Twitter statuses can be coded for, and used as, accurate predictors of depression or indicators of PTSD.
Rabat – The notion of mental health in Morocco is one that is continuously evolving. It is a concept that is deeply entrenched both in the Moroccan cultural paradigm, as well as its rich folklore.
The World Health Organisation (WHO) released a report in 2017 stating that there are only 0.84 psychiatrists in Morocco per 100,000 members of the population with only 11 mental hospitals. The report also highlighted that Morocco had no strategy in place to address child and adolescent mental health, neglecting a severely vulnerable demographic.
Another report published in 2006 by WHO noted that there were only 306 psychiatrists catering to a population of over 33 million, a number that has probably not increased significantly with time.
In addition, a study conducted by Moroccan researchers in 2009 showed that close to half of Moroccans deal with a mental health disorder, and 26% suffer from major depressive disorder. These numbers are extremely alarming, especially considering the fact that WHO found that only 4 mental health hospital beds are available per 100,000 of the population.
Another impediment to Morocco’s mental health interventions lies in the country’s culture: in order to address one’s mental health, one must be able to recognize that what one suffers from could be qualified as a mental health issue.
According to the World Bank, 37.5% of the population lives in rural areas, with an unstable income and no mental health facilities. El Rhermoul and associates, a group of UK based psychiatric academics and practitioners, conducted a study in 2017, centered on the views of carers and patients in regards to depression in Moroccan women. The qualitative study found that, amongst other things, a big proportion of women believed the evil eye was the cause of their depression.
Jinns and legends
Debra Stein, a Canadian psychiatrist highlighted the way that the healing of the psyche is often anchored within the symbolic culture in which it occurs. She wrote a powerful essay published in the Canadian Medical Association Journal on the way she perceived psychiatry in Morocco to be anchored in Moroccan traditional notions such as jinns and shour.
These traditional concepts are both ingrained in Islamic and Moroccan culture, and respectively refer to spirits as well as ‘black magic’, to put it simply. Although Stein emphasized the fact that Moroccans were increasingly leaning towards a psychodynamic and medical interpretation of their symptoms, she also highlighted the fact that the population will rely on the symbolism of their culture to help them adhere to the medical demands of mental health.
This dynamic interplay of cultures and beliefs is also one that our mental health sector will need to take into account, be it in regard to the information it disseminates and to its interventions.
The question that Morocco faces is this: given that we are a country faced with limited infrastructure in regard to mental health, as well as lacking practitioners, how do we begin to tackle and understand the severity of the problem?
Given that our country’s cultural dimensions make it difficult for individuals to fully understand the state of their mental health, how do we even begin to target and structure our interventions?
Who do we give our limited resources to first, and can we count on the patient to know just how dire their situation is?
The answer could be smartphones
The answer, it seems, could lie in big data: a surprising statistic, highlighted by the ANRT in 2019, is that 99.8% of Moroccans have mobile phones, where 75.7% percent of them have smartphones, and 74.2% have access to the internet on their phones. Furthermore, 90.7% of Morocco’s rural population owns a phone, Facebook and Instagram are used by 88.4% and 44.7% of the population respectively.
According to the research conducted by scientists such as DeChoudhury et al., and Coppersmith et al., published in 2013 and 2018 respectively, social media such as Twitter statuses can be coded for, and used as, accurate predictors of depression or indicators of PTSD.
Studies have shown that Natural Linguistic Processing can be used to identify and screen for suicide risk when taking into account someone’s social media, as well as additional mental health conditions.
It is not surprising therefore that, increasingly, tech conglomerates are turning towards big data to both monitor and predict outcomes in physical health, with mental health following closely behind. This obviously raises ethical considerations in regards to data privacy as well as outsourcing personal information for a profit; nonetheless, it is interesting to see the way that big data can be used as a preventative measure for health.
To use Moroccans’ social media use, Facebook posts, and Instagram captions as indicators of their mental health could be an efficient way of bypassing practitioners’ reliance on biased self-reporting, that as we know, might be deeply skewed due to culture (thinking one is msaher, or bewitched, as opposed to depressed).
Social media data, if used as a means to monitor for mental health, also means practitioners can evaluate and access even the most geographically isolated members of the population. Phones provide direct access to isolated geographical regions in Morocco which lagging infrastructure makes it difficult to reach.
It will, and can be possible, to prioritize those who need our limited resources the most simply by having access to their anonymized data; it’s just a question of making sure that this data belongs to the individual, and that this is a tool to empower Moroccans to monitor their mental health as opposed as a means to ‘keep tabs’.
Given that Morocco’s start-up industry, and technology industry, is slowly on the rise, and that young minds are set to explore the ways technology can benefit Morocco, I suggest that in addition to looking at policymakers and the government to resolve the hurdles facing Moroccan mental health, we might also look to our start-ups. We should look to, our graduating tech minds, our expats living abroad. These are the people who can help us, to explore the ways that our country’s prevalent use of social media. These bright young minds might help us understand, assess, and prioritize those that need our mental health infrastructure the most.
After all, the power is, quite literally, in our hands.