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Psychology in Yemen

Developing short and long-term programs requires adapting research knowledge and experience obtained from regional and international sources to be appropriate to the Yemeni landscape and to accelerate Yemeni progress in the field.

By Maan A. Bari Qasem Saleh, PhD

Psychology in Yemen

Psychology in Yemen is at an exciting time in its development. By describing the current status of psychology in Yemen and some of its history, I hope to provide a foundation for understanding its development and to foster interest in international collaboration and cooperation with Yemeni psychologists. The field of psychology in Yemen has been fortunate to receive governmental support, albeit modest, and has also benefited from human resource development projects that have enabled Yemeni students to study psychology, in other Arab countries (16% - in Egypt, Iraq, and Jordan, Sudan), former socialist countries (75% - in Soviet Union, Bulgaria, Cuba, East Germany, and Hungary) and Western countries (7% U.K, France and the United States). Psychology in Yemen has developed against a context of a country whose national and social development has taken place within a legacy of wars, internal struggles, poverty, high rates of reproduction, and illiteracy.  Mental health disorders are still placed in a context with close connections to myth, superstition, witchcraft, jinns, and devils. Accordingly, there is a social stigma associated with mental health issues and by extension psychology that will likely continue for some time. In this article, I present a broad picture of psychology in Yemen covering its human resources, education and training institutions, the development of psychological services, the National Mental Health Program, professional non-governmental associations (professional NGOs) in psychology, and Psychologists and Leadership.

Human Resources
Surveys conducted by the Yemeni Mental Health Association (YMHA) in the years 2002 to 2006 have provided figures of 3580 individuals in Yemen with at least a BA in psychology. These include 139 people working in higher academic institutions, 64 in the health sector, 31 in social work associations, 157 in education (schools), and 900 in governmental offices, military, police, and the private sector.  The rest are unknown. Among these individuals are 51 with a PhD Degree (most of whom are employed in the academic sector) and 159 with a Master’s degree, whose employment spans the range of categories above.


Yemeni Psychologists by Degree and Employment Area

 
Degree
Field PhD MSc/MA BSc/BA Total
Academic 45 45 49 139
Education 2 20 135 157
Health 4 35 25 64
Social Services 0 9 22 31
Other 0 50 850 900
Unemployed 0 0 2289 2289
Total 51 159 3370 3580

Educational and Training Institutions
Two types of institutions provide educational and training experiences in psychology: departments of psychology and the Yemeni Medical Council, through the Ministry of Health.  There are fourteen Departments of Psychology, housed in Faculties of Arts, Education or Medicine in Yemeni universities, that serve the educational, research, and accredited professional development needs for the nation. A dilemma for psychology from the Yemeni point of view is that psychology is primarily found in the Faculty of Arts. This means that most students graduate from an Arts curriculum in high school and have little if any exposure to Mathematics, Physics, Biology, Chemistry, or other natural sciences.  Taking scientifically-rich courses such as Statistics, Anatomy, and Physiology poses a challenge for these students, making psychology a less alluring career path.

The activities in psychology departments are generally limited to teaching (lecturing, exam supervision) and do not include research or service activities to the community. There are various reasons for this, including scarce resources and the ensuing limitations and loss of motivation, social stigma associated with mental health issues, the newness of the discipline in the Yemeni context, and a critical shortage of experienced specialists.  Despite these circumstances, there are some individual leaders who devote their time and energy to serving their profession and communities and who have achieved recognition for their departments and universities in regional and international research and application arenas.

Departments of Psychology in Yemeni Universities

University Faculty Founding Date Number of Faculty Members Male Female
Sana's Art 1983 18 4 14
Sana's Education 1975 12 8 4
Aden Education 1970 12 6 6
Aden Medicine 1975 5 3 2
Aden Art 1999 8 5 3
Taiz Education 1994 9 6 3
Taiz Art 2003 3 2 1
Hadramut Education 1975 10 7 3
Al-Hudaida Education 1997 15 7 8
Thamar Art 2000 7 6 1
Ibb Education 1997 20 18 2
Total     119 72 47

*There are 20 additional faculty members in 6 branch faculties in other governorates. Source: YMHA Survey


In 2003, the Yemeni Council for Medical Specialization under the Ministry of Health established a national academic qualification program that provides for one year of post-baccalaureate training in clinical psychology. By 2007, thirty individuals from the Sana’a governorate had graduated from this program. In Aden, the first course in this training program was inaugurated in 2006 It is also worth mentioning that there are higher education programs at the Master's level in General Psychology in the Arts Faculties of Sana’a, Aden, and Thamar universities. 

