Mental health encompasses emotional, psychological, and social well-being, and affects how we think, handle challenges, feel, and make choices [1]. Mental well-being is essential at every stage of life, from childhood and adolescence through to older adulthood. Good mental health allows people to realize their full potential, cope with life stressors, be productive at their workplaces, and make meaningful contributions to their communities [2]. Therefore, supporting mental health is necessary for a healthy society. However, the burden of mental health disorders is continuing to grow worldwide, and has significant impacts on health and social well-being, human rights, and economic consequences globally [3].
There are numerous causes of mental health challenges, including family history, violence in homes and communities, and broader issues such as war or international conflicts. Common mental health challenges include depression, posttraumatic stress disorder (PTSD), schizophrenia, anxiety, and stress disorders. However, depression, anxiety, and stress are the most common forms of mental illnesses. For example, depressive disorders are the fourth leading cause of the global disease burden, affecting an estimated 450 million people and causing a significant amount of disability worldwide [4]. The burden of illness attributable to mental health in general is ranked second, behind ischemic heart disease [4]. A systematic review [5] revealed that approximately one in five respondents (18%, 95% confidence interval [CI]: 16.3–18.9%) were identified as having had a common mental disorder during the 12-months preceding assessment, and around 29% (95% CI: 25.9–32.6%) had experienced a common mental disorder at some time during their lifetimes. That review also revealed gender imbalances in the prevalence of common mental disorders, with women experiencing higher rates of these disorders. There was also evidence of consistent regional variation in the prevalence of common mental disorders within countries. For example, countries in North and South East Asia had consistently lower 1 year and lifetime prevalence estimates than other regions. One-year prevalence rates were also low in Sub-Saharan-Africa, whereas English-speaking counties returned the highest lifetime prevalence estimates [5].
In the Arab world, it is estimated that approximately 17.7% of the population [6] suffers from depression. However, this estimate may be underestimated because stigma toward mental illness in Arab societies means many people avoid seeking help from mental health services. This is of particular concern as many populations in the Middle East are affected by conflict and war, meaning vulnerable groups are at high risk for PTSD, depression, anxiety, and other mental health problems [7]. Another population in the Middle East region at risk for mental health problems is “blue collar” migrant workers or expatriates. These workers are generally without health insurance coverage and include domestic maids who often work under poor conditions [7].
Mental health disorders contribute to Mental Health burden in the United Arab Emirates (UAE). However, there are very few studies done on the prevalence of mental health disorders throughout the Middle East, partly due to social stigma associated with mental health. The prevalence of mental health problems among students and the associated impact on UAE society have not yet been explored. Building understanding of these factors is important to inform development of interventions that work in the UAE context.
There is a paucity of evidence from research on mental health in the UAE and the Middle East in general. However, available data indicate there has been an alarming increase in mental illnesses in the region. For example, depressive, addictive, stress-related, and anxiety disorders, along with childhood behavioral problems (such as attention deficit hyperactivity disorder) are increasingly common, along with psychotic disorders such as schizophrenia [8]. Recent WHO statistics indicated UAE estimates of the prevalence and incidence of mental health disorders were consistent with global estimates. However, these estimates and projections do not reflect the extent of the problem. Despite the UAE’s financial resources and established mental health legislation, the resources allocated to the mental health sector are modest compared with the prevalence of mental health disorders. Mental health is also a neglected area of research in the UAE and many other Arab countries. For example, between 1989 and 2008, only 192 studies on mental health in Gulf Cooperation Council (GCC) countries were published, with the UAE being the most prolific in terms of research volume [9].
It is widely recognized that depression and stress are likely to progress to chronic diseases or vice-versa. A study conducted among people with diabetes in Sharjah found a strong correlation between mental health status and diabetic complications, with patients with depressive symptoms having inadequate self-care, more severe physical symptoms, and lower adherence to prescribed care regimens than those without these symptoms [10]. These findings suggested that improving mental health as part of comprehensive patient management plans for diabetes may improve the overall long-term outcomes for these patients [10].
Students and young people are also affected by mental health problems. However, there is a paucity of data in the Middle East for this population. Students face many challenges related to their studies, such as the burden of exams and assignments, lack of sleep, and concerns about future employment, society’s expectations, and higher studies [11]. Research suggests there is a high prevalence of depression, anxiety, and stress symptoms among students. For example, a study involving secondary school girls in the Kingdom of Saudi Arabia (KSA) showed that 73% had symptoms of at least one of three studied disorders (depression, anxiety, and stress) and 50% had symptoms of at least two disorders [11]. That study reported the prevalence of depression was 42%, that of anxiety was 66%, and that of stress was 53% among participating students. Students’ scores for depression, anxiety, and stress were also positively and significantly correlated; however, no significant association was found between students’ sociodemographic characteristics and scores for the three studied disorders [11]. Another study involving university students from Turkey found similar prevalence rates of depression, anxiety, and stress (27%, 47%, and 27%, respectively), although anxiety and stress scores were higher among female students than male students [12]. That study also showed that first- and second-year students had higher depression, anxiety, and stress scores than other students. However, students who were satisfied with their academic performance had lower depression, anxiety, and stress scores than those who were not satisfied [8; 12].
In general, UAE culture does not encourage individuals to express emotions publicly. Mental health professionals therefore need to be trained how to handle patients in this context, encourage clients to express their emotions, and understand how they impact their overall well-being. The literature highlights the need to identify people experiencing mental health problems rather than waiting for them to access services. However, major obstacles include identification of such illnesses and reluctance to seek mental health support. People experiencing mental illness should be encouraged to ask for help. This means they must have access to effective and appropriate services, social support (e.g., from family, friends, colleagues, and the wider community), and robust mental health policies focused on protecting and helping them. However, more than 40% of countries throughout the world do not have policies on mental health. Further, 30% of these countries do not have effective programs for mental health [2]. This implies that many people may not receive the Mental Health assistance they may need. In addition, issues such as stigma mean that people may not receive the necessary social support.
There is, therefore, a need for customized sets of efficient interventions to be identified and implemented. For public health interventions, for example, identifying such interventions should be in consultation with the community. In those communities where cultural barriers may prevent specific effective interventions from being considered, working with the community elders may open doors to introducing such interventions. Another issue is inadequate human resources for mental health. For example, some Arab regions have only one psychiatrist per 1 million people. A possible solution is to educate and train primary care and family physicians to recognize and treat common psychiatric disorders. However, before such solutions are adopted, it is important to build an accurate understanding of the prevalence and impact of mental health problems in relation to specific target groups, such as students.
Therefore, this study aimed to clarify the prevalence of common mental health problems (i.e., depression, anxiety, and stress disorders) among undergraduate students in the UAE using a certified international measuring survey instrument known as DASS. We focused on university students, as this group is considered to represent the country’s future. In particular, we targeted undergraduate students at a university -. It is expected that the findings will provide decision-makers with evidence as to the extent of mental health problems among undergraduate students in the UAE. We also aimed to clarify correlations between students’ sociodemographic characteristics and the prevalence of depression, anxiety, and stress disorders, which may help in developing targeted interventions.