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  2. Khalid Bazaid
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  3. Muhammad Waqar Azeem
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  4. Fathelaliem Abdelrahim
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  5. Ahmed A. Abd Elgawad
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  6. Bibi Alamiri
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  7. Ahmed Malalla AlAnsari
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  8. Ali Alhamzawi
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  9. Ahmad Mohammed Al Mai
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  10. Aisha Motwakil Bakhiet
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  11. Mahmoud Bashtawi
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  12. Füsun Çuhadaroğlu
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  13. Mazen Hedar
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  14. Mohammad Holdar
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  15. Samah Jabr
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  16. Ather Sajjad Jafri
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  17. Amjad Jumaian
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  18. Suaad Moussa
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  19. Abdelgadir Hussein Osman
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  20. Katayoon Razjouyan
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  21. Eyad Yanes
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  22. Anthony Guerrero
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  23. Norbert Skokauskas
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Consortia

Consortium on Academic Child, Adolescent Psychiatry in the Middle East (CACAP ME)

Corresponding author

Correspondence to Carolyn E. Clausen.

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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.

Additional information

This article is part of the focused issue: The European and Global Perspective on Training in Child s Adolescent Psychiatry.

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Clausen, C.E., Bazaid, K., Azeem, M. et al. Child and adolescent psychiatry training and services in the Middle East region: a current status assessment. Eur Child Adolesc Psychiatry 29, 51–61 (2020). https://doi.org/10.1007/s00787-019-01360-2

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  • DOI: https://doi.org/10.1007/s00787-019-01360-2

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