Data insights are based on population-based household surveys representative at the national and/or sub-national levels.
Years of conflict, mass displacement and poverty have hit Yemen’s women and girls especially hard. The COVID-19 pandemic compounded the erosion of protection mechanisms and increased the vulnerability of women and girls to gender-based violence and harmful practices like child marriage.
Marwa* has experienced these stresses firsthand. At age 9, she was left to care for her younger siblings after her parents divorced. Her father began to abuse her, beating her severely and refusing to let her go to school.
With the spread of COVID-19, many families have disintegrated, and violence is spreading.
“Marwa called our family counselling hotline in a miserable condition,” says Ishraq, a psychologist at a UNFPA-supported mental health hotline in Sana’a. Overwhelmed with worry for her siblings and fears about the pandemic and the escalating conflict, Marwa was having a hard time eating and sleeping.
The mental health toll of what is now the world’s largest humanitarian crisis has been staggering.
Even before the pandemic, an estimated one in five people in war-ravaged Yemen suffered from a mental health disorder, according to a 2017 study conducted by the Family Counselling and Development Foundation. The proportion is now likely as high as one in three, according to Dr. Bilqis Jubari, a psychotherapist and associate professor at Sana’a University.
There are many obstacles to getting help. Mental illness is highly stigmatized in Yemen, and mental health care remains scarce. There are extremely few psychiatrists or psychologists, and some of the few existing mental health care facilities have closed due to the pandemic.
Like Marwa, many survivors of gender-based violence experience a deterioration of emotional or mental well-being as a result of what they’ve been through. The silence and stigma around gender-based violence can exacerbate these impacts.
Mental health care and psychosocial support are therefore an integral part of the response to gender-based violence, alongside services like medical treatment, legal support, provision of basic needs like food and shelter, cash assistance and economic empowerment.
The Interagency Minimum Standards for Gender-based Violence in Emergencies Programming, which define what UNFPA and other agencies need to achieve to prevent and respond to gender-based violence during humanitarian emergencies, require that women and girls have safe access to quality, survivor-centred psychosocial support focused on healing, empowerment and recovery. The standards also specify that health services for survivors must include specialized and clinical mental health care for those assessed as needing it.
Mental health assessment and care, psychosocial support and counseling are also included as part of the Essential Services Package for Women and Girls Subject to Violence, a guidance tool created by UNFPA, UN Women, WHO, UNDP and UNODC through the Joint Global Programme on Essential Services to support the design, implementation, coordination and evaluation of services across the health, social service, police and justice sectors.
In Yemen, UNFPA has long provided quality psychosocial support to survivors of gender-based violence, through non-specialized services staffed by social workers and delivered through safe spaces, shelters, mobile teams and outreach activities.
For many survivors, non-specialized services make a significant contribution to recovery. But some suffer more severe mental health problems, and may even be at risk of self-harm or suicide – requiring specialized mental health care.
In 2018, UNFPA began providing such specialized care, including psychiatric evaluation, medication and counselling, delivered by trained psychiatrists and psychologists like Ishraq. There are currently eight specialized mental health and psychological support centres in Yemen, run by local partners in the Aden, Ibb, Hadramaut, Hajjah, Sana’a, and Taizz Governorates.
The telecounselling provided by Ishraq and her colleagues is one key strategy to get these critical services to those who otherwise would not be able to access them. It has played an increasingly critical role as the pandemic disrupted access to in-person services, while demand for mental health care and psychosocial support has surged.
In response, UNFPA increased the number of counsellors to staff its toll-free hotlines. The number people reached through the hotline doubled in the first half of 2021 compared to all of 2020.
people, or two-thirds of Yemen’s population, or were in need of humanitarian assistance in 2021
coordinating service providers and other stakeholders to ensure coverage and access to quality response and prevention services, as part of the humanitarian response
Marwa got the help she needed – not only for herself, but for her family, too.
“After diagnosing Marwa’s condition, we found that the solution revolved around treating her and providing psychological support to her father,” Ishraq says. With Marwa’s consent, counsellors secured treatment for her father, who was experiencing paranoia and delusions.
Marwa received more than a dozen telephone therapy sessions, which focused on developing problem-solving skills and other tools for mental wellness, as well as building up her self-esteem.
“I made it clear to her that she was a strong girl, having taken care of her sisters, herself and her father after her mother's departure,” Ishraq says. “I helped her see her achievements.”
Over 6 million women in Yemen require urgent access to protection services. But the availability of these lifesaving services – along with the full array of services supporting the health, well-being and human rights of Yemen’s women and girls – is in jeopardy.
Despite the vast scale of humanitarian needs in Yemen, humanitarian operations are seriously underfunded. As a result, essential services like mental health care and psychosocial support are in danger of being dramatically scaled back, even as needs continue to grow.
*Name changed for privacy and protection.
My only wish is for this service to continue to grow and expand. Cases are increasing daily.