Psychological Services

Private clinics
There are about 45 private mental health clinics in Yemen run by psychiatrists. Psychologists work in a limited number of these clinics, supervised by psychiatrists. Drugs and electroshock (ECT) are the typical treatments in these setting.  A few work within a collective therapeutic team model. Unfortunately, there are no designated clinics for children. 

Psychological Assessment
In Yemen, clinical diagnosis and assessment is not standardized.  The psychological tools that are available generally have been translated into Arabic and have been adapted by Egyptian psychologists. Thus, the majority of cases are diagnosed based on the individual knowledge and experience of each clinician.

Patient Management and Psychotherapy
Successfully treating mental illness often involves the use of psychopharmacologic drugs (prescribed by psychiatrists and, in rural areas, by psychologists). While effective, the use of such medications is limited in the Yemeni situation, as they are unaffordable for most patients. The use of ECT remains widespread. Unfortunately there are few programs and evidence-based models for treatment that are proven effective and appropriate for the culture. There are individual settings, however, where institutional or individual initiative has led to the establishment of models that demonstrate the potential and effectiveness of psychological services in the Yemeni context. These include psychological counseling services sponsored by the Yemeni Mental Health Association in collaboration with schools and universities.

Hotline Telephone for Psychological Aid (Aden)
This mental health tele-counseling service, established in 2000, is affiliated with the Yemeni Mental Health Association in partnership with the Faculty of Medicine and Health Sciences of Aden University. This service is the first officially documented service of its type in an Arab country. Five well trained and experienced psychologists work in shifts along with the President of the Association. As of 2007, the number of calls received numbered 4,072 of which 72% were from female callers. The distribution of calls according to problem type was: 6% family violence, 9% emotional problems, 4% sexual concerns, 10% disturbances of childhood and adolescence, 10% school difficulties, 35% mental disorders (e.g., schizophrenia, mental retardation), and 26% a variety of other problems.

School Behavioral Counseling Program
This program was established by the Yemeni Mental Health Association in 2002. It partners the Association with the Education Office of the Aden governorate, and reflects an important goal of the Association to be responsive to the community with respect to social service issues. The program team consists of ten psychologists and social work specialists with extensive professional experience. The problems of the more than 1200 pupils served in the years between 2002 and 2006 were 66.8% emotional-behavioral, 24.1% educational, 0.9% sexual, and 8.1% school discipline.

Hotline Telephone for Psychosocial and Legal Support (Sana’a)
This service, run by the Arab Human Rights Institution, was established in March of 2002. It is located in the capital city of Sana’a. The Institution operates with a team of four psychologists.

Educational and Psychological Counseling Center (Sana’a University)
This Center was established to serve students in September of 2005 with an academic and administrative team consisting of 16 individuals headed by a psychologist. Ten specialists also provide services (treatment and diagnosis) to students on a daily basis. In addition, the Center offers training courses, organizes cultural and scientific sessions, and provides consultation to mental health clinics.

Student Counseling Center (Taiz University)
The Student Counseling Center was established in May of 2006 and is located on the campus of the College of Education and provides services mainly to students but sometimes to family members. Its team consists of 17 psychologists headed by a psychologist. In its short existence, the center has provided guidance services to 155 students, male and female. The distribution of problems was: 45.1% social, 12.2% academic, 38% emotional, and 3.2% special needs.

