Mental Health in TurkeyTurkey, a land of diverse cultures and traditions, serves as a bridge connecting Europe and Asia. With a profound history that shapes its very core, Turkey has undergone substantial recent transformations, marked by modernization and urbanization. This evolution has propelled economic growth and infrastructure development to new heights. Nonetheless, alongside these encouraging advancements, there have been noticeable challenges, particularly in the realm of mental health. While common mental health disorders such as anxiety and depression are prevalent in Turkey, as they are in numerous other nations, the country has experienced a comparatively higher rate of psychiatric hospitalizations in recent times.

The Prevalence of Common Disorders

According to the World Health Organization (WHO), the population of Turkey has confronted a surge in mental health challenges over recent years, with individuals grappling with anxiety and depression, stemming from factors like natural disasters, economic downturns and the ongoing COVID-19 pandemic. The WHO’s findings indicate a staggering 3.2 million people affected by depression, accompanied by an over 50% escalation in the usage of antidepressants during the past five years. With an increasing number of individuals in Turkey seeking medical support for their mental well-being, the prevalence of these issues underscores the significance of global education regarding the essential understanding of the mind on par with the physical body.

UOSSM

The Union of Medical Relief and Care Organizations (UOSSM), established in 2012 in France, is a collaborative effort of member organizations from countries including the United States, Canada, the United Kingdom, France, Switzerland and Turkey. Together, these members pool resources and coordinate projects to deliver relief and medical assistance to victims of war in Syria. Amid the complex relationship between Turkey and Syria, Turkey has extended aid to refugees seeking refuge within its borders. Throughout the past decade of the Syrian crisis, mental health has emerged as an enduring concern, growing even more pronounced due to the ongoing exposure to traumatic experiences. In response, Turkey has instituted an array of mental health programs and provided medications, aiming to alleviate the profound psychological distress endured by the affected population.

Psychiatric Hospitalization

Amidst the pandemic lockdown, notable trends have emerged in the realm of psychiatric conditions. While it is widely acknowledged that rates of patients grappling with anxiety and depression tend to surge during lockdown periods, a distinct rise in the diagnosis of bipolar disorders has also been observed subsequent to the pandemic quarantine. This uptick in psychiatric hospitalizations serves as a clear signal for policymakers to redirect their focus toward enhancing mental health services and implementing preventative measures to effectively manage the mental well-being landscape in Turkey before the situation gets worse.

Stigma and Awareness

As various nations grapple with distinct stigmas and societal expectations, these diverse social dynamics present barriers for individuals dealing with physical and mental illnesses. A social study has unveiled a correlation between supernatural causal beliefs and heightened stigma surrounding mental health. Conversely, the recognition of one’s ongoing stress levels has demonstrated a capacity to diminish this stigma.

Conclusion

In conclusion, Turkey’s intricate tapestry of diverse cultures stands as a testament to its remarkable evolution over the years. Turkey’s journey through economic, social and political changes has led to an elevation in the rates of common mental health issues within the population. Nevertheless, Turkey is dedicated to alleviating societal pressures by offering robust mental health services and resources for its citizens to rely on.

– Sandy Kang
Photo: Flickr

Mental Health in Papua New GuineaNestled in Oceania and comprising numerous smaller islands, Papua New Guinea (PNG) boasts a landscape as diverse as it is captivating. A tapestry woven with mountains, rainforests and coasts offers a backdrop for a profound cultural mosaic — one adorned with over 800 languages and the legacy of indigenous heritage. Yet, within this beauty lies the challenge of limited access to health care, education and foundational infrastructure. Furthermore, there is a broad range of diverse mental health concerns in Papua New Guinea.

