May 6
Anxiety and Depression from the Civil War Still Haunt Algerians
Recently, Abdou Semmar, in his show, talked about the taboo of the Algerian civil war, citing research that, after the civil war, Algiers had high rates of mental illnesses. In 2017, the Algerian Ministry of Health developed the 2017–2020 National Mental Health plan to tackle the issues of mental illness in Algeria. In a research by the Ministry in 2017, experts found that 900 000 Algerians consulted a mental health professional that year, while the number of psychiatrists in the country as of 2018 is 900, and the number of psychologists is 2000. In 1999, a study done in Algiers by the ministry of health showed that 37.4% of the population of Algiers at the time suffered from PTSD and 23.3% had anxiety as a result of the civil war. The population at the time was around 1.5 million, now 3.7 million.
Those who were in Algiers at the time of the civil war and stayed there have a higher chance of having mental illnesses, even if undiagnosed. To add to that, the war of independence 30 years beforehand is known to be the cause of many mental illnesses.
Franz Fanon, as a psychiatrist at the time of colonialism of war, says that the “colonialist’s violence bred in the colonised a constellation of pathological behaviours. And perhaps because of that inextricable link, he argued that violence was an essential part of the anticolonial struggle.” — Joelle Abi Rached, 2021
Data about the prevalence of mental illnesses in Algeria is lacking, the above data is from Global Mental Health in Our World In Data. The organization acknowledges that its numbers cannot be made to make conclusions when comparing countries or years.
The Algerian Ministry itself referenced a study in 2007 that says depression rates at that year were 4.5% and anxiety rates were not calculated. The study also found that 0.35% of the population suffered from PTSD, a big difference from the population of Algiers which was found to have 37.4% sufferers of PTSD.
A study made in 2005 by the National Institute of Health found that people living in urban areas have double the rates of mental illnesses as those in rural areas.
Algeria currently houses 19 Psychiatric hospitals with 4500 beds and 27 Psychiatric services in public hospitals with a total of 591 beds.
This year, 1200 recent graduate doctors left the country to pursue a career in France, making the number of mental health professionals in Algeria insufficient, especially in some parts of the country. Laghouat, for instance, has only one private psychiatrist in the hospital of the Wilaya. Moreover, doctors prefer other specialties, says Farid Bouchene, Vice President of the Algerian Society of Psychiatrists.
Psychiatry in Evolution
Some mental illnesses, like ADHD, have only been added to the Diagnostic manual in 1980, in its 3rd edition. In Algeria, and other countries in Europe, ADHD medication in the form of stimulants is not sold, but non-stimulants are. In this sense, the world is not in agreement with medications, or necessarily diagnoses criteria and mental illnesses.
To understand this, we can look at the history of the field that is rapidly changing, and how the Algerian government, higher education institutions, and doctors may cube unable to keep up.
The DSM, the Diagnostic and Statistical Manual of Mental Disorders is the key book that is used by psychiatrists to diagnose patients with mental illnesses, and it went through several changes throughout the years. The fast-changing information in this book of knowledge makes Algeria, sometimes, with its psychiatrists, lack updates and information. Many psychiatrists practicing still believe, for instance, that ADHD is only for children and does not include adults.
“The Algerian’s criminality, his impulsivity, and the
violence of his murders are therefore not the consequence
of the organization of his nervous system or of char-
acterial originality, but the direct product of the colonial
situation.” — Frantz Fanon on mental illnesses as a result of colonization, in The Wretched of The Earth, 1961.
References
https://www.sante.gov.dz/images/Prevention/MH_Policy_Brief.pdf
Fanon, F. (2007). The wretched of the earth. Grove/Atlantic, Inc..
