Mental health in mass gatherings

Abstract

Background:Hajj pilgrimage, in Saudi Arabia, is one of the world's largest religious mass gatherings. We have similar mass gathering scenarios in India such as the Amarnath Yatra and Kumbh. A unique combination of physical, physiological, and psychological factors makes this pilgrimage a very stressful milieu. We studied the emergence of psychopathology and its determinants, in this adverse environment in mass gathering situation, in Indian pilgrims on Hajj 2016.Materials and Methods:This is a descriptive study analyzing the mental morbidity in 1.36 lakh Indian pilgrims during Hajj 2016, using SPSS software version 19.Results:Totally 182 patients reported psychological problems. Twenty-two patients (12%) required admission. Twelve (6.8%) pilgrims reported a past history of a mental illness. One hundred and sixty-five (93.2%) patients never had any mental symptoms earlier in life. The most common illnesses seen were stress related (45.7%) followed by psychosis (9.8%), insomnia (7.3%), and mood disorders (5.6%). The most common symptoms recorded were apprehension (45%), sleep (55%), anxiety (41%), and fear of being lost (27%). Psychotropics were prescribed for 46% of pilgrims. All patients completed their Hajj successfully and returned to India.Conclusions:Cumulative stress causes full spectrum of mental decompensation, and prompt healing is aided by simple nonpharmacological measures including social support and counseling in compatible sociolinguistic milieu.

The Nature and Availability of Mental Health Services in Arab Gulf Countries: A Scoping Review

“…Lastly, a variety of other mental health services were reportedly available in Saudi Arabia, including NET, social support and counselling as effective nonpharmacological measures in treating pilgrims who suffered stress during Hajj gathering [45], and the 12-month treatment of mental disorders reported in the Saudi National Mental Health Survey (SNMHS) to have shown a high level of unmet need of treating mental disorders in the country [43]. NET is both appealing and supportive for patients and previous study reported that it widely used across various countries in Africa, Asia, and Europe [65].…”

“…NET is both appealing and supportive for patients and previous study reported that it widely used across various countries in Africa, Asia, and Europe [65]. In comparison to the social support and counselling provided to Hajj pilgrims [45], a meta-analysis reported that there is a high effect size between social support and mental health where higher social support is needed for the mental health of elderly people, patients, workers, and women [66]. For the 12-month treatment of mental disorders, this treatment modality has been also reported to be effective in treating mental disorders and suicidal thoughts and behaviours among college students in eight countries including Australia, Belgium, Germany, Mexico, Northern Ireland, South Africa, Spain, and USA [67].…”

“…Other included studies were one feasibility trial using a comparative study comparing T-CBT results with results for counselling sessions [42], one face-to-face community epidemiological survey using the Saudi National Mental Health Survey (SNMHS) on treatment rates of 12-month mental disorders [43], one descriptive, historical study on historical development and current challenges of psychiatric and psychological services and availability of psychotherapy [44], one descriptive study analysing mental morbidity in 1.36 lakh Indian pilgrims during Hajj 2016 [45], and a case study for feasibility and potential benefit of T-CBT for Saudi patients [46].…”

“…Other Mental Health Services Other mental health services reported in Arab Gulf countries include criminal forensic psychiatry assessment in Kuwait [26], psychiatric outpatient services in Oman [28], a 1-day workshop on a stress management intervention to reduce levels of burnout in Qatar [30], and mental health services provided by traditional healers in UAE [47]. In Saudi Arabia, other mental health services have also been reported including NET to reduce PTSD symptoms of traumatised firefighters [33], social support and counselling provided to Indian pilgrims who suffered stress during the Hajj gathering in 2016 [45], and 12-month treatment of mental disorders reported in the Saudi National Mental Health Survey (SNMHS) [43].…”