5 Facts About Mental Health in Papua New Guinea 

  1. Limited Access to Services – Research shows that PNG has about 748,000 cases of mental illness, ranging from anxiety disorders to eating disorders. Yet, despite national efforts, the development of small psychiatry units within provincial hospitals is almost nonexistent. While there might be an upturn in the number of trained mental health nurses, the bulk of program graduates veers toward broader medical fields, forsaking mental health facilities and psychiatric institutions to wrestle with staff shortages. Broadly speaking, PNG’s health services struggle with a lack of resources and support, casting a shadow over the country’s health care landscape. In this intricate equation, mental health, despite its vital significance, is marginalized, drawing even less focus than other crucial health care components.
  2. Stigma and Cultural Beliefs – Stigma casts its shadow across many nations, yet in PNG, it creates a paralyzing fear that deters those dealing with mental health issues from seeking help. The apprehension stems from the haunting thought of losing not just the support of loved ones but also the respect of peers. In a society where some diminish the gravity of mental health concerns, those grappling with such challenges are unfairly deemed weak, leading to a forfeiture of the respect they rightfully deserve. 
  3. Post-Traumatic Stress Disorder (PTSD) – PNG has weathered prolonged spells of social discord, particularly evident in regions like Bougainville and the Highlands. Triggered by specific traumatic social events, post-traumatic stress disorder has emerged as a pressing mental health concern within PNG’s landscape, warranting focused attention.
  4. Lack of Government Efforts – The imperative to improve mental health lies in a nation’s government actively engaging in public education and furnishing resources for mental health services. Regrettably, in PNG, the availability of such services, alongside other essential support systems, remains limited. Consequently, individuals often find themselves compelled to seek solace in traditional healers, given the absence of viable alternatives. The pandemic has exacerbated this already critical scenario, effectively severing the connection between people and their trusted local traditional healers due to restrictions on physical interactions. Recently in PNG’s new National Health Plan 2021-30, there is no mention of mental health.
  5. Headstret – Fortunately, PNG receives support from a non-governmental organization (NGO) known as Headstret. This organization is dedicated to eradicating the stigma surrounding mental health disorders within societies, like that of PNG. It strives to raise awareness about mental health challenges through promoting well-being education. Its Facebook page, established in 2019, Headstret has 3,700 supporters globally.

Conclusion

Papua New Guinea’s multifaceted geographical landscape, coupled with its linguistically intricate composition, gives rise to numerous challenges. The stigma around mental health issues is a significant deterrent for patients seeking assistance, underscoring the crucial roles that services and education play.

The prevailing reality reveals a dearth of adequate measures being taken in this regard. Given this circumstance, individuals hailing from various nations have a unique opportunity to make a positive impact by fostering awareness, enlightening others and offering resources to assist those who are grappling with such issues. One notable example is the organization known as Headstret, which is diligently working to alleviate numerous mental health challenges in Papua New Guinea.

– Sandy Kang
Photo: Pixabay

Mental Disorder Diagnosis
According to the
World Health Organization (WHO), as of 2017, the incidence of mental illnesses increased by 13% worldwide. With the COVID-19 pandemic, beginning in 2020, anxiety and depression increased by 25%. Much of the burden of mental illness is still concentrated in low-income, developing countries. Here is some information about some of the issues impacting mental disorder diagnosis for low-income populations and what can be done to provide equal care.

Mental Health in Developing Countries

There is a strong association between poverty and mental illness. Lower SES is associated with a higher risk of mental disorder diagnosis. Poverty can lead to poor physical health, which is often comorbid with mental disorders. These health issues give rise to higher spending on treatment which feeds back into the cycle of poverty. Dynamics like these are especially pronounced in developing countries where factors such as war and natural disasters exacerbate negative outcomes. The WHO reports that one in five people affected by conflict will develop conditions like anxiety, depression and post-traumatic stress disorder. 

Receiving a Diagnosis

Developing countries face a variety of barriers to mental health diagnosis. Many people are unable to receive a diagnosis due to unavailable or unaffordable health care. Countries like Afghanistan and Ghana only have 0.296 and 0.065 psychologists per 100,000 people, respectively. When people are able to find a practitioner, they may not be able to afford their services. A 2019 report by the World Bank said that populations in developing countries spent $500 billion out of pocket on health care.

