Culture

Take Aniseed not Antidepressants: battling Arab taboo (II)

Zena Youseph has first-hand experience battling one of the bigger elephants in the Arab room. In this second installment of her three-part Sajjeling series, Zena delves into the history of mental health taboos in Arab societies…

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To know from where the taboo surrounding depression and mental illness stems in my family, and in many other Lebanese and Arab families, we need to explore its cultural roots in the Levant (or in the Arab region, at large) by taking a little trip back in time.

Arab cultures traditionally placed a heavy emphasis on family: safeguarding the family, providing for the family, and, one day, inshallah, creating your own family. Indeed, the first and most important collective unit is the family, followed by the local community and then larger society. These values have been adopted and endorsed in the Middle East for centuries.

As a result, there is less emphasis on the individual as compared to the collective in the Arab world, which is a worldview not necessarily shared by Western countries.

Arab culture is, generally speaking, a communal one. It is also patriarchal, family-oriented and embedded with strong moral codes and social mores, many of which stem from religion. People in the Arab world tend to be a lot more friendly and familiar with each other, and a negative side-effect of this sense of familiarity is, of course, a greater inclination for gossip and speculation. If a family’s household name were maligned then they would feel shamed within their community, and the shaming could result in their shunning by others in the community.

Given this, it is fairly easy to see the reason for which people from this part of the world were – and still are – not so keen to disclose unsavoury information about their family or themselves. Mental disabilities as well as developmental disorders, such as autism, often go undiagnosed in children for fear it will ‘shame’ the family.

I decided to read up on where this stigmatisation stems from. To my surprise, I learned that the first psychiatric hospitals in the world were built in the Middle East: the first in Baghdad in 705 AD, the second in Cairo in 800 AD and the third in Damascus in 1270 AD. Renowned physicians such as Muhammad Ibn Zakariya Al-Razi treated patients with mental illnesses. Ibn Sina (sometimes spelt Avicenna), the famous Persian polymathic scholar who penned the fourteen volume Canon of Medicine (Al-Qanun fi’t-Tibb), also wrote extensively about psychiatric health care.

But, around the same time, there arose a superstitious belief in the Arab and Muslim world that mental illness was a punishment from God, or that afflicted individuals were possessed by ‘evil spirits’, or had been affected by ‘the evil eye’ (Isabat al-’ayn). These superstitions were not taken lightly – nor are they now – as evidenced by the prevalence of the Nazar, a five fingered talisman with an eye in the centre thought to ward off the ‘evil eye’. Scholars like Ibn Sina disagreed with these superstitions as they weren’t based on scientific inquiry.

As a teacher who has taught both in the Middle East and in schools in Australia with a high percentage of students of Arab descent, this has informed me as to why many parents refuse to send their son or daughter to a psychologist for assessment of any possible intellectual impairments or developmental disorders, such as Dyslexia, Autism Spectrum Disorders and Attention Deficit Disorder. Indeed many are in denial, hoping that their son or daughter will eventually integrate and, for lack of a better word, be ‘normal’.

A similar culture of fear and mistreatment existed in England during the Victorian era in the 19th century, with the mistreatment and punishment of women who were diagnosed with “female hysteria” when they exhibited symptoms such as insomnia, fainting, nervousness and sexual desire, treating them with methods such high pressure showers or clitoridectomies. Women were regarded as mad or crazy, due in large part to the lack of knowledge and research into the causes of mental disorders.

Presently, the investment in mental health facilities and research in the Arab world is markedly inadequate. Of the three Arab countries that have provided estimates of mental health expenditure, Palestine has spent 2.5 percent of their their total expenditure on health, Qatar one percent and Egypt less than one percent. And disappointingly, given the region’s history in pioneering world psychiatry scholarship, there is a marked lack of scholarly research into the causes of mental illness in the Arab world.

Psychiatrist Ziad Kronfoll, who works at the Weill Cornell Medical College in Qatar, stated in an interview in 2012: “Most medical schools in the Arab world have a rudimentary psychiatry program… Little attention is given to teaching interviewing skills or changing attitudes toward mental illness… Clinical research is generally lacking. While there are promising initiatives in Lebanon, Egypt, Morocco and some GCC states, this is unfortunately the state of affairs in most countries.”

Sadly, so long as this remains the status quo, the outlook for change in cultural attitudes towards mental health remains bleak.

