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There is evidence that mapping mental health systems (MHSs) helps in planning and developing mental health care services for users, families, and other caregivers. The General Administration of Mental Health and Social Services of the Ministry of Health over the past 4 years has sought to streamline the delivery of mental health care services to health consumers in Saudi Arabia. We overview here the outcome of a survey that assessed the Saudi MHS and suggest strategic steps for its further improvement. The World Health Organization Assessment Instrument for Mental Health Systems was used systematically to collect information on the Saudi MHS in 2009-2010, 4 years after a baseline assessment. Several mental health care milestones, especially provision of inpatient mental health services supported by a ratified Mental Health Act, were achieved during this period. However, community mental health care services are needed to match international trends evident in developed countries. Similarly, a larger well-trained mental health workforce is needed at all levels to meet the ever-increasing demand of Saudi society. This updated MHS information, discussed in light of international data, will help guide further development of the MHS in Saudi Arabia in the future, and other countries in the Eastern Mediterranean region may also benefit from Saudi experience.

Background With the growth of information technology, there is a need for the evaluation of cost-effective means of monitoring and support of field workers involved in large epidemiological surveys. Aim The aim of this research was to measure the performance of a survey help desk that used knowledge management tools to improve its productivity and efficiency. Knowledge management tools are based on information technologies that improve the creation, sharing, and use of different types of knowledge that are critical for effective decision-making. Methods The Saudi National Mental Health Survey’s help desk developed and used specific knowledge management tools including a computer file system, feedback from experts and a call ticketing system. Results are based on the analyses of call records recorded by help desk agents in the call ticketing system using descriptive analysis, Wilcoxon rank-sum test (p < 0.01) and Goodman and Kruscal test (gamma). The call records were divided into two phases and included details such as types of calls, priority level and resolution time. Results The average time to resolve a reported problem decreased overall, decreased at each priority level and led to increased first contact resolution. Conclusion This study is the first of its kind to show how the use of knowledge management tools lead to a more efficient and productive help desk within a health survey environment in Saudi Arabia. Further research on help desk performance, particularly within health survey environments and the Middle Eastern region is needed to support this conclusion.

Previous global and regional studies indicate that adolescents and young adults (i.e., youth) are affected by various mental disorders with lifelong consequences. However, there are no national estimates of mental disorders prevalent among Saudi youth. Using data from the Saudi National Mental Health Survey (SNMHS), we examined the lifetime prevalence, treatment, and socio-demographic correlates of mental disorders among Saudi youth (aged 15–30). A total of 4004 interviews were conducted using the adapted Composite International Diagnostic Interview (CIDI 3.0). Cross tabulations and logistic regression were used to generate estimates for the SNMHS youth sample (n = 1881). The prevalence of a mental disorder among Saudi youth was 40.10%, where anxiety disorders affected 26.84% of the sample, followed by disruptive behavior disorders (15.44%), mood disorders (9.67%), substance use disorders (4%) and eating disorders (7.06%). Sex, education, parental education, income, marital status, region, and family history of disorders were significant correlates of various classes of mental disorders. Only 14.47% of Saudi youth with any mental disorder received treatment for a lifetime disorder. Age, parental education, and family history of disorders emerged as significant correlates of mental health treatment. Lifetime mental disorders are highly prevalent among Saudi youth. There is an unmet need for culturally sensitive and age-appropriate treatment of lifetime mental disorders among youth in Saudi Arabia.

