Worldwide, nearly a billion people suffer from mental disordersaccording to the World Health Organization (OMS). Approximately 75% of individuals suffering from these conditions, whether neurological or related to the use of psychoactive substancesdo not have access to the necessary care. Behind these figures, there are faces, lives, stories often marked by silence and isolation. These sufferings, sometimes ignored or poorly understood, affect more than 17% of the population in Morocco, making mental health an immense public health challenge.
According to the Ministry of Health and Social Protection, these disorders constitute the first cause of disability (22.3% of the disability burden) and the second cause of national morbidity (10.52% of the global disease burden), just after cardiovascular diseases (25.68%) and before cancers (8.02%). Yet too many people remain without access to the care they need, adding to an already heavy burden for individuals and their families. The ministry also recalls, in a press release published on the occasion of World Mental Health Day (October 10), that the provision of mental health care in Morocco mainly includes 11 psychiatric hospitals and 34 psychiatric services integrated into general hospitals, thus providing 2,260 beds. There are also 4 psychosocial rehabilitation establishments, with specialized teams including 1,301 psychiatric nurses and 362 physician-psychiatrists spread across the private and public sectors, i.e. one doctor per 100,000 inhabitants, while the World Health Organization recommends a rate of coverage of 1.7 doctors per 100,000 inhabitants. In 2023, these services made it possible to care for 250,624 people using a medico-psycho-social approach.
Faced with this worrying situation, several actions are being taken by the ministry. In this capacity, he is preparing the launch of the Multisectoral Strategic Mental Health Plan 2030, developed in collaboration with all relevant stakeholders, including people with lived experience of mental health problems.
Contacted by the newspaper “Le Matin”, Mohamed Hachem Tyal, psychiatrist and psychoanalyst, who participated in the development of the Multisectoral Strategic Plan for Mental Health 2030, affirms that it is an ambitious initiative which aims to respond to many of the sector’s challenges. This plan was developed after almost two years of reflection, involving leading experts from various sectors. What makes it unique and different from the plans that preceded it is its multi-sectoral approach. Mental health is not limited to a medical problem: it is influenced by many factors such as education, housing, work, and even social policies. This plan is therefore designed to address mental health in a comprehensive manner, involving several ministries and civil society actors.
The specialist emphasizes that one of the main objectives of this Plan is to fill the gaps in access to care. This includes not only increasing the number of mental health professionals in underserved areas, but also improving the training of these professionals. It is also planned to strengthen infrastructure, increase the number of beds available in psychiatric hospitals and improve psychosocial rehabilitation services. “We look forward to it, but we question the possibility of its applicability. It is essential that this plan does not remain just a theoretical document. The real question is how to implement it effectively and sustainably on the ground. It is part of a broader reform dynamic of the health system, especially with the introduction of generalized medical coverage. The idea is to make mental health more accessible to all, by integrating this care into the overall public health offering,” says Professor Tyal. “We hope that this time, the objectives will be achieved in a concrete way, because so far, despite the efforts made, the previous plans have unfortunately not achieved the expected results,” he continues.
An awareness campaign launched
On the occasion of World Mental Health Day (October 10), the Ministry of Health is organizing a national awareness campaign from October 10 to 17, 2024 that aims to raise public awareness about mental disorders. “This campaign offers an opportunity to raise awareness and further investment in mental health at the individual level and in living environments, including the workplace,” reads the press release. And added that “this campaign aims to inform citizens as well as health professionals about the importance of mental health. It will be carried out in two parts: a face-to-face part, with information sessions, workshops and conferences organized in different cities to encourage direct exchanges with the population, and a digital part, which will include the dissemination of educational content on social networks and ministry platforms. The aim is to inform and raise awareness about mental health problems and support options.
Interview with Professor Hachem Tyal, psychiatrist and psychoanalyst
Le Matin: How would you describe the current mental health situation in Morocco?
Professor Hachem Tyal: Mental health in Morocco faces major challenges, as highlighted by the Minister of Health himself. It is the poor relation of our health system for many reasons.
The stigma surrounding mental disorders remains one of the main obstacles. In Morocco, mental illnesses are often perceived as a shame or a defect, which pushes many patients to delay consultation. They suffer in silence, for fear of being judged or socially excluded. Indeed, many people do not consider mental disorders to be real illnesses requiring medical treatment. Often, 70 to 75% of affected people do not seek medical attention. This phenomenon is accentuated by the lack of awareness and information, which leads to a considerable delay in the diagnosis and treatment of mental disorders and therefore a worsening of pathologies.
Access to care is also complicated by financial factors. Many patients, especially in rural areas, cannot afford regular treatment or travel to cities where mental health professionals are concentrated. Patients who wish to consult a professional often face economic barriers, which prevent them from receiving the necessary help in a timely manner.
It must also be emphasized that the delay in the detection and treatment of mental disorders is costly not only to patients, but also to the State. A late diagnosis, in fact, generates additional expenses for the health system, particularly in terms of more complex and longer care.
In terms of infrastructure and human resources, we observe a worrying imbalance. The country has fewer than 400 psychiatrists for a population of more than 37 million people, and more than 60% of these psychiatrists are concentrated in large cities like Casablanca and Rabat. This means that many parts of the country, especially rural and landlocked areas, are severely underserved when it comes to mental health care.
What actions should be taken to increase public awareness of mental health problems and reduce the stigma associated with these disorders?
The stigmatization of mental disorders remains one of the most difficult barriers to overcome. To change this perception, it is imperative to strengthen awareness campaigns through different channels: the media, schools, businesses, and health associations. We must continually reiterate the message that mental health is as important as physical health. Mental illnesses are real and treatable, and they’re nothing to be ashamed of.
The media play an important role in this mission. Often, mental disorders are misrepresented in the media or associated with extreme behaviors, further fueling prejudice. We need more balanced media coverage, with stories from people who have overcome their disorders and experts who can explain the different types of mental illness and the treatments available. Massive awareness raising within schools is also essential. If we can educate young people from an early age about the importance of mental health, we can hope to reduce stigma in the long term.
How to strengthen specialized teams and human resources in the field of mental health in Morocco?
It is crucial to increase the number of psychiatrists, specialized caregivers and psychologists in public institutions. In psychiatry, more trained personnel are needed, because supporting patients requires techniques and constant presence. In addition, the profession of psychologist still does not have a status in Morocco, which slows down their recruitment. We also need occupational therapists, a specialty that is almost non-existent in the country, but essential for the rehabilitation of patients.
Other health professionals must also be better trained in the particularities of mental health to identify early signs of mental disorders and refer patients to the right specialists.
What message do you want to convey to the Moroccan population regarding the importance of mental health?
Above all, mental illness should not be hidden. If signs appear, you should consult quickly. Families must be made aware of these disorders and supported to better support their loved ones. We must believe in the recovery of patients and give them the chance to return to an active and dignified life.