By Zena Youseph

Zena is an English and Special Needs Teacher who lives and works in Cairo, Egypt. She has an abiding passion for Middle Eastern politics, history, music and art. Born to hardcore Nasserist parents that left for Australia during the early days of the Lebanese Civil War, she maintains that the only person she would happily lose an arm to meet is the late ex-Egyptian president Gamal Abdel Nasser. 

Mental Health is no light issue. If you need support or someone to talk to, call Beyond Blue on 1300 22 4636, or Lifeline on 13 11 14.

*Zena’s story doesn’t end here. Stay tuned for part three of her three-part series on Sajjeling.*

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8 replies »

  1. To simplify this as just taboo is a little too lacking in comprehension of the history of psychology, psychiatry, the manipulation of science and the lack thereof in the twin fields and the large amount of quackery that occurs in the ‘industry’. Arabs are also very good at smelling out a rat, and the industry is so defunct and ill reputed from its inception in the west which is no older than 150 years and it’s purpose abundantly known. It is also of no coincidence that psychological, and psychosocial maladies are far less prevalent in Arab countries despite the extreme climates, wars, poverty, and yes I agree taboo to some extent. But it is rather disingenuous and lacking in historic understanding to even think the west has a clue about what it’s doing with psycho-social disorders, with the onset of faux-diseases, pseudo-conditions coupled erected by a conglomerate of multi-billion dollar industry connected at the hip at manipulative and quackery science to the enslavement of humans through the corpo-pharmaceutical industry. It’s not quite as simple I’m afraid and you really need to understand how the industry was created and why. The complaints of Arab-Muslim, Western trained and taught psychologists is a naive and uncalculated tag along of Western wishing and dreaming to force an alien culture on to the Arab culture. To subject them to the same rigours they destroy their own communities with, that is incoherent and obsessive labelling of the most trivial of matters. One need not even look further than the dsm to see how they have faked diseases and conditions for decades. Starting with a handful of supposed mental diseases and disorders now ranging in thousands upon thousands of ‘voted on’ (yes, they merely vote on writing in these disease into the dsm every year) diseases and conditions. There is a reason why all of what they profess is looked down upon in the Arab world. Besides, the Sufi’s have been healing (note I didn’t say curing although that often occurs) humans for centuries. Granted, this is not to throw the baby out with the bath water, their is a place for valid and scientific neuro-psyche and various other psychological methodologies of measurement and recording of behaviour, but the treatment and or behaviour correction, especially the method of pharmaceutical manipulation is largely a croc of lies and pseudo to put it politely. There are far more works on psycho-spiritual disorders, their remedies, treatment, and now the link through science to gut health, and overall holistic well being are related in the Islamic realm of knowledge than their are works, journal articles and or industries in the west.

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    • Hi there. I wrote the article and thank you for talking the time to respond. I don’t really see what is so “disingenuous” about researching a topic and providing empirical evidence. Your claim that mental illness doesn’t exist is not only false, it’s an insult to people with autism, dyslexia, bipolar and schizophrenia, as well as other conditions. These have been proven by neuroscientists to be caused by impairments/chemical imbalances in the brain. Further, there is actually a lot of published evidence that there are many sufferers of mental illness in the Arab world, in part 3 I discuss these studies but here’s one: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2276523/ now, granted, you are correct in saying that in some countries people can be diagnosed unprofessional, and the pharmaceutical industry are peddling medication to capitalise on the “mental health industry”. This has nothing to with east vs west, I find that reductive. As I stated in the article, the first treatise on psychiatry was written by Ibn Sina. The first psychiatric hospitals in the world were in the Middle East. Please look at the hyperlinks. Also, in Australia it is much, much harder to get medication for mental conditions, you need to see a psychiatrist to get a script. In Egypt where I’m currently living, you can literally order anti-depressants on the phone and have them delivered to your door. So much for Arabs smelling a rat!

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    • No offense, but this smacks of a lack of scientific understanding and a deliberate bias against any form of western medicine.