Telephone Hotline of the Mental Health Unit of the Cultural Health Center Sana’a
This service is operated by the Cultural Health Center established in 1996 by the talented physician, artist and poet, Dr. Nazar Ghanim in Sana’a in 1996. The Center ceased to function due to a financial deficit in 1999 but reopened in May 2006. There is also a clinic for emotional guidance that is part of the Center and is currently headed by a psychologist.

National Mental Health Program
The National Mental Health Program was established in the late 1980s with the help of the World Health Organization (WHO) and the Ministries of Health from the North and South Yemeni governments at the time. The project concentrated on treatment in mental hospitals and on the care of mentally ill patients by qualified psychiatrists. The National Mental Health Program was established in response to recommendations put forward by the first National Workshop on Mental Health in Yemen, organized in cooperation with the International Committee of the Red Cross in October 2002. A mental health program was established by ministerial resolution was then administered as a component of the primary health care division in the Ministry of Health. The administration consists of four psychologists headed by a psychologist.

Non-Governmental Associations (NGOs)
In Yemen, NGOs that are chiefly focused on mental health have increased in quantity and quality since the establishment of a new Associations Law in 2001 that permitted the formation of professional organizations. According to a 2006 report there were six associations in the country headed by psychologists, comprising a membership of 1,235 (Saleh, 2008).  Most of the associations are new and struggling under a number of obstacles; nonetheless they continue to advocate for and provide services.  In the past few years, these associations have played influential roles in the campaign to combat physical, mental, and sexual violence against women and children. They have also organized celebrations for International Mental Health Day, conferences, workshops, seminars, publishing endeavors, radio and television programs, and contributions to journals and magazines through articles in psychology. Finally, they have advocated for the establishment of a formal code of ethics for psychologists, often at great personal and emotional expense that is little acknowledged and commended.

Publications
There are two bi-annual journals published by YPA (twenty volumes), another by the Doctor and Clinical Psychologists Association (DCPA) (three volumes), and two newsletters published periodically by the YMHA (thirty volumes).  The Aden Central Psychiatric Hospital has also published ten newsletters. The main obstacles to publishing and printing are financial resources and the lack of technical facilities for actual printing and dissemination. 

Research
Research in psychology and mental health is not well developed, mainly because of a lack of research capacity and the absence of research institutions in psychology and other mental health-related fields. Most of the research in psychology is carried out at Yemeni universities by graduate (PhD and MA) students and teaching faculty. The YPA and the YMHA have taken an active role in launching research initiatives and community surveys related to a variety of mental health-related issues including violence against women and children, Qat addiction and behavior, female genital mutilation, and suicide.  Lack of sustainable funding remains one of the biggest drawbacks to undertaking research.

Psychologists and Leadership 
In November 1989, for the first time in Yemen two psychologists (Dr. Maan Saleh and Mr. Ahmed Nasser) were elected to the local council of Aden (the then capital of the democratic Republic of Yemen, South Yemen). In 1991, the first woman (a psychologist Dr. Aza Ghanim) became the Faculty of Education Dean at Sana’a University. After unification of North and South Yemen in 1990, Mr. Ahmed Nasser won a seat in the first elected parliament in Yemen in April of 1993. In 1997 and again in 2001, two psychologists became vice presidents of the World Federation of Mental Health for the Middle East Region (Dr. Hassen Khan and Dr. Maan Saleh). In September of 2003, Professor Ahmed AL- Sofi  became the first psychologist to become the Rector of the University of Taiz. And in 2004, in Beijing China  the first Yemeni psychologist and second Arab psychologist, Dr. Hassen Khan, was elected as a board member of the International Union of Psychological Sciences(IUPsyS).

Summary
Psychology is emerging in Yemen, but it will be important to build on the foundation that is being constructed. Until Yemen develops its own research knowledge base, addressing the psychological service needs of Yemeni communities requires creativity and commitment.  Developing short and long-term programs requires adapting research knowledge and experience obtained from regional and international sources to be appropriate to the Yemeni landscape and to accelerate Yemeni progress in the field.
Goals for the future include:

  • Fostering qualitative and quantitative improvements in graduate and post-graduate higher education and training in psychology, including establishing psychological laboratories that meet international standards. Doing so will enable Yemen to train specialists with culturally appropriate skills who can respond to the needs of society.

