Lee Eileen, Bruckner Tim A, Alluhidan Mohammad, Alamri Adwa, Alhabeeb Abdulhameed, Nakshabandi Ziad, Alqahtani Mohammed M J, Herbst Christopher H, Hamza Mariam M, Alazemi Nahar
The World Bank, 701 18th St NW, Washington, DC, 20006, USA.
AMBOSS GmbH, Torstrasse 19, 10119, Berlin, Germany.
Hum Resour Health. 2024 Jul 16;22(1):51. doi: 10.1186/s12960-024-00929-6.
Mental, neurological, and substance abuse (MNS) disorders describe a range of conditions that affect the brain and cause distress or functional impairment. In the Middle East and North Africa (MENA), MNS disorders make up 10.88 percent of the burden of disease as measured in disability-adjusted life years. The Kingdom of Saudi Arabia (KSA) is one of the main providers of mental health services and one of the largest contributors to mental health research in the region. Within the past decade, mental health resources and services has increased.
We employ a needs-based workforce estimate as a planning exercise to arrive at the total number of psychiatrists, nurses, and psychosocial care providers needed to meet the epidemiological need of mental health conditions of the population of KSA. Estimates for a potential mental health workforce gap were calculated using five steps: Step 1-Quantify target population for priority mental health conditions. Step 2-Identify number of expected cases per year. Step 3-Set target service coverage for each condition. Step 4-Estimate cost-effective health care service resource utilization for each condition. Step 5-Estimate service resources needed for each condition.
The planning exercise indicates an epidemiologic need for a total of 17,100 full-time-equivalent (FTE) health care providers to treat priority MNS disorders. KSA appears to have a need-based shortage of 10,400 health workers to treat mental disorders. A total of 100 psychiatrists, 5700 nurses, and 4500 psychosocial care providers would be additionally needed (that is, above and beyond current levels) to address the priority mental health conditions. The shortfall is particularly severe for nurses and psychosocial workers who make up 98.9 percent of the shortfall. This shortage is substantial when compared to other high-income countries. Overall, the workforce needed to treat MNS conditions translates to 49.2 health workers per 100,000 population.
Challenges to addressing the shortfall are Saudi specific which includes awareness of cultural customs and norms in the medical setting. These challenges are compounded by the lack of Saudi nationals in the mental health workforce. Saudi nationals make up 29.5 percent of the physician workforce and 38.8 percent of the nursing workforce. Policymakers and planners supplement this shortfall with non-Saudi providers, who must be mindful of Saudi-specific cultural considerations. Potential solutions to reducing the shortfall of mental health care workers includes nurse task shifting and training of general practitioners to screen for, and treat, a subset of MNS disorders.
精神、神经和物质使用障碍（MNS）描述了一系列影响大脑并导致痛苦或功能损害的病症。在中东和北非（MENA），以伤残调整生命年衡量，MNS障碍占疾病负担的10.88%。沙特阿拉伯王国（KSA）是该地区精神卫生服务的主要提供者之一，也是精神卫生研究的最大贡献者之一。在过去十年中，精神卫生资源和服务有所增加。
我们采用基于需求的劳动力估计作为一项规划活动，以得出满足沙特阿拉伯王国人口精神卫生状况流行病学需求所需的精神科医生、护士和心理社会护理提供者的总数。使用五个步骤计算潜在精神卫生劳动力缺口的估计数：步骤1-量化优先精神卫生状况的目标人群。步骤2-确定每年的预期病例数。步骤3-为每种状况设定目标服务覆盖率。步骤4-估计每种状况的具有成本效益的卫生保健服务资源利用率。步骤5-估计每种状况所需的服务资源。
规划活动表明，治疗优先MNS障碍总共需要17100名全职等效（FTE）卫生保健提供者。沙特阿拉伯王国似乎因需求而短缺10400名治疗精神障碍的卫生工作者。为解决优先精神卫生状况，还需要额外100名精神科医生、5700名护士和4500名心理社会护理提供者（即超出当前水平）。护士和心理社会工作者短缺尤为严重，占短缺人数的98.9%。与其他高收入国家相比，这一短缺相当严重。总体而言，治疗MNS病症所需的劳动力相当于每10万人口中有49.2名卫生工作者。
解决短缺问题面临的挑战是沙特特有的，包括对医疗环境中文化习俗和规范的认识。精神卫生劳动力中沙特国民的缺乏使这些挑战更加复杂。沙特国民占医生劳动力的29.5%，占护士劳动力的38.8%。政策制定者和规划者用非沙特提供者来补充这一短缺，他们必须考虑到沙特特有的文化因素。减少精神卫生保健工作者短缺的潜在解决方案包括护士任务转移以及培训全科医生筛查和治疗一部分MNS障碍。