      Let’s go through your points here:

      – First of all, there is a strong taboo within, at least, my experience of the middle east and Arab cultures. I could give numerous examples of young people I have met with clear social, emotional and learning difficulties that have been repeatedly ignored by parents because they were more concerned with how they looked than anything to do with the wellbeing of their children. They desperately want to be proud of the model they have in their heads, and feel a sense of childish shame whenever the child doesn’t meet these standards, blaming the child rather than themselves for having ambitions far outstripping their current capability because of their various needs. However, whilst this is typical here, it is also typical within the west, too: it is because of an insidious, encroaching form of aspirational individualism promoted by the west, that is, in the Arab world, seemingly focused on a patriarchal or matriarchal figure whose own individual wants and needs inform the notion of whether or not those beneath them are a success. Anything less is considered taboo. I would know, as I suffered in a family where that was the case, and my mother blindly did that to us despite hating that her mother did it to her.

      – Next, psychiatry is not considered “quackery” by most sensible people who have studied the field in any way. The direct causal link between, say, Edward Bernays using his uncle, Sigmund Freud’s, psycho-analysis techniques to successfully develop massively influential advertising and propaganda campaigns, or Ron Laing’s work with mothers suffering stress and looking at the differences between their attitude outside the family unit and inside the family unit, show a clear cause-and-effect understanding of various mental maladies and ways in which to treat the actual causes. Whilst many psychiatrists often do end up finding more problems than solutions, the reason for this is that there are no easy answers and most people have minds like spaghetti, with everything mixed up in a tumultuous subconscious that the psychiatrist then has to pick apart. Then, there are the specialist schools such as CBT (cognitive behavioural therapy) where someone discusses problematic behaviour, attitudes and thoughts with a therapist who offers them potential alternatives to destructive patterns of behaviour: instead of thinking your co-worker hates you, think why they might be acting the way they are, such as they’re having a bad morning, or have received bad news. All of these have practical real world applications which have resulted in a massive body of evidence that they result in positive change in the lives of others. You must concede this, unless you believe that thinking more positively, and being more forgiving, are things the world could do without.

      – “Arabs are very good at smelling out a rat”: everyone conforms to their own biases. That is all this is. As I often point out, there are probably a similar number of geniuses, idiots, bigots, good-natured souls, heroes and villains within any demographic. To pretend otherwise isn’t evidence, it’s logical error.

      – “no older than 150 years old”: let’s look at some of the things that are also no older than 150 years old – mass produced automobiles, iPhones (or, indeed, any real mobile phone technology), modern computers, the entertainment industry comprising of television, cinema, gaming and music, electric streetlights, Fanta, nuclear power, quantum mechanics, widespread acceptance that inequality of any kind is disgusting, various vaccines such as the polio vaccine which eased the suffering of millions, and much, much more. Disparaging something as lacking age is especially insane when you consider that America is probably the great superpower of our lifetime, like them or loathe them, but is a country without any real history given how, in its current form, it hasn’t even been around five hundred years. Indeed, the form of medicine or science being practised 150 years ago, in any field, would not just be indistinguishable to today, but considered brutal, dangerous or downright psychotic (recently, a US prison decided, for whatever dumb reason they had, to use a 150 year-old anesthetic on a female prison, by pouring sugar into her open wound – despite its age, it didn’t work).

      – “It is also of no coincidence that psychological, and psychosocial maladies are far less prevalent in Arab countries despite the extreme climates, wars, poverty”: This is just untrue: it is far less reported because of the social stigma and far less visible because those suffering from such conditions are kept from the public eye. And because it isn’t reported or seen, the populations of these countries can proclaim that there is no problem, which feeds into xenophobic notions of cultural superiority alongside a general laziness that means you don’t have to deal with the problem, either. As Zena said above, this has happened in the west, too, with women in the Victorian era. It is also a hallmark of the war on drugs in the west, where, due to punishments far outstripping the crime, dubious propaganda, and a government crackdown on any sensible discourse, politicians claim that drug users are all poor criminals out to steal your children, when most people who’ve done any research know that users are more likely to work in law (needing, say, amphetamines to help them through the long nights of work prior to, and during, cases) or academia (for similar reasons) or be involved in drugs due to a lack of opportunities, usually denied by the same government calling them all layabouts, than through any active choice of their own. But the problem remains invisible because it is easier to call them all shiftless layabouts, feel a sense of superiority, look tough, and not actually do anything to help. There are also similar problems with homelessness, where people make tough speeches that amount to nothing, rather than, say, the Finnish model, where they just give homeless people homes so they can take part in society. In the Arab countries, there is a similar process for most people when it comes to mental health: deny there is a problem, act tough with anyone who behaves in a problematic way by shunting them from public life to reinforce your denials, claim you’re culturally superior, and then have to do even less than you normally would because it’s the easiest option. Heck, the lazy approach is kind of rational in some ways: why do you want the hassle? But the truth is that the hassle, as it were, is the heart and soul of the drive for equality of all people, regardless of their circumstances. Put another way, a friend told me that someone she knows, a native of an Arab country, asked why their were so many more people suffering mental health problems in the UK: she, rightly, pointed out that we just don’t exclude them from society. Heck, I once met a politician from our most right-wing party, and he had Down syndrome.