While rates of mental illness in developing countries are already high, the lack of access to health care raises the question of whether these statistics are accurate or if some are falling through the cracks without being diagnosed.

Misdiagnosis

When people in these areas are able to be diagnosed, they may not receive the most accurate diagnosis. A study conducted in six low- and middle-income countries in Africa and South Asia reported poor training for mental health professionals and inadequate knowledge of mental health issues. Without a proper understanding of the complexity of mental health, providers can make mistakes with serious consequences. There is evidence that racial and ethnic minorities, who are disproportionately affected by poverty, are also more likely to receive an incorrect mental disorder diagnosis. Some of this may be due to bias and discrimination. 

Another factor impacting diagnosis is culture. Diagnostic manuals tend to be written from a Western perspective that does not always translate to other cultures. For example, patients may vary in the types of symptoms they present with. Asian patients are more likely to report physical symptoms than emotional ones. Cultural background may also prevent people from seeking out treatment. Physicians must keep these cultural differences in mind to ensure that an accurate mental disorder diagnosis is made. 

Stigma Surrounding Diagnosis

The stigma surrounding mental disorders is prevalent cross-culturally. In some countries, mental health is rarely discussed openly and is treated as a taboo subject. In Ghana, for instance, those suffering from mental illnesses are isolated. They may decide not to seek treatment or express their feelings due to shame. Those already diagnosed often face harmful stereotypes and social ostracization. 

Stigma stems from various factors, but insufficient mental health literacy is one of the greatest contributors. This includes both academic research on mental health and widespread knowledge among the general public. Developing countries tend to fall behind in mental health research. Improving educational efforts to increase mental health awareness is shown to be effective in reducing public stigma.

A Brighter Future

Though there are many issues surrounding mental disorder diagnosis, there are steps that can be taken to improve the situation. Huesofthemind Wellbeing Foundation (HOTM) is one nonprofit that is spreading awareness about mental health. Founded in India, HOTM is a member of the United Nations SDSN Youth. The organization breaks down mental health stigma by providing workshops and running campaigns to spread awareness. Topics range from educational stress and burnout to dance therapy. The organization features lists on its website of mental health professionals available to provide online therapy. For those who cannot afford professional help, HOTM offers free resources to learn about mental disorders and share personal stories to connect with others. Free, online resources are a valuable tool, both for people who are newly diagnosed and others who are farther along in their mental health journey. 

Mental health is an integral part of overall well-being. For many, a mental disorder diagnosis can be the first step toward improving their health. Improving access to quality mental health care and education ensures a brighter future for all.

– Yesenia Aguilera
Photo: Flickr

Mental Health in Tunisia
Tunisia, a center of Arab culture and home to 11.7 million Tunisians, has been making significant strides in improving its care for mental health across all stages of life. Battling the overwhelming stigma and discrimination against individuals facing mental health issues, Tunisian citizens have been working diligently to change attitudes toward mental health in their country. Mental health in Tunisia ranges from disorders to everyday anxiety struggles; however, most cases go undiagnosed as many are afraid to bring upon themselves the stigma associated with being publicly labeled as a person with a mental health disorder. Nonetheless, consistent effort to reduce mental health stigma has improved Tunisia’s overall public health. 

The Conception of Mental Health Among the Youth

Since 2012, International Alert, a peacebuilding organization, has been working with Tunisia to support a peaceful democratic transition, guaranteeing the inclusion of excluded and marginalized groups. In 2022, they conducted a survey-based study to analyze the impression of mental health among Tunisian youth and their personal experiences with mental health struggles. The study concluded that Tunisia’s youth lacked knowledge about mental health. However, when questioned about mental health in Tunisia, there were both positive and negative responses. A significant number of participants rated their mental health negatively and were reluctant to admit their struggles with mental health issues. They were also hesitant to seek assistance from mental health facilities or psychologists, despite being aware of the need for professional help. 

