In early September, a man committed suicide by jumping on the tracks in front of an oncoming train at a Cairo Metro station.
The response was shocking: Egypt’s Metro authority warned commuters not to commit suicide on the tracks because it would be an inconvenience to the public.
The insensitivity notwithstanding, it brought to light the issue of suicide in Egypt.
In the past three months, there have been more than seven cases of suicide by people jumping in front of Metro trains in Cairo.
Mental health and suicide are tough subjects in Egypt, as elsewhere. But public services are severely underfunded, professionals often lack adequate training and the stigma surrounding the issue means that mental illness is misunderstood and not talked about.
“Being depressed isn’t terminally ill but if you have a mental health issue and you go to Abbasiya [a mental health hospital in Egypt] or something, someone’s father won’t allow me to marry their daughter,” explained Ally Salama, who started the Facebook page Break the Silence Egypt to open a conversation about the issue among young people.
The Break the Silence Facebook page shares knowledge about mental illness and, perhaps more importantly, attempts to make people feel comfortable talking openly and honestly about it.
Just how prevalent mental health problems and suicide are in Egypt is difficult to gauge because of the stigma surrounding the issue – many people are unwilling to admit to having a problem.
As such, official statistics are often misleading and incomplete, augmenting the already complex situation of how exactly to define mental health illnesses.
A nationwide survey carried out in April by the Ministry of Health found that 25 per cent of Egypt’s population was suffering from some kind of mental health problem.
Of this, more than 40 per cent had anxiety disorders while 30 per cent of respondents identified as having depression linked to substance abuse, with a higher proportion suffering in the countryside, where there are fewer opportunities and more poverty.
Mental illness also seems to be on the rise.
Figures released in March 2017 by the General Secretariat of Mental Health stated 516,000 people were admitted to mental hospitals across the country in 2016, compared to 444,650 in 2015.
According to a study by the Journal of Clinical Psychiatry, Egypt is by far the most affected country in the region for depression, according to the metric of Disability-Life Adjustment Years (DALYs), a metric to measure overall disease burden.
Egypt ranks first in terms of DALYs with a figure of 622,000, with Saudi Arabia the next highest in the region with 201,000 DALYs.
Those suffering are also often young, explains Mr Salama, arguing that it’s because they are unable to secure their future by getting a good education and job.
“Why do a lot of people in Egypt commit suicide? Because they feel trapped,” Mr Salama says.
To compound matters, in Egypt, romantic and sexual encounters are largely taboo outside of marriage. Often the only way that people can be open to family and society at large about their relationships is to get married.
But marriage is expensive and, with Egyptian youth unemployment averaging at 30 per cent in recent years, making it work is out of reach for many.
That’s why, among other reasons, Mr Salama believes it’s so important for people to start talking more openly about mental health problems.
“People avoid it, people don’t talk about it and then the pressure falls on the kids, it’s toxic,” Mr Salama says. “A lot of adults don’t really realise it – because a lot of kids suffering don’t talk to the people closest to them.”