To date there have been no studies that attempt to prevent postpartum depression or anxiety among Arabic speaking women in the Middle East, including Qatar.

When Khadija, 34, a Sudenese resident in Qatar, gave birth in August 2020, she wished to be surrounded by her husband and mother, who had been present during her first pregnancy in 2018. Due to COVID-19 restrictions however, she was forced to stay alone in the hospital.

“I was crying all the time at the hospital because they were not allowing my husband to stay for more than 15 minutes; my mother was also only able to visit for 10-15 mins, “ said Khadija, who later suffered from severe postpartum depression (PPD) after delivery.  

The health clinic did not screen her for PPD,  a medical condition that many women get after having a baby, characterised by strong feelings of sadness, anxiety, and in extreme cases, suicidal thoughts.

Three days after delivery, she was dismissed from the hospital, and when she reached home, her anxiety increased. She hated her body. She cried every day, and this feeling went on for a few months.

Khadija’s experience is not an isolated occurrence.  According to a recent World Health Organisation (WHO) report, the COVID-19 pandemic increased the prevalence of anxiety and depression by 25% worldwide.

Devastating challenges, such as deaths, health fears, economic strife and physical social isolation have taken a toll on the mental health of millions worldwide in recent years, disproportionately affecting women and mothers at a higher rate.  

Despite this unfortunate rise, the heightened impact of the pandemic on mental health has shown to be a silver lining, easing mental health stigma and expanding services and accessibility across countries.

This can be seen in an increase in Digital Mental Health (DMH) around the world, with more people using therapy apps, hotlines, and even social media such as TikTok for mental health diagnosis and care. 

Applications for mental health and wellness include journaling, meditation tools, mood trackers and apps that connect users with licensed professionals for therapy. 

Even though many of these platforms already existed prior to 2020, the COVID-19 pandemic accelerated their growth as many of them positioned themselves as solutions to close the access gap widened by the global health crisis.

Before the pandemic, many people were unable to access traditional forms of therapy, which involved patients and therapists sitting face-to-face. However, the increased demand from patients seeking more easily accessible therapy services has led to the development of mental health apps around the world.

In Qatar, a  new online therapy app called Therappy, the first of its kind, is making mental health care more accessible for women like Khadija, who oftentimes are forced to suffer silently due to mental health stigmas and a lack of confidential access to the necessary help.

Challenging mental health stigma and accessibility

While Therappy had been in the works since before the pandemic hit, the app officially launched on apple store in June 2022, rendering it the first Qatar based App that provides online counselling from the comfort of your home.

The founders of this app, Najla AlKuwari and Noof Almahmoud, sought help from mental health resources after becoming new mothers and dealing with the pressures of child-rearing and postpartum. They came up with this idea after realising the lack of access to mental health services tailored to their specific needs.

“We noticed that a lot of mothers avoid going through a medical clinic to seek mental health care because of fear of stigma, fear of being labeled as a bad mother,”  AlKuwari  told Doha News, emphasising that the app aims to reduce stigma by  providing users with online access to psychological counselling via video sessions, messaging and calls.

“So far we have more than 450 clients signed up on the platform, and right now we  have almost 20 verified therapists who can be booked through the app,” she added.

Funded by Qatar Foundation, the app allows you to book a session discreetly and with therapists from different backgrounds, including Arabic speakers who understand the cultural context of the region.

When comparing to in-person sessions, this app is more affordable, giving access to users who may not have health insurance or enough money to afford regular standard therapy sessions.

“We have a price range starting from QR180-onwards when the range for in-person appointments is between 400 to 600 QR,” AlKuwari told Doha News. 

“So our hope is to be able to provide the support and help for everyone who needs it, and we hope to be a global platform in the future, offering the widest range of therapists from different backgrounds,” she added.

Privacy concerns: is online therapy better?

While in-person therapy might sound better due to face-to-face interactions,  the online mental health industry has been booming since the pandemic. 

“There are plenty of apps serving people in North America, but there is still a general lack of apps helping people in the Middle East, which is what we are trying to do,”AlKuwari told Doha News. 

When it comes to protecting consumers and their private information, AlKuwari argued that this app offers more privacy than actual in-person therapy sessions in the region.

“We don’t require a lot of personal information,  we don’t take your ID information. We don’t take your resident information, which you are obliged to give out in person. We only require your first name and email,” she said, addressing the safety concerns generated by online spaces.

Users of the app select a therapist by looking through a list of providers that includes thumbnail photos, bios that resemble resumes and client reviews.

Clients can switch therapists at any time using the apps, with information transfer between therapists being done securely, and remaining confidential. 

Mental health care during the Pandemic

Qatar has been working on tackling the stigma and raising awareness regarding the importance of mental health in the country.

The country’s mental health line has received more than 37,000 calls since its launch in April 2020, Hamad Medical Corporation [HMC] told Doha News in October last year. 

The helpline, launched in collaboration with Qatar’s Ministry of Public Health and the Primary Health Care Corporation, is run by a team of mental health professionals who​ provide assessment and support to between 200 to 300 callers a week.

According to the World Federation for Mental Health, between 75% and 95% of people with mental health disorders that are living in low- and middle-income countries, have no access to mental health services. However, issues of access also occur in wealthier countries albeit at a lower rate.

Stigma remains to be a big concern and, often, people with mental illness do not receive the treatment they are entitled to due to the stigma and discrimination they experience together with their families or caregivers.

The perinatal health clinic in Sidra Medicine is also one of the first of its kind in Qatar to provide mental health care to mothers like Khadija, who oftentimes experience postpartum depression and other mental health issues.

Before the pandemic, 29% of new mothers experienced symptoms of anxiety, whilst 15% reported feelings of depression.

The numbers have almost tripled since the pandemic, with 72% of new mothers reporting symptoms of anxiety and 41% experiencing symptoms of depression.

Research by Sidra Medicine in collaboration with Northwestern University Feinberg School of Medicine, found that perinatal mental mental health disorders are more prevalent amongst women living in Qatar than in most western countries.

“Although interventions exist to prevent postpartum depression and anxiety, to date there have been no studies that have attempted to prevent postpartum depression or anxiety among Arabic speaking women in the Middle East, including Qatar,” researchers said.

This new therapy app removes some of these barriers, increasing accessibility and awareness of mental health care in the region.

“In our society, it takes a lot of courage to admit that you need help. And it takes a lot of courage to go and get that help, which is why this app is important,”AlKuwari concluded.