      – “the onset of faux-diseases, pseudo-conditions coupled erected by a conglomerate of multi-billion dollar industry connected at the hip at manipulative and quackery science to the enslavement of humans through the corpo-pharmaceutical industry”: Let me break this down into parts:

      1. “faux-diseases” these are not. One of the definitions of a disease is something that prevents the body from working properly. So let’s look at anxiety: anxiety is a condition where, for no reason whatsoever, you get an overwhelming sense of worry or nervousness that is triggered by a variety of things, depending on what caused it within you. The symptoms then extend to those when people feel worried or nervous: tingly sensations all over that can develop into a sensation similar to pins and needles, nausea because you feel so nervous it makes you want to vomit, excessive sweating which reinforces the sense of nervousness which makes you sweat more, headaches which can become so strong that they can cause eye problems or make it hard to do anything but sit in a room without any lights on and just hurt, and many, many more. All of these symptoms are real. But, I hear you say, aren’t they just all in their head? Completely made up? Well, I ask you: what is the difference? Your head is the primary tool by which you understand and experience the world – in a real sense, everything is in your head. This computer screen you’re experiencing right now? In your head. Your understanding of the colour blue? In your head. Heck, we know, due to synesthesia, that one wire crossed in the brain can make people see smells, or taste colours. We know that perspective isn’t something visual because there is a blind man who can paint with perfect perspective due to touch as a consequence of his synesthesia. Why is it so hard to grasp that it doesn’t matter whether or not it is in someone’s head when they’re feeling pain, because that is just as valid a sensory experience as someone being stabbed in the head with a fork. The origin of the pain only becomes important when treating it, and would you honestly deny someone in pain treatment because you don’t think it is real? Why does it even involve you, anyway? It is their pain!

      2. “erected by a conglomerate of multi-billion dollar industry”: Yes, Big Pharma at colossal scumbags. Doesn’t mean that their LIFE-SAVING DRUGS are any less effective.

      3. “manipulative and quackery science to the enslavement of humans”: except, the money isn’t in enslavement, it’s in freedom. You think someone confined to a wheelchair until they get the right medication to reverse the disease they have, or free them from the pain they were feeling, is somehow more enslaved then they where when they were confined to a life of pain in a chair? And how is it manipulative? These big companies aren’t going around infecting everyone, no matter what wacky conspiracy theories you go around reading, because by now someone would have come forward expressing their overwhelming guilt at having took part in these deliberately caused pandemics. After all, the drug companies don’t force you to take their drugs – they offer you the option of taking them, but it is the doctors, whose Hypocratic Oath states that they must, “Do no harm,” that usually demand that you take them. And they do that because they don’t want you to suffer and die. For the person whose severe depression renders them incapable of even getting out of bed in the morning, and whose anxiety leaves them unable to sleep at night, a small sedative can completely change their life and get them back functioning and happy. What you propose is mere survival (humans are capable of functioning, so they damn well should, regardless of their pain and suffering) whereas what I’m talking about is living (being happy and able to contribute to the world).

      – “you really need to understand how the industry was created and why”: Again, you’re alluding to conspiracy theory here. The truth is that the industry was created because their were widespread medical, social and psychological issues that could be addressed only by very wealthy people funding organisations due to the economy of scale involved in treating these problems. Simply put, a bunch of chemists can create a cure, but they can’t mass produce it, and those people who can can’t create it, and neither of them can keep doing it unless they make a healthy profit to pay their wages and cover the cost of mass production.

