The Invisible Wounds of War: 35,000 Mental Health Cases in Marib, Eastern Yemen

Yemen Monitor / Reports Unit:

Coinciding with World Mental Health Day (October 10), the dimensions of a silent humanitarian crisis are unfolding in Marib governorate (eastern Yemen), which over more than a decade of war has become a refuge for the largest gatherings of displaced people in Yemen. Alongside the physical destruction and challenges of displacement, the governorate is living under immense psychological pressure that threatens the well-being of over two million displaced people and the host community, resulting from persistent fear, the trauma of loss, and instability.

Mental health challenges stand out as one of the most complex and neglected consequences of the war, as health authorities deal with physical diseases and epidemics, while mental illnesses remain in the shadows. Reports from specialists indicate a worrying increase in cases of depression, anxiety, and post-traumatic stress disorder (PTSD), especially among children and women who have experienced the harshest forms of trauma due to displacement, loss of breadwinners, and deteriorating living conditions.

Despite efforts by public health offices, civil society organizations, and international organizations to improve psychological support services, these efforts remain limited compared to the scale of the great need. The number of psychologists in the governorate is not proportional to the number of cases, and mental health care services are only available on a limited scale within public hospitals or through temporary programs implemented by humanitarian organizations.

35,000 Cases

The Director General of the Public Health and Population Office in Marib governorate, Dr. Ahmed Al-Obadi, revealed in a special statement to “Yemen Monitor” that “field reports have recorded approximately 35,000 mental health cases” in the governorate.

The United Nations and international organizations estimate that up to 20% of the population in conflict areas in Yemen may suffer from mild to moderate mental disorders, and about 3-4% may suffer from severe disorders. Given that Marib’s population exceeds two million, the recorded figure of 35,000 cases represents the “tip of the iceberg”.

Al-Obadi stressed that this reality requires urgent action to provide necessary support for psychological and social specialists in hospitals and schools, in addition to strategic proposals including “opening a university major in psychiatry at the University of Saba Region, and establishing a specialized hospital that provides integrated mental health care services.”

The Need for a Hospital and Specialists

Despite relative calm at times, Marib remains a repeated target for Houthi ballistic missile and drone attacks. This continuous threat fuels “hypervigilance” and “complex post-traumatic stress disorder” among the population, preventing psychological recovery and making the environment mentally unsafe.

In the same context, the psychiatrist in Marib, Dr. Mahyoub Al-Mekhalfi, confirmed to “Yemen Monitor” that the trauma resulting from war and displacement has “left deep psychological effects,” requiring balanced professional intervention focusing on psychosocial support.

Al-Mekhalfi called for “spreading a culture of mental health awareness and training local cadres on emergency intervention mechanisms,” emphasizing the necessity of “combating the societal stigma” associated with mental disorders, to enhance social cohesion and the community’s ability to adapt.

Al-Mekhalfi stressed: the importance of establishing more than one hospital and specialized center in Marib due to the high density of cases there.

Psychological pressure is not limited to the direct trauma of war but is exacerbated by the severe economic downturn. The loss of livelihoods, unemployment, and rising prices represent continuous daily pressures that increase levels of anxiety and depression among families, especially among breadwinners and mothers.

Patients’ Reluctance to Seek Help

For his part, “Abdulhaq,” one of the workers in the field of psychosocial support, points out that “interest in mental health in Marib is still weak due to a lack of community awareness and a scarcity of specialized cadres.” The crisis is compounded by the reluctance of many affected individuals to seek help for fear of stigma, making their cases “more complex over time.”

It is worth noting that Marib, which was once a relatively small city, has witnessed a massive population inflation exceeding its service capacity by more than 400%, leading to unprecedented pressure on the exhausted infrastructure (water, electricity, health, education). This environmental and service pressure directly reflects on the mental health of the population.

Amid the ongoing threats posed by the war, mental health remains one of the forgotten fronts, no less dangerous than any military front, where the safety of mind and psyche is the cornerstone of any future individual or societal recovery and stability for Yemen.