Obstacles: Institutional and Social

There are two types of obstacles evident in the study: institutional and social obstacles. These two categories can be intertwined and mutually reinforcing. For instance, the lack of accessible services has resulted in an absence of a mental health culture in Tunisia. Additionally, the cost of treatment further exacerbates the issue of inaccessibility for marginalized and discriminated groups in Tunisia. The stereotypes that arise from the absence of a mental health culture have led to prejudice, stigma and bullying against individuals who struggle with mental health issues daily.

READ Training

Based on the background information regarding mental health in Tunisia, it is evident that both social and institutional changes are necessary. In 2017, a team of psychiatrists from Razi Hospital initiated the Responding to Experienced and Anticipated Discrimination (READ) program. This program aims to provide anti-stigma training to medical students at Tunis Medical School. The effectiveness of this training has been demonstrated in high-income countries, raising hopes among professionals for similar outcomes in Tunisia.

The main goal of the Tunisia READ training is to build people’s knowledge of stigma and combat its daily effects on individuals. Awareness of attitudes towards mental illness and psychiatry is the first step towards improvement because recognizing a problem is essential to fixing it. Following this goal is the aim to reduce discriminatory behavior towards individuals with mental health disorders and their caregivers.

Despite the initial challenges posed by the pre-existing attitudes of medical students and citizens, the trainers of this program persevered and remained consistent in their goals. They actively engaged with people to implement an improved attitude towards mental health in Tunisia.

Conclusion

In conclusion, Tunisia has been actively addressing the stigma surrounding mental health and making efforts to improve the overall care for individuals facing mental health issues. The study conducted among Tunisian youth highlighted the lack of knowledge and reluctance to seek professional help, indicating the need for institutional and social changes. Initiatives like the READ training program have shown promise in raising awareness and combating stigma, with dedicated trainers working persistently to foster a positive attitude towards mental health in Tunisia. Continued efforts and consistent engagement are crucial for achieving lasting improvements in mental health care and reducing discrimination in the country.

– Sandy Kang
Photo: Pixabay

Mental Health in CroatiaSince declaring independence from Yugoslavia in 1991, the Central European nation of Croatia has faced numerous difficulties, including a devastating war from 1991 to 1995, that have contributed to a rise in mental health issues among its population. However, since joining the European Union in 2013, the Government of Croatia has focused on implementing community-based solutions and other health care reforms to address the problem.

The State of Mental Health in Croatia

Statistics show that mental health in Croatia has declined since the end of the war in 1995. For example, a 2009 study noted that the period of transition following the war was marked by “a dramatic rise in the prevalence of post-traumatic stress disorder, especially among soldiers.” Similarly, a 2010 comparative study of patients suffering from mental illness in Germany and Croatia revealed that the prevalence of war trauma and post-traumatic stress disorder (PTSD) was significantly higher among Croatian patients, with 78% reporting experiences of war trauma and nearly 62% exhibiting PTSD. By contrast, only 6.8% of the study’s German participants reported experiences of war trauma and only 30% exhibited PTSD.

More recent statistics indicate that Croatia has continued to witness a significant rise in mental health conditions. For instance, a 2019 study by scholars at the Croatian Public Health Association and the University of Zagreb School of Medicine estimated that some 30% of the Croatian population was struggling with one or more mental health issues, with 50% of those conditions developing at 14 years of age. The study stated, “Mental disorders account for the largest and fastest-growing categories of the burden of disease in Croatia,” making clear that mental health is a key concern in improving overall health within the nation. However, in 2019, just 6% of Croatian females and 5% of Croatian males over the age of 15 reported consulting with a mental health professional.

Though significant, the figures from these studies highlight a need for even more effort toward ensuring the effective detection, diagnosis and treatment of mental health issues in Croatia.

Community Care

On the bright side, the Croatian government has been introducing reforms that target the growing national epidemic of mental health conditions. Noting that factors like the COVID-19 pandemic and recent earthquakes have exacerbated the problem, in 2022, the government adopted the Strategic Framework for Mental Health. Outlining plans of action to be implemented between 2022 and 2030, the framework prioritizes mental health as a public health concern. It focuses on early detection and prevention of mental health conditions, increasing access to mental health care and improving the effectiveness of treatment.