Background Mental disorders account for a significant proportion of the world’s disease burden and are more significant among females than males. However, most global mental health research is sex neutral, including in the Kingdom of Saudi Arabia. This study, therefore, estimated the prevalence of mental disorders and investigated the sociodemographic correlates, sex disadvantage factors, and treatment-seeking in Saudi women concerning lifetime and 12-month mental disorders. Method The Saudi National Mental Health Survey is a stratified multistage clustered area probability design. Lifetime and 12-month mental disorders were assessed through the Composite International Diagnostic Interview (CIDI 3.0). The correlates considered for this study included age-at-interview, education, marital status, employment status, socioeconomic status (SES), any chronic condition and household characteristics (region, urbanicity, and income), as well as domestic violence, age at marriage and in a polygamous marriage. Data was analysed using PROC SURVEYFREQ procedure as well as logistic regression in SAS 9.2. Results Overall, 24.7% and 35.9% of Saudi women experienced at least one of the disorders in the prior 12 months and at least once in their lifetime, respectively. Anxiety disorders were the most frequently reported 12-month and lifetime disorders, followed by mood disorders. The region, urbanicity, chronic conditions, employment status, as well as certain sex disadvantage factors were significantly associated with both 12-month and lifetime disorders. Most women did not seek treatment for 12-month mental disorders (86.2%) and lifetime disorders (73.8%). Conclusion Our study confirms that mental health issues, particularly anxiety and mood disorders, are highly prevalent among Saudi women, influenced by chronic conditions and sex-related factors like domestic violence and polygamy. Future research should focus on improving mental health literacy, using rigorous study designs to explore female-specific variables, and investigating genetic and environmental factors.

Background Substance use disorders (SUDs), encompassing alcohol (AUDs) and drug use disorders (DUDs), are significant global public health concerns. While SUDs are well-documented worldwide, data on their prevalence and impact in Saudi Arabia remain scarce. This study investigates the epidemiology and burden of SUDs in Saudi Arabia using data from the Saudi National Mental Health Survey (SNMHS). Methods The SNMHS is a nationally representative cross-sectional epidemiological household survey, consisting of a sample of 4,004 participants aged 15–65. The survey employed a stratified multistage clustered sampling design and used the WHO CIDI 3.0 to determine diagnoses. Descriptive statistics and multivariate binary logistic regression were used to analyze the data. Results The lifetime, 12-month, and 30-day prevalence of any SUD were 4.03%, 1.88%, and 0.78% ( p  < 0.05), respectively. DUDs were more prevalent than AUDs overall. SUDs were significantly associated with younger age, lower education, low income, exposure to traumatic events, family burden, and childhood adversities. High psychiatric comorbidity and role impairment were observed. Treatment seeking was moderate, with only 44.9% of those with lifetime SUDs seeking any form of treatment. Conclusions SUDs in Saudi Arabia are more prevalent than previously thought, associated with significant psychiatric comorbidities and role impairment. Despite this, treatment seeking remains inadequate. These findings underscore the need for targeted prevention and intervention programs tailored to the demographic and cultural context of Saudi Arabia.

ObjectiveAnxiety and depression are among the top contributors to disability in the Kingdom of Saudi Arabia (KSA), but little is known about their economic impact. This study estimates the economic burden of moderate to severe symptoms of anxiety and depression among adults in KSA.Design and settingA cross-sectional survey was administered via a web panel. Participants were asked to fill out the Patient Health Questionnaire-4 (PHQ-4) for themselves and on behalf of other household members to capture prevalence rates. Those who reported at least moderate symptoms of anxiety or depression filled out a longer survey with questions on healthcare utilisation and productivity losses due to symptoms. These responses were monetised using prevalence rates and population estimates to calculate per-person and total annual costs.ParticipantsPrevalence estimates are based on responses from 1164 participants on behalf of 3202 Saudi adults. Of these, 269 individuals with symptoms completed the longer survey.Primary outcome measuresPrevalence of anxiety and depression; healthcare utilisation (medications, outpatient, inpatient) and productivity losses due to absenteeism and presenteeism.ResultsIn total, 26.2% reported at least moderate symptoms consistent with anxiety and/or depression. Among those with symptoms, direct healthcare costs due to anxiety and depression averaged Saudi riyal (SAR) 3431.95 per person annually. Indirect costs via absenteeism and presenteeism averaged SAR 9702.87 and SAR 24 577.28 per person assuming that anxiety and/or depression episodes last for 6 months. Summing up the healthcare costs and productivity losses yields a total annual economic burden of SAR 163.3 billion. Absenteeism accounts for 24.8% of this total (SAR 40.5 billion), presenteeism accounts for 62.8% (SAR 102.5 billion) and healthcare resource utilisation accounts for 12.4%(SAR 20.3 billion).ConclusionsThe overall prevalence of anxiety and depression in KSA is estimated at 26.2%. The economic burden associated with these symptoms amounts to SAR 163.3 billion or 4.1% of GDP. Absenteeism and presenteeism costs account for the vast majority of the total, but a large percentage (nearly 60%) also report emergency department visits and unplanned hospital admissions. Evidence-based interventions should be considered to address the health and economic burden of these conditions in KSA.

