8 January 2024 – Years of conflict have cast a dark shadow on Yemen, both on its physical infrastructure and on the health and well-being of its people. Mental health has been overlooked for far too long, and now a hidden crisis is festering.

Mental health and psychosocial support (MHPSS) services are lacking in many parts of the country, owing to shortages of trained professionals and treatment facilities. Even where such services are available, people may feel unable to access them owing to social disapproval.

An estimated 7 million people, about a quarter of Yemen’s population, grapple with psychological trauma and stress inflicted by the ongoing conflict. All require mental health support, yet only 120 000 of this number have consistent access to services.

A WHO collaboration with the European Civil Protection and Humanitarian Aid Operations (ECHO) has helped to strengthen mental health and psychosocial support in Yemen and prioritize the most vulnerable groups with mental illness.

Two stories among millions

Asma’s* story exemplifies the tragedy of this neglected crisis and the silent struggle of those affected. Living under the constant stress of war, Asma experienced the depths of depression. She withdrew from life, which left her isolated and contemplating escape.

“I felt down; I was always zoned out and wouldn’t want to leave my room,” Asma explained. Her mental health continued to decline until she reached a point where she didn’t want to meet a single person and yearned for escape: “I felt trapped in my house, I wanted to leave everyone behind and run away.”

It was only through her family’s concern and eventual action that Asma sought help at one of the WHO-supported mental health departments. With therapy and counselling, Asma found solace and a path to recovery, reclaiming her ability to connect with loved ones and embrace a brighter future.

Asma’s story is far from unique. Many suffer in silence and avoid seeking support, fearing the stigma associated with mental illness. But Nabilah*, an English teacher and a mother of 5 children, took a different path. Aware of her mental health struggles and driven by a desire to heal, she defied stigma and was unafraid to seek help.

At first, Nabilah suffered from what seemed to be the symptoms of an allergy, as well as a sleeping disorder and anxiety. She saw a dermatologist, who revealed that Nabilah’s skin complaint had been caused by psychological factors. He advised her to find ways to reduce her stress levels to clear up the issue, or seek mental health support.

Recognizing the link between her anxiety and physical symptoms, Nabilah found professional support before the burden became too much. “I’m not ashamed,” said Nabilah. “Mental illness is just like physical illness, which can be cured.”

Nabilah studied psychology at university for 3 years, so knew about mental illness and types of mental disorders. “I was fully aware that I was suffering mentally and it had started to affect my medical condition,” she said. “I tried to beat it considering my knowledge and awareness, but it was beyond my capacity, so I sought support before it got worse.”

This case highlights the importance of awareness and education. Moreover, Nabilah’s courage reveals the need for both individual awareness and social acceptance of mental health struggles.

Widening access to mental health support

Dr Ashgan Yousef, a mental health worker in Yemen, highlighted the critical shortage of resources and trained professionals and the need for collective action to scale up services and build a robust mental health support system.

“Mental health support in Yemen faces a clear shortage, especially in terms of availability of a trained cadre,” said Dr Yousef. “Mental health is an important part of universal health care. We work to raise awareness of the importance of mental health and provide the necessary support for people with mental disorders. We hope to continue to improve services and scale up mental health care to reach more people who need support.”

Partnerships like the one between WHO and ECHO are crucial to address the service gap and increase access to quality MHPSS. Through this partnership, WHO has strengthened 17 MHPSS units across Yemen through rehabilitation of facilities and provision of new furniture and equipment. WHO has also supplied the same units with psychotropic medications, and worked to provide capacity-building on MHPSS for mental health workers across the country

WHO worked with the Ministry of Public Health and Population to develop the country’s latest national mental health strategy – the first update since 2010. The launch of the new strategy, in October 2022, marked a significant step towards a more comprehensive and accessible health system.

An urgent need for more action

Yemen’s mental health crisis is a silent battle and demands urgent attention. By prioritizing mental health care, combating stigma through greater awareness, and building a robust support system, Yemen can help those struggling in the shadows to embrace life once more.

Asma’s journey from isolation to recovery shows how it’s possible to heal even amid the bleakest circumstances: “Finally, I can connect with my family and lead a normal life. This change has transformed me and those around me.”

* Names have been changed to protect identities.