“All countries can be thought of as developing countries in the context of mental health,” says a 2018 report by the Lancet Commission on Global Mental Health — a sobering diagnosis for the worldwide distribution of mental health resources. Only 20% of people suffering from depression in the developed world receive proper treatment. In the developing world, this rate plummets to 4%. The world also puts a lower dollar value on recovering the years lost to those with mental illness, investing only 85 cents for each year of illness, as opposed to $144 for each year lost to physical diseases like HIV/AIDS and tuberculosis. Here are five ways to tackle the problem of mental health care in the developing world.
5 Ways To Improve Mental Health in the Developing World
- Empowering Nurses – The lack of psychiatrists in developing countries is severe, and the task of mental caretaking often falls on nurses who are undertrained and overworked, but a 2020 report from the Journal of Family Medicine and Disease Prevention offers a solution that works from the ground up. Training Mental Health Nurses (MHNs) to prescribe medicine and treatments with the guidance of available psychiatric staff, and encouraging nursing colleges to incorporate a mental-health curriculum that both incentivizes MHN training and develops in collaboration with other doctoral programs, has the potential to strengthen the quality of mental health care and lessen the amount of time people in developing countries must wait to get it.
- Combining Economic and Psychological Assistance – There is an undeniable connection between economic hardship and poor mental health, but solely financial assistance can overlook important cultural and environmental variables for mental well-being. Dr. Leyla Ismayilova, a professor of social work at the University of Chicago, has been studying the effects of the Trickle Up program in Burkina Faso since 2017. Trickle Up was established in 1986 to lift the extremely poor out of poverty and make them “economically self-sufficient” after two years, and operates in Africa, India and Latin America. Her study indicates that economic assistance from Trickle Up combined with family counseling produces better outcomes than economic assistance alone, decreasing hunger, depression and trauma while increasing self-esteem among children. Child and family mental health is of special concern in Burkina Faso, one of the poorest nations in the world where, according to a 2012 survey, 1.25 million of its children (37.8%) are engaged in child labor, and where harsh parental discipline and domestic violence are widespread. Family counseling was able to empower children within their families, giving them a voice and elevating them beyond simple instruments of income. By encouraging families to talk through their problems while giving them an economic leg up, mothers were more inclined to protect and nurture their children rather than impose cruel corporal punishments, such as depriving them of food or forcing them to stand in uncomfortable positions. Counseling also helped curb domestic violence by reducing male resentment of women as breadwinners, allowing husbands to open up emotionally instead of internalizing their anger and frustrations.
- Technological Outreach – Roughly 88 psychiatrists serve the entire nation of Kenya, leaving one for every 5 million people, most of them based only in Nairobi. However, free apps like TrustCircle, developed by the Psychiatric Disability Organization and U.S. app developers, have the potential to connect millions of Kenyans without the ability to travel with mental health specialists. The app also provides free, anonymous and clinically tested screenings for conditions like PTSD, substance abuse disorder and depression. Africa especially is a fertile testing ground for this kind of technological outreach due to its combination of very low attention to mental health care (46% of countries in Africa have no standalone mental health policies) and a burgeoning trend of digital connectivity. For instance, mobile phone ownership in Ghana increased from just 8% to 83% between 2002 and 2025. A 2022 study by The Brookings Institution showed a 9.8% decrease in mental distress and a 2.3% decrease in the likelihood of severe mental distress among low-income Ghanaians who were given mobile-calling credits during the COVID-19 pandemic, increasing their ability to make unexpected calls and decreasing their dependence on digital loans. If low-cost connectivity is enough to have a positive impact on mental health, then low-cost mental health connectivity could reap exponential benefits in the developing world.
- Decreasing Stigma – The social ire directed towards mental illness in the developing world prevents people not only from seeking treatment but from even disclosing that they are sick at all. A potent example comes from a 2011 study of people suffering from schizophrenia in India, where 46% of participants felt discriminated against by their community and 42% by their own families. One of the largest and most exciting efforts to combat stigma is the Indigo Partnership, which started in 2018. A partnership between several low-to-middle-income countries like China, Ethiopia and Nepal, its five-year mission is to identify stigmatizing language and behavior and develop culturally adapted ways of intervening through communities and health care providers.
- Empowering Families and Communities – There are some truly inspiring examples of community mental health empowerment throughout the developing world. In Rawalpindi, Pakistan, the Family Network for Kids project uses technology to train family members and neighbors of children with developmental disorders to provide care, reaching 270 families. The African Mental Health Foundation, in partnership with Columbia University and the Canadian Government, works with traditional healers and clergy in Eastern Kenya to collect vital data on mental illness in their communities, and to direct those in need to mental health care centers. The Friendship Bench project in Zimbabwe, the result of 20 years of research in the country, has empowered 600 grandmothers since 2006 to provide talk therapy in their communities, reaching 30,000 people in just 2017 and reducing depressive symptoms to a degree recognized by the Journal of the American Medical Association in 2016.
– John Merino