Similar to global trends, mental disorders are a major public health concern in Saudi Arabia. Therefore, in 2010, Saudi Arabia became the first country from the Gulf Cooperation Council states to join the World Mental Health (WMH) Survey Initiative, which collaborates with Harvard University and has undertaken over 33 countries. The Saudi National Mental Health Survey (SNMHS) was conducted with the support of the King Salman Center for Disability Research (2023) to bridge the gap between mental health service demands. The study aimed to understand (1) the prevalence of mental health problems and their burden in the Saudi community; (2) the individuals who are most at-risk in Kingdom of Saudi Arabia (KSA); and (3) the best ways of offering mental health services in KSA. As a result, this project became a milestone in providing healthcare practitioners and policymakers with data to establish relevant preventive, therapeutic, and rehabilitation services in the KSA. The survey results found that about 34% of Saudis meet the criteria for a mental health condition at some time in their lives. The occurrence of mental health conditions across a lifetime in Saudi Arabia is comparable to the United States at 47.4%, New Zealand at 39.3%, France at 37.9%, and the Netherlands at 31.7%.

Further evidence suggests that people with neurodevelopmental disorders (NDD) experience mental health problems such as anxiety, depression or anger, and these are often associated with impairments in cognition and emotion regulation. NDDs are multifaceted conditions characterized by impairments in cognition, communication, behavior, and/or motor skills. Thus, considering the strong evidence set out in Saudi national study and the recommendations for future research, this research was initiated to examine the most studied neurodevelopmental disorders reported in the KSA to explore public knowledge, attitudes, and behaviors.

Findings showed that the most studied neurodevelopmental disorders reported in the KSA were attention deficit hyperactivity disorder (ADHD, n = 8 studies) and autism spectrum disorder (ASD, n = 13 studies). Summary analysis of 21 studies showed an overall lack of knowledge about ASD and ADHD, misconceptions and misunderstandings about these health conditions.

The knowledge gap did not differ between different population groups, that is, health professionals, students, and the general public. However, participants with higher levels of education (e.g. PhD) were more aware of ASD and ADHD. Furthermore, the lack of knowledge was associated with stigmatized attitudes about children with ASD and ADHD. In fact, pressure from schools to prescribe medication was one of the most common concerns for mothers was fear of the side effects of medications. ASD and ADHD were associated with a higher probability of depression and anxiety among parents/caregivers and children. In addition, parents mentioned barriers such as bathing, playing, and feeding that affected their quality of life. Most parents were stigmatized because of their children’s health by the public, medical professionals, schools, and services provided to children. The main information sources were the Internet, media, and social networks. Continuing medical education was not associated with better knowledge about ASD and ADHD.

Geographical analysis revealed that most studies were conducted in the Central and Western provinces of Saudi Arabia, potentially limiting the breadth of understanding of perceptions and behaviors regarding NDDs across the country. Consequently, based on the contribution of the Saudi National Mental Health Survey (SNMHS) and its recommendations for more research on risk factors and triggers for the development of mental health disorders among Saudis, further studies are recommended in all regions of the KSA. Research in all regions will provide a comprehensive assessment of the strengths and challenges faced by children and parents, and will inform real and feasible steps to improve the quality of life within the country, rather than in individual regions. This holistic approach will inform policies and practical recommendations to increase knowledge about NDDs and mental health disorders in Saudi Arabia, thereby enabling people to rethink their attitudes and behavior.

Additional resources should be allocated to diagnosis, awareness, management, early intervention, education, and health care to better support people with ASD and ADHD. One of the first steps in this could be the educational sector. Educational institutions should undergo comprehensive training to increase awareness and knowledge of special education and to encourage open communication and transparency. This will increase the confidence of parents and children to spend their days in the least restrictive environment possible. In addition, schools should increase the number of special education teachers and therapists who can positively influence attitudes in relation to and behavioral support for children with ADHD and ASD.

Finally, parents of children with ASD and/or ADHD should be educated and encouraged to discuss any developmental concerns with their child’s pediatrician and seek support throughout the child’s life. Parents should share their concerns about important barriers to health care seeking, whether cultural, lack of knowledge or challenges in health care delivery, accessibility, proximity, or cost. Creating communities for parents of children with ADHD and ASD may have additional benefits not only for children’s well-being, but also to reduce depression and anxiety among parents who may have similar experiences. Ultimately, by protecting and speaking up for the rights of their children, parents can ensure that they receive appropriate services from schools, intervention programs, and health care providers alike.