ObjectiveTo assess prevalence and correlation of factors of family burden associated with mental and physical disorders in the general population of Saudi Arabia.Setting and participantsA secondary analysis of data from the Saudi National Mental Health Survey (SNMHS).Outcome measuresMental and physical health disorders of first-degree relatives and objective (time, financial) and subjective (distress, embarrassment) family burden.ResultsWe found significant caregiver burden for family members with mental health disorders. Around one-third of the sample was providing care for a family member with a health issue. Within this group, 40% had a mental health diagnosis. 73% of the study population reported experiencing some form of burden as a result of the care they are obligated to provide for their family members. We found the highest burden on male caregivers, in providing care for family members with serious memory disorders, mental retardation, schizophrenia or psychosis, followed by, alcohol and drug disorders, anxiety, depression or manic depression.ConclusionOur findings for family burden were statistically significant, indicating potential negative impact on caregiver coping ability with the demands of caring for family members with health issues. A comprehensive review of national mental health policies is required to integrate aspects of community mental health promotion, scale-up prevention, screening interventions and social support to protect against the difficulties of mental illness and reduce the burden on caregivers, the family, society, health system and the economy.

Background The World Mental Health-Composite International Diagnostic Interview (CIDI) 3.0, originally in English, is a fully-structured interview designed for the assessment of mental disorders. Although Arabic translations of CIDI from countries like Lebanon and Iraq exist, a Modern Standard Arabic translation was developed to suit the Saudi population. While the translation model used in the present paper has been used to translate instruments in Asian and European languages, there is no study to the best of our knowledge which has used this specific model to translate a validated instrument from English to Arabic. Case presentation This paper describes the Saudi adaptation of CIDI 3.0. The TRAPD team translation model—comprising of translation, review, adjudication, pretesting and documentation—was implemented to carry out the Saudi adaptation of CIDI 3.0. Pretests involving cognitive interviewing and pilot study led to translation revisions which consequently confirmed that Saudi respondents had a good understanding of various items of the instrument. The adaptation procedures for the Saudi CIDI 3.0 were well documented and the instrument was linguistically validated with the Saudi population. Conclusion The TRAPD model was successfully implemented to adapt the CIDI 3.0 to be used as the main survey instrument for the Saudi National Mental Health Survey, findings of which will provide health policy makers mental health indicators for health decision making and planning.

Background The World Mental Health surveys have been known to apply high standards of quality control, but few studies have been published to document this. Furthermore, the effectiveness of quality control has rarely been reported in the Middle East. Case presentation The focus of this paper was to highlight the implementation of quality control procedures in the Saudi National Mental Health Survey under the World Mental Health Survey Consortium. The paper summarizes the guidelines implemented for the various phases of survey quality control—the quality assurance procedures, the quality control procedures and the quality control appraisal components—as per previously prescribed recommendations in literature. Conclusions Survey quality management is a process and not reducible to a single event. Midstream corrections are warranted by detecting problems and intervening appropriately. The Saudi National Mental Health Survey implemented such procedures through continuous quality improvement.

Psychotic expression is influenced by unique contexts, including the individual’s culture. The majority of research on psychotic experiences is quantitative and from Western, democratic societies. This article explores the explanatory models used by Saudis to describe psychotic experiences (i.e., hallucinations and delusions). Using open-ended responses to a structured psychosis screener embedded within a comprehensive mental health survey instrument, we conducted thematic analysis on data representing the psychotic experiences of 59 individuals. We found that Saudis report religious (e.g., Jinns) and cultural (e.g., modest clothing) frameworks alongside biological, psychological, and social mechanisms which potentially trigger an alternative reality for the affected individual. Our findings suggest it may be helpful for health care professionals to consider individual differences and work with religious leaders (e.g., Shaykhs) to prevent misdiagnosis and mistreatment. In-depth qualitative studies are needed to examine trajectories of psychotic symptomatology among Saudis and the specific language used to describe such occurrences.