      – “a naive and uncalculated tag along of Western wishing and dreaming to force an alien culture on to the Arab culture”: This is madness. You know in the Western world they claim that Muslims are trying to force an alien culture onto them? Do you know why? Because it makes it easier to discriminate against those groups, and keep normal, poor people divided and acting against each other and our best interests. Either way, dealing with mental issues tends to focus on individual needs, not massive global demographics, so you’re letting your conspiracy theories get in the way of talking about the actual issues, here.

      – “To subject them to the same rigours they destroy their own communities with, that is incoherent and obsessive labelling of the most trivial of matters”: First of all, our communities are spoiled and entitled, but are considerably robust and nowhere near likely to be destroyed in any sense of the word. However, I do agree that there is an obsessive labeling of the most trivial of matters, but, again, this is not something of which psychology professionals are unaware. Indeed, on the publishing of the latest DSM-MD (Diagnostic and Statistical Manual of Mental Disorders), most professionals joined the public in condemning some of the definitions of juvenile specific disorders simply because they described children being children, and were seeking to pathologise the known development of children. But, then, this is also part of a long-running political and social war against youngsters, and fits into a wider trend of suggesting teenage rebellion, which is important, is something that should be quashed rather than given healthy outlets, which in turn causes more problems later in life. The truth is that psychology doesn’t have all the answers: instead, it has sombunall of the answers (sombunall was a word created by Robert Anton Wilson, which means “some, but not all”, which was intend to correct an English language specific prejudice where we use all, but don’t mean all, simply meaning “most”, but “sombunall” hammers it home better than “most” would).

      – “Starting with a handful of supposed mental diseases and disorders now ranging in thousands upon thousands of ‘voted on’ (yes, they merely vote on writing in these disease into the dsm every year) diseases and conditions”: It isn’t voted on: originally, the definitions were taken from census data, in order to learn what was out there in the world. This is a basic starting point for national or international study in all fields. It then expanded as they found more and more different variations on what they had already found, or areas that they had not covered previously. This is the sensible way to go about things: in football, you don’t just label all strikers as Eusebio because he was one of the great strikers and because it is convenient, you allow them to use their own names to recognise their differences as people; in cinema, you don’t ban films if they don’t fit into a simplistic generic description because it would be too confusing for people to have a horror and a comedy in the same film; in a massively complex field such as mental health, you don’t stick with a handful of definitions because that is easier, as it is unrealistic and antithetical to the notion of discovery and understanding the various complexities of that field. After that, they set the DSM-MD up for peer review – a tradition where experts in the field can review the information as presented and suggest problems with it to ensure it is more rigorous – before publication. And people were still allowed to disagree with it publicly, as it isn’t a rule book: its advisory, and the fact that it has to be periodically changed to reflect changes in society and definition reflects, again, the fact that no real, respectable field of scientific inquiry or medicine has all the answers, just sombunall of the answers. In fact, any field suggesting that is has all the answers is undeniably the field of the quacks.

      – “There is a reason why all of what they profess is looked down upon in the Arab world.”: I believe I already covered this above, but I also want to add that an inflexible and resistant culture than will not engage with or take part in discourse on the topic at hand is one which believes it has figured everything out. Why, then, might I ask, do I see the exact same symptoms and problems recurring within the Arab world that there are in the UK, but see most of those students with those problems recover and go on to be happy and successful, supported in the areas in which they can achieve, whilst in the Arab world many refuse to acknowledge their issues and then wonder why they are suffering the same outcomes time and time again? In the computer game, Far Cry 3, the character of Vas keeps telling the protagonist that the definition of madness is doing the same thing over and over and expecting different results, and he repeats it to hint that he, too, is mad. But he has a point: a lack of introspection and sympathy for others, merged with an out of sight, out of mind attitude, and the unaware familial bullying around the need for success which will always be the family’s, but never the student’s, always lead to stress, panic, worry, and, eventually, disengagement and a lack of success. I, personally, think you guys should be allowed to do what you want to do, even if it is rejecting the sizeable and comprehensive amount of research into what works best with people suffering from mental health issues. I just don’t think you have a right to tell me I’m wrong because all your gang agrees with you that they want to ignore all that evidence.

