Psychiatry Research EG

Introduction Norris et al. (2004) suggested that trauma is much more common in developing countries than in the developed world, where more of the resources to treat trauma are available. Trauma in developing countries is more challenging to treat and more difficult to study. Most trauma treatment and research resources are in Europe, which constitutes only 7% of the world population. It is a well-known fact that the psychological impact of trauma outweighs the physical impact by an estimated 4 : 1 ratio (Everly et al., 2010). The psychological impact of natural and man-made disasters can be overwhelming for individuals, their families and communities. Since the Arab spring, we have discovered the extent of oppression and torture that the fallen regimes practiced on their people and this oppression must have clearly created many psychiatric problems in the population (Filiu, 2011). It is important for the new democratic governments in the Arab world to deal with the aftermath of the previous totalitarian regimes including mental illness. This needs to be undertaken in a way that makes the psychiatric services community oriented, more acceptable to the local populations and more responsive to their needs (Ben-Tovim, 1987). Psychiatric disorders are associated with very severe stigma in the Arab world (Sartorius and Schulze, 2005). This increased in the colonial period owing to the mental hospitals that were built and which replaced the small and less stigmatizing community-oriented Muslim medieval hospitals (Maristanes) that operated in keeping with the principles of Islamic Medicine (Keller, 2007). This stigma was also increased owing to Arab cinema, which portrayed these mental hospitals and their patients in a very demeaning way. The emphasis in the new Arab psychiatric services should be on the treatment of the consequences of oppression. It should also incorporate traditional concepts of mental ill health and traditional treatments used (Pirajno, 1955). Mental health services need to be named and shaped to serve this function so that they will be acceptable for the population to use (Ben-Tovim, 1987). We suggest that mental health services centres are established under the name of ‘Centres for the Care of Victims of Torture and Political Violence’. These services will work in parallel with and complement the already present psychiatric hospital services and will work gradually to replace them with less stigmatizing and more community-oriented services. The new services should have a strong trauma treatment element in addition to traditional elements such as general psychiatry, child psychiatry and substance abuse psychiatry (Hien et al., 2004). We recommend that a centre is established in each major city and extended and expanded upon as demand increases for the service. Initially, the service should operate during office hours and then the need and feasibility of a community duty system in liaison with the psychiatric hospitals should be established at a later date.