For people who live and breathe work, not having a job can seem catastrophic. The economic downturn has affected every strata of society, but for high-flyers the sudden crash of reality can be more than they can handle. Private mental health clinics are experiencing a rise in patients since the stock market fell. Doctors have claimed that they have seen up to a 20 per cent increase in patients seeking treatment, many from management positions.
"What defines us?" Dr Layla Asamarai, the head of psychology at Rashid Hospital in Dubai, asks. "Dubai is one of those places in the world full of posh appearances and one of a select few places in the world where what you drive and what you wear all affect what people think of you and what you think of yourself." She says that social interaction is organised into cliques, where access is granted or taken away based upon what you drive, where you live and what you do. As families have to buckle down and cut back, cracks in relationships begin to widen, affecting relations between husband and wife, parent and child.
"People feel like they're going crazy," said Dr Yousef Allaban, a psychiatrist at the American Centre for Psychiatry and Neurology in Abu Dhabi. "People come in and say 'I don't know what's going on ... I'm yelling at my wife, yelling at my children'. They cannot fall asleep, they cannot focus, they're afraid of losing their jobs." But what about those without family? More than 80 per cent of the population are expatriates who cannot settle here permanently and whose extended families live elsewhere.
Many patients feel trapped and isolated. Family and friends that they would usually turn to for help are a world away and going through their own troubles. Reaching out to friends and family is what keeps one redundant architect in Dubai going. The 42-year-old professional, who preferred to remain anonymous, says when she lost her job back in November she didn't know what to do with herself. After working a steady job for the past 20 years, the long days of unemployment were too much to bear.
"I have good days and bad days," she says. "When you aren't working it can be a bit depressing." To cope, the redundant architect visited a close friend in Manilla, Philippines, shortly after losing her job. Her father also came to Dubai to visit her all the way from Canada. "Friends and family are important in keeping you sane," she explains. "My dad visiting was amazing. If I was by myself I know I would have been bouncing off the walls."
Of course, spending time with loved ones is only part of the solution. She advises meeting as many people as possible, networking, and, most importantly, just getting out instead of resorting to watching television on the couch. "It's easy to take it personally, but don't," she explains. "Whatever you do, stay active. Get up, get ready and get out. Get into a positive routine. It keeps your mind going."
Dr Allaban agrees maintaining a positive sense of self-worth is essential to well-being. "There won't be a sense of belonging because they feel that they've been abandoned, not only by their organisation, but psychologically they'll go into an irrational mode of thinking, believing that they've been abandoned by the world around them," says Dr Raymond Hamden, a clinical and forensic psychologist at the Human Relations Institute in Dubai.
For people who have not been made redundant, the situation at work has become far more stressful. In addition to the increased workload and personal loss of colleagues who are friends, there is the added fear that they are next to go. "The workplace environment will be both depressive and anxious," Dr Hamden explains. "When the boss calls or human resources starts assembling people to discuss the future of the company, people will always assume the worst-case scenario. People's fear will be that they will be made redundant."
Fear can quickly turn to anger when employees feel that people at the executive level are making decisions at their expense. Many companies are working to ease the transition for their employees. Counselling services are being expanded in some organisations, with many offering special seminars for workers. He says that one corporation decided that all employees would take a 25 per cent pay cut in exchange for keeping everyone on the books.
"What we find is that corporations where the employees tended to behave in a sharing and caring way with their fellow human beings are healthier organisations," Dr Hamden says. "They help each other by helping the organisation succeed." It is usually stress over human relationships, as opposed to financial ones, that lead people to get treatment. One of Dr Hamden's clients was seeking help to deal with the guilt he was feeling over a business deal with friends that was no longer viable because of the financial downturn. "He had come to me because he was having psychological distress because what he had lost was directly related to a working relationship with friends," he remembers.
"It had nothing to do with the money. It had to do with the honour of his integrity and responsibility to fellow human beings. He was having distress because he had lost face with his friends. For him, the human code of honour was much more important than money." The increase in the number of people seeking treatment has been reported from private clinics only. "People aren't often aware that public hospitals have these services, so it might be a matter of accessibility," Dr Asamarai, from Rashid Hospital, says.
There has been no increase in the demand for psychological help at public hospitals in Abu Dhabi, according to SEHA, the health services company. "We thought we would see an increase since the economic crisis, but we have not," Dr Asamarai says. "People might still be in the problem-solving stage. But maybe people didn't get that chance, maybe people have left." While most of the people seeking treatment are fairly well off, it will be those who cannot afford treatment who will need the most help, says Dr Sana Hawamdeh, assistant professor of psychiatric mental health at the University of Sharjah.
"Most people think that millionaires and rich people will be affected, but the impact will be especially marked in people living with low to middle incomes," she explains. "They don't have access to treatment, or the treatment available is very limited." Many countries spend less than 2 per cent of their national health budgets on mental health, she says. In the UAE mental health is not covered by most insurance plans, and when it is included there is often a cap that stops people from getting the help they need.
"People who are vulnerable will need more professional help." @Email:amcmeans@thenational.ae
