Highlights

Abstract

Keywords

۱٫ Background

۲٫ Gender and mental health in the Arab world

۳٫ Women’s mental health services in Qatar

۴٫ Developments following the steering committee report submission

۵٫ Future directions

Declarations of conflict of interest

Author contributions

Financial disclosure

Acknowledgements

Data Availability

References

Abstract

Investigations into gender differences in the epidemiology of common mental disorders have highlighted the fundamental role of socio-economic factors as the key determinants in experiencing mental ill health and access to treatment. Women are almost always at a socio-economic disadvantage across cultures throughout the world and as a result experience mental health inequality. This disparity in control over their socio-economic determinants is even more stark in the Middle Eastern and North African region. This region has additionally also cultural and legal conditions that make women empowerment and access to health difficult. Qatar launched an ambitious National Health Strategic program and identified women’s mental health as a priority. This paper describes the development of a gender aware mental health service in Qatar, first of its kind in the region. It describes the challenges that exist in the region when attempting to develop such a service and some challenges that are unique to Qatar. This paper sets out a template of important principles that will be valuable for countries in the MENA region and beyond to develop evidence-based gender aware service that focuses on female empowerment and better mental health outcomes.

۱٫ Background

Epidemiological data from across the world have reiterated that there exists a gender-based difference in mental health morbidity between men and women (Kessler et al., 1995; Leibenluft, 1999). From a summary of evidence in an epidemiological review by, Weissman and Klerman (1977) showing higher prevalence of mood and anxiety disorders among women, these findings have been replicated by subsequent community based epidemiological studies over the subsequent decades (Weissman et al., 1996, Kessler et al., 2005; Piccinelli and Gomez Homen, 1997).

However, studies conducted in societies or groups with socially homogenous gender roles and empowerment did not always support these findings (Egeland and Hostetter, 1983; Jenkins, 1985; Loewenthal et al., 1995). More specifically, these studies underlined the role of social factors underpinning these differences rather than the traditionally understood genetic basis (Parker and Brotchie, 2010). Over time, accumulating evidence for a social model as the variable that explains gender differences came to be seen as the only viable framework within which the evidence could be properly examined (Pan American Health Organization, 1995; World Health Organization, 1998).

It has been increasingly recognized that gender determines how the individual will interact with, have access to and have control over the socio-environmental determinants of mental health with the women universally having less control and access (WHO, 2000). The social position of women and their economic condition tends to be different from men and varies across the countries and has been shown to impact mental health (WHO, 2000). States economic policies and access to resources including those of health vary according to gender and most countries have their Gender Development Indices (GDI) lower for women than men (United Nations Women white paper 2018).