Get your mental counselling online in UAE

What do you do if you live away from the city, and you need to see a therapist regularly? It could be for any issue troubling you. You might need to see a therapist for marriage counselling, anxiety issues, depression, bi-polar disorder or any of the nearly 200 diagnosis that falls under mental health. Do you drive all the way out to Abu Dhabi or Dubai twice/thrice a week to see a mental health counsellor, and pay anything from Dh600 upwards for a session? Or do you not seek help at all - not a smart call, needless to say. What happens to people who can't afford the high cost of mental healthcare but want professional help?
Mental healthcare in the UAE is an expensive business and this has created advocates in the UAE for cheaper mental health solutions.
Dr Lata Bijlani, general practitioner at Falcon Medical Clinic who's been practising in Dubai for 22 years, touches upon the issue of social stigma around mental health, and the fact that insurance doesn't cover the costs. "In today's digital world, it is easier to get people to open up about their psychological problems online rather than in person." This is especially true for teenagers and 'millenials', never parted long from their phones, and rarely offline. Dr Bijlani says: "The social stigma involved with taking help for psychosomatic issues produces an inertia in which the first step is the hardest. The need for repeated sessions also makes the cost prohibitive, as it is not covered by insurance. The need of the day is affordable online counselling."
Online counselling (or telecounselling, or distance counselling for mental health) is when you can set up an appointment online on a video link - like Skype or Facetime - for non-emergency cases. This wouldn't work for a person contemplating suicide who will need immediate, physical intervention. Online counselling applies for non-emergency cases - depression, bipolarity, phobias, anxiety, etc.
Virtually non-existent in the UAE, telecounselling (different from telemedicine, which exists in the UAE; but conceptually similar) is a means to offer clients help in their homes, at their convenience, and crucially, at a more affordable price. There are, of course, red flags to watch out for - such as the certification of the counsellor. Clients should ask for the credentials of their counsellors to feel assured that they're getting professional help from properly trained people.

UAE law on telemedicine
According to the definition in the 'Health Authority of Abu Dhabi (HAAD) Standards for Tele-consultation in the Emirate of Abu Dhabi', mental health is specifically excluded from tele-consultation. Citation: "Telemedicine excludes all services involving invasive clinical interventions; prescribing of medications including prescribing the use of narcotics and controlled medications for treatment (eg. mental health or other disorders that require the use of controlled drugs)."
But Rachna Buxani, a licensed mental health counsellor in the United States (Miami, FL) says: "The laws governing telecounselling here in the UAE are unclear."
On a visit to Dubai, Buxani, who still considers the city home as she grew up here, talks about the need for distance counselling for mental health in the UAE. She worked in Dubai as a counsellor and has dealt with hundreds of mental health cases in children.
"In Dubai as much as elsewhere, there are families breaking apart, couples struggling and teenagers having problems. Mental health concerns are pretty universal. And reported cases are far less than actual cases. If someone doesn't seek out help, then you don't have a statistic for them. The WHO did a study, I think in 2014, in which they said four per cent of the population ails from mental illnesses. Now, keep in mind that this is reported population. There must be lots more that go undiagnosed and thus not reported. In another study in 2011, it was outlined that there are 0.3 psychiatrists, 0.5 psychologists, 0.25 social workers and 0.4 other health workers for every 100,000 people. This indicates the clear shortage of mental health professionals in the UAE."
Buxani explains telecounselling would be cheaper for people seeking help because of the drastically cut operational costs and no rent to pay. "For a counsellor," she says, "if you aren't spending on a place, a secretary, then it's cheaper. You charge your clients less, and there's more flexibility of time. I'm doing that from there. It's a way of offering affordable help".
"We wouldn't Skype you. There are programmes that are HEPA regulated websites, to regulate confidentiality. There are certain technology that's encrypted and okay to use," she says.
Privacy and stigma
The online solution might appeal most to youngsters, and the people who don't want to be spotted by their social set going in to meet a counsellor. Manisha Khiani, school administrator for Rajagiri International School, says: "Distance counselling is an extremely helpful concept. It offers convenience, serving clients with limited mobility, time restrictions or anyone seeking help who is reluctant to see a counsellor in person."
Speaking of the privacy angle, Khiani says: "The counsellor's physical absence diminishes the client's initial fear or need to save face while presenting a problem. The most important aspect of this concept is the need of licensed, trained and affordable help, which will definitely provide help and support to many in dire need."
How it works
You go through an orientation process with your client, says Rachna Buxani. "The States is very, very particular about its rules. Obviously you have forms need to be filled. It's very much like your face-to-face counselling: intake forms, your bio-psycho-social, complete documentation, sign release consent, etc." Telecounselling, she says, works especially well for teens and tweens. "Technology is something that they're using a lot anyway. They're very private people, teenagers are going through an awkward phase of life".
Choosing a psychologist is a very personal decision for most people. There are (roughly) 200 mental health diagnosis. People have to know they're getting the right treatment/ counsellor for what they're ailing from. As much as you won't go to a dentist for an orthopedic problem, choosing the right counsellor is crucial. Shorouk Nafie, counsellor at the German Neuroscience Center, encourages people to exercise caution in choosing the right counsellor, and the right medium for getting help: "The government entities have very strict regulations to license healthcare provider and physicians in the UAE. The goal is to keep a certain quality level and prevent patients from fraud."
Another factor is trust. Nafie says: "Psychotherapy requires a trustworthy relationship between patient and professional. Otherwise the therapy will not work. Patients have to evaluate if they are able to establish this kind of relationship with someone on the Internet. If they are sure about the qualification, licensing and regulations of the healthcare provider and they trust the professional, it can work".
nivriti@khaleejtimes.com