Mental health matters — and it is time to do better

“Like Real Estate, Health is Location, Location, Location” — George A. Kaplan.

Undoubtedly, our health is the product of an array of factors, including the environments that we inhabit throughout our time on this earth. Most commonly, we believe our health is primarily affected by physical factors: Pollution levels, lack of open green spaces and noise levels, to name a few. While that is true, we often disregard how vital the social factors are and how crucially they contribute to our health. Inherently, our culture gives us a blueprint for such social factors. We are fortunate to be part of a collectivist culture that believes in the necessity of social cohesion, strong social networks and caring for one another. Emerging research in public health demonstrated that living in a neighbourhood where neighbours have strong ties to each other is associated with better health outcomes, including decreased risk of myocardial infarction and stroke, and better sleep health outcomes. The more we explore the intersection of culture and health, the more we realise that research is supporting many of the habits naturally present in collectivist cultures like ours. 

But as research advances, a red flag within eastern cultures becomes more evident and prominent: Why do we continue to stigmatise mental health despite evidence that identifies many cultural factors that should improve it?

Our issue is no longer a mere lack of understanding of mental health in our region. We are now, unfortunately, looking at a mental health crisis arriving to our shores. We can no longer afford to ignore the prevalence of negative mental health outcomes within our society. For decades, we have failed to address the elephant in the room: Mental health should matter, and the issues associated with the topic are more present in our population that we would like to believe. For decades, our narrative in response to mental health issues has been one that involves accusations of a lack of faith, notions of toxic masculinity where we just need to “man up” and face hardships, as well as simple disregard for complaints and the burying of issues. Today, I write with the hope of delivering one message: Mental health matters just as much as physical health does, and it is time to treat it as such. The first step is an urgent call to destigmatise mental health within our communities to avoid a crisis before it becomes inevitable to avoid. 

The current COVID-19 pandemic, beyond the physical toll of deaths and infections, forced extended lockdowns, an increase in unemployment, and created huge financial strains for many households. Naturally, such factors contributed to an increased prevalence of anxiety and depressive symptoms. Our research group at Columbia University explored this issue and recently published a paper at “BMJ Open” highlighting the high prevalence of anxiety and depressive symptoms among Jordanian adults during lockdown periods earlier this year. Among a sample of 1240 Jordanian adults, approximately half self-reported a certain degree of anxiety levels as well as depressive symptoms. Given the association of anxiety and depressive symptoms with other health outcomes, there is an urgent need to address the underlying factors contributing to anxiety and depressive symptoms and to begin destigmatising mental health.

While conducting this research, we learned two things: Jordan is severely understudied when it comes to mental health, and we have an absurdly high prevalence of mental health complaints. We lack an understanding of the issue precisely because we have been underestimating it for decades. Simply put, we have a problem that needs to be addressed now. The cost of undervaluing mental health on society is significant, and while the long-term goal should be to renovate our healthcare system to increase accessibility to professional care and normalise treatments for mental health, short-term goals should also be put in place to decrease stigma and to educate individuals.

The roots of mental health issues are a result of interplay of physiological, psychological and social factors. Those are the same exact factors that can contribute to a headache or chest pain. If we are not ashamed to complain and seek professional help for our physical health, why do we still associate mental health with shame and stigma? The current pandemic has really brought issues of mental health to the forefront and we no longer can afford the choice of ignoring it. Our region continues to be heavily understudied in the context of mental health, but we now are fortunate to have basic understanding that informs us of increased prevalence of anxiety and depressive symptoms.

While such research could be used to inform policymakers to intervene, we all have a responsibility to address the issue at hand: To destigmatise mental health before the effects are widespread. My responsibility is two-fold; to continue understanding mental health in Jordan as a public health researcher and to do my part in address issues of toxic masculinity that stigmatise mental health within my social network. Whatever your role in society is, ask yourself: What is your responsibility in contributing to decrease the stigma surrounding mental health so that we can all have a happier tomorrow?

Together, we can do better. Together, we can build a happier tomorrow.

Yazan Ahmad Al-Ajlouni is a Public Health Researcher at the Columbia University Mailman School of Public Health in New York City and a medical student at New York Medical College. He contributed this article to The Jordan Times