      – “Granted, this is not to throw the baby out with the bath water, their is a place for valid and scientific neuro-psyche and various other psychological methodologies of measurement and recording of behaviour, but the treatment and or behaviour correction, especially the method of pharmaceutical manipulation is largely a croc of lies and pseudo to put it politely.”: If you’ll excuse me, I’m going to label this STRIP-CLUB PSYCHOLOGY. The reason is, that in certain seedier parts of the world, there are establishments where the semi-nudity of female staff members is greeted with the affections and lustful leering of a small, usually male, portion of the local demographic who really should have reached a certain numeric valuation with regards to their time spent on this blue sphere, but, alas, have a form of arrested development that most of society and the media choose to encourage. However, in these establishments, they have a rule: look, but don’t touch. Hence, STRIP-CLUB PSYCHOLOGY. You’re proposing, with some magical thinking here, that the world of psychology and its various other branches closely associated with it, should measure and record abhorrent behaviour, but then should not treat it or modify it in any way, especially not with pharmaceuticals. I’m sorry, but this isn’t a model for medical treatment: it’s a model for the torture of the doctor and patient, and is the exact opposite of the basis of all medicine – “do no harm”! If you just note down what is happening and then do nothing, what is the point? At least the idiots pouring sugar into an open wound I mentioned above were trying to help. Your suggestion is undoubtedly the laziest, most selfish, most conceited form of action that I have ever, ever heard. It is the equivalent of a paramedic arriving at the scene of a car crash and deciding that it would be best to observe the wound, rather than, you know, disinfecting it to prevent infection, sewing it up to prevent blood loss, and then driving the patient to a hospital so that they can be treated to ensure there aren’t further massive problems that could kill them. And that is without even discussing the fact that some psychological disorders are actually symptoms of physical problems, such as brain tumours, or neuro-syphillus, for example, or liver problems. All things which, hey, guess what, can be treated by actual doctors, but are often found due to treatment by actual psychiatric professionals and therapists. And for those who don’t have something physically wrong, how dare you dictate to them how they should live their lives? I’m guessing you have never had any of the many problems that the rest of us deal with on a daily basis, so let me put it in terms you can understand: if someone is missing a leg, why shouldn’t they get a prosthetic? If someone’s eyes aren’t functioning properly, why shouldn’t they have glasses? If I don’t have the same balanced production of chemicals in my brain that you do, why shouldn’t I be allowed to that? But, oh well, you’ll be fine, so who cares, right? Funny how you slam and try to shame the west, but end up showing the same sense of individualistic self-entitlement that drives the many things you claim to abhor.

      – “overall holistic well being”: apologies, but I couldn’t tell if this was a redundancy (“holistic” and “overall” meaning the same thing) or if you were advocating holism, which is genuine quack science. Do a quick search for “holistic therapy ben goldacre” online, and you should find his blog of articles about him exposing bad science and problems with big pharma, but from the perspective of someone who cares about doing no harm.

      So, to summarise:

      Psychology isn’t “quackery” just because it is recent. Things being old don’t make them worthwhile.
      Be careful of your own biases, because they are not facts, especially when applied directly to a wide group without any statistical basis for drawing such conclusions.
      Just because problems are hidden from public view does not mean they’re there; certainly, the young people of the Arab world have similar problems to the young people of the western world, it’s just in the west the problems are visible and treated, and in the Arab world sumbunall parents ignore the problem for their own reason.
      Big Pharma is nobody’s friend, but they don’t exist to make people worse, either, because where is the profit margin in something that makes people ill?
      There is no Arab vs the west battle: it is rich people in those countries using that as an excuse to keep poor people divided.
      Mental health professionals don’t have all the answers because no school of education, scientific inquiry, or medicine claims to have all the answers on account of there being no unifying theory of everything, ever.
      Strip-Club Psychology, that notion of look but don’t touch, is the idea of doing nothing but harm, rather than doing no harm.

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      • I’m sorry CEF I think you escalated the meaning. Mental health is very real regardless of what people may assume ask me many years ago I had twelve ECT’s Electrocunvulsive therapy, it helped for a while it required staying in hospital for 3 months, constant observation & evaluation of different medications. I now still suffer from chronic depression thankfully not as bad as it was & slowly weaned off the medication. If I hadn’t had that at the time I probably would have been dead.

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  2. As a past counsellor & current social welfare officer you sometimes would witness fragmented parts of the soul return home where they have become like special guests at a glorious Banquet, one unifying whole sitting at the table when a therapist experiences this work they truly appreciate and understand the deep suffering mental health patients have endured daily.
    Beautifuly written Miss Zena Youseph

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