Mental health is a significant global health concern, and many countries are striving to find effective solutions. According to the 2022 World Mental Health Report, about one in eight people in the world live with a mental disorder. Creating a positive mental health environment has been a complex journey for the citizens of Nicaragua, as they have faced many external hardships, including political regimes and natural disasters.

Mental Health in Nicaragua

In Nicaragua, there is a severe lack of health care professionals for those suffering from mental health issues. According to the World Health Organization’s (WHO) Mental Health Atlas in 2020, there were only 250 mental health professionals in the entire country. That means for every 100,000 people, there are less than four mental health professionals. Medical professionals are necessary for Nicaraguan citizens to attend to their health needs. Without their care, the citizens must manage their health issues on their own.

The lack of those professionals is only one part of the problem. The places where those people go to get the help they need are also an issue. There are only five mental health outpatient facilities attached to a hospital in the country and only one main mental hospital which had a total number of 1, 179 admissions, according to WHO. This severe lack of resources for those dealing with mental health in Nicaragua can lead to many people not receiving the help they need.

Within the population of Nicaragua, approximately 24.9% live in poverty, according to the World Food Programme (WFP). Since there are few medical professionals and places, those who live in poverty and suffer from mental health have almost nowhere to go.

This difficult reality is still prevalent in Nicaragua, even so, the country is working towards fostering positive mental health. Education and outreach are two of the key factors when it comes to changing the mental health crisis. Here are three programs that are reworking mental health in Nicaragua:

ANDEPSI

Due to the lack of mental health professionals in Nicaragua, The Nicaraguan Association for the Development of Psychology (ANDEPSI) has set out to change this issue. ANDEPSI started in 2016 and has continued to promote mental health to the citizens of Nicaragua. Psychology professionals in Nicaragua are better equipped to address mental health issues through the dedication of ANDEPSI to enhancing their training. Education is the first step, as ANDEPSI works with both students in university and senior professionals, updating both groups on advancements in mental health. This leads to better-equipped workers handling mental health challenges.

The association educates those within this field and those in the community through regular educational events in the media. Through this level of outreach, the ANDEPSI is promoting a well-rounded education of professionals that trickles down to the individuals affected by mental health in Nicaragua. More educated professionals can result in those who live in poverty getting the help they need closer to them rather than travelling to one of those five outpatient facilities. The group has made small but meaningful progress such as creating alliances with national universities, joining the International Union of Psychological Science, and has organized meetings to discuss climate change action in the country, according to the American Psychological Association (APA).

The Mental Health Innovation Network

The Mental Health Innovation Network (MHIN) is conducting a research project focusing on improving Nicaragua’s mental health literacy. The project’s approach includes educating teachers who will then educate students and developing an “innovative tech platform to support youth self-education on mental health.” This allows both students and teachers to learn more about the reality of mental health and decrease the surrounding stigma. The group conducted their initial research which showed promising program results such as lower psychological distress scores among students. Researchers within the group also reported that “90% of intervention teachers and students were very satisfied with the curriculum and felt it was important to continue to offer it in school programming.”

The project plans to implement a variety of resources beyond the education curriculum, such as a platform to discuss these issues. Platforms like this help educate and encourage those who face these issues to get the help they need. The Ministry of Education plans to continue this form of education and the research group is looking to work with policymakers to increase the program’s outreach.

CISWH

The Center for Innovation in Social Work and Health (CISWH) has gone a different route regarding mental health in Nicaragua, through social work trips. In 2022, the CISWH trip partnered with many Nicaraguan companies and organizations, such as the National Autonomous University of Nicaragua FAREM-Estelí (UNAN-FAREM). The Superemos Foundation, based in Estelí, conducted psychosocial seminars as part of its community development work through health and social services.

The seminars, focused on trauma and mental health, educated many community members such as the Estelí Department of Public Defense and medical personnel from the University. CISWH travelled to other parts of the country to conduct seminars on other issues, including the environment.

Along with mental health, the group pushes for environmental activism. They met with La Mariposa, a school and hotel that uses its profits to fund rural community projects. Those on the trip learned about La Mariposa’s current plan to improve access to clean water. By educating people on these issues in communities, it brings awareness and potential help within these programs. For those living in poverty, community outreach is one of the many ways they can receive training and education on issues such as mental health and the environment.

This form of outreach allows citizens to engage with each other and get educated on global issues. In the future, CISWH plans to continue this outreach remotely as it trains UNAN-FAREM students in social and psychology.

The Path Forward

Mental health in Nicaragua is a critical and complex issue with deeply intertwined with the country’s socio-political landscape. Through these organizations, it is clear that the solutions to the mental health crisis start with educating those on the front lines. Medical professionals and students alike must be kept informed and updated on the various aspects of mental health care. Community outreach goes hand in hand with that as it empowers the citizens to receive education on this topic.

Mental health and poverty are two sides of the same coin. When a person is mentally sound, they can reach for better opportunities to work out of poverty. This boosts the economy as well since if more people are working then the economy is bound to grow. By engaging with people, the country can alleviate mental health and open the door for more conversations regarding it.

While mental health is still an ongoing issue in Nicaragua, suicide-related deaths have been improving since 2018 and stands at 4.35 deaths per 100,000. There has also been an increase in community-based mental health services from 2017 to 2020. As Nicaragua continues to navigate its country’s challenges, addressing these mental health issues needs to be a priority to ensure the well-being and resilience of its population.

– Tess Curran

Tess is based in Boston, MA, USA and focuses on Technology and Global Health for TheBorgen Project.

Photo: Wikipedia Commons