  • Offering annual scholarships abroad, for a period of at least five years duration, across the different fields of psychology, with sensitivity to issues of gender and allocations to facilitate female travel.

  • Encouraging the appointment of psychologists in the schools to practice specialized activities for students in the prevention and treatment of emotional and behavioral problems as a means to strengthen primary mental health care.

  • Broadening the faculty role so that university professors can engage in research while being supported by a clear administrative and legislative mandate to do so.

  • Encouraging the appointment of psychologists in all social care homes for special needs groups to help in rehabilitation and reintegration efforts and authorize qualified psychologists to conduct assessments and provide counseling in juvenile courts across all governorates.

  • Appointing psychologists in central governorate prisons to a police rank and salary and including them as official staff members in rehabilitation and penal institutions. This will raise the profile of the profession and add to the security, accountability, and effectiveness of institutions.  This recommendation also extends to appointing psychologists to military ranks and salary and including them in the staff of special institutes for military health care.

References
American Psychological Association: www.apa.org 

International Red Cross Yemen. (2004). The Second Conference on Mental Health in Yemen (unpublished document). 

Ministry of Planning. (2000). Human Resource Development Report. Sana’a; Ministry of Planning.

Ministry of Planning. (2004). Annual Statistics Book. Sana’a: Ministry of Planning.

Ministry of Health. (2007). Report on The National Program of Mental Health: The present situation of mental health (unpublished). Sana’a: Ministry of Health.

Saleh, Maan A.Bari (2008). Experience of Mental Health Association in Yemen. Journal of Social Science, Aden University, 22, 55-62.

Yemeni Mental Health Association. (2006). Al-Seha-Al-Aqilia, No. 25-28.

Yemeni Mental Health Association. (2007). Al-Seha-Al-Aqilia, No. 29-30.

Acknowledgments
I want to recognize  and express my appreciation to the many individuals who provided information and contributed to this report, especially:

  • Dr. Aza Ghanim, Professor, Head of the Psychology Department, College of Education, Sana’a University;

  • Dr. Najat Saem, Assistant Professor, YMHA Representative in Sana’a and Head of the Psychology Department in the College of Arts, University of Sana’a.

  • Dr. Abdullah Shuwel, Associate Professor, Head of the Psychiatry Department, Faculty of Medicine, Sana’a University, and Coordinator of the Diploma of Clinical Psychology in the Yemeni Council for Medical Specializations.

  • Dr. Saleh Ghanim, Coordinator of the Mental Health Program in the Ministry of Health.

  • Dr. Nazar Ghanim, Professor, Head of the Cultural Health Center and Professor of Social Medicine, Sana’a University.

  • Raja Masabi, Head of the Arab Foundation for Human Rights.

  • Dr. Balqis Gobary, Vice Director of Educational and Psychological Counseling Center, Sana’a University.

  • Dr. Anisa Dukum, Associate Professor in the Psychology Department, College of Education, Taiz University and Head of Student Guidance Services, YMHA Representative in Taiz.

  • Dr. Ali Ahmed Wadi, Head of Psychology Department, College of Arts, Al-Hudaida University.

  • Dr. Abdul-Hakim Bin Braik, YMHA Representative in Hadramout and Assistant Professor in the Psychology Department, College of Education, University of Hadramout.

  • Dr. Abdo Al-Himyari, YMHA Representative in Damar, Associate Professor in the Counseling Department, College of Arts, University of Damar.

  • Dr.Abdul-Wahid Abdul-Rahman, Associate Professor, Head of the Department of Psychology, College of Education, University of Aden.

  • Dr. Mazain Shamsan, Assistant Professor, Department of Psychology, College of Arts, University of Aden

  • Dr. Mohamed Al Salahi, Head of the Department of Psychology, Faculty of Education, Ibb University.

  • Louise Lambert, Mental Health Canada

  • Dr. Nancy Russo, Professor of Psychology, Department of Psychology, Arizona State University

  • Dr. Merry Bullock, Senior Director, Office of International Affairs, American Psychological Association