Implementing community-based treatment and support programs is a key component of the framework. Furthermore, it emphasizes developing telemedicine services and providing care through “mobile multidisciplinary teams.” These initiatives are part of a larger effort, outlined in Croatia’s National Health Development Plan for 2021-2027, to make the country’s health care system more accessible, affordable and effective.

Croatia’s Young People

While community care is a focus of Croatia’s mental health care reforms, the Croatian government and the Ministry of Health have also recognized the need to focus on youth mental health services.

As of June 2023, UNICEF estimated that some 11.5% of Croatian young people between 10 and 19 years of age are struggling with mental health issues, and, according to the World Health Organization (WHO), 75% of mental illnesses in Croatia develop by the time individuals reach their mid-20s. To tackle this issue, Croatia’s Strategic Framework for Mental Health 2022-2030 emphasizes introducing mental health education and treatment into schools. This includes developing social-emotional learning programs to help young people better understand and express their feelings, as well as implementing peer support and counseling programs. Such reforms are part of the government’s initiative to destigmatize mental health in Croatia, ensure treatment for those who need it and reduce the development of mental health conditions.

Visible Progress

Evincing the Croatian government’s commitment to improving mental health care in the country, Croatia’s suicide rate per 100,000 people had already fallen from 12.31 in 2013 to 11.01 in 2019, according to the WHO’s Mental Health Atlas 2020 report. Additionally, the number of mental health workers per 100,000 people rose from 59.86 in 2017 to 67.84 in 2020. Such statistics demonstrate the visible success of early government interventions aimed at improving mental health care in Croatia. With the Croatian government’s continued efforts to develop the country’s mental health system, expand its services and reach more of the population, mental health care in Croatia can record more progress in the years to come.

Matilda Davey
Photo: Flickr

Mental Health Initiatives in SwedenSweden has often been ranked among the nations with the highest rates of quality of life and overall happiness. In addition to its stellar system of care and initiatives, the country is ripe with luscious natural landscapes and green spaces, providing its citizens with a pure, accessible, cost-free way to de-stress. These qualities work alongside mental health initiatives in Sweden. Many also recognize Sweden for its healthy balance of work and culture.

While mental health rates were low in the past, mental health initiatives in Sweden have been improving in recent times. Due to its growing success, many other nations are looking to the Nordic country as an example of progress, especially since the COVID-19 pandemic.

Government Policies

While there is still work to be done, mental health initiatives in Sweden are on the rebound. In 2016, the Swedish government introduced and implemented a mental health strategy focusing on “prevention and awareness, accessibility to care and greater emphasis on vulnerable groups.” This includes introducing methods to prevent severe conditions and increasing access to mental health treatments. Users can obtain treatment via county council mental health providers or generic services by the municipalities’ social welfare system. These municipalities provide care to individuals with mental illness, including school-aged children and patients recently discharged from a medical facility.

Options Available to Patients

There are many options available to Swedes who are living with mental illness. Numerous crisis hotlines staffed by volunteers are readily available for Swedes to utilize. These include SPES, available to those grieving the loss of a loved one to suicide, The Rainbow Line, available to LGBTQ+ individuals, Kvinnofridslinjen, available to women facing violence or threats of violence and BRIS, available to anyone who needs support.
Another initiative available to patients is the Young Health Programme (YHP), founded and operated by AstraZeneca. YHP is a global disease prevention program with a unique focus on mental health awareness for those aged 10 to 24. Researchers collected findings by surveying 1,350 discussions with the BRIS child helpline. They published the results so mental health professionals could access those findings. Patients, their families and health care professionals utilized five short films based on the team’s findings as part of their treatment process. To date, more than 29,000 children have used these methods to receive support for their respective conditions.

Outlook on the Future

Sweden’s efforts to strengthen its mental health initiatives are creating meaningful changes for patients and their families. Policies and policymakers are focusing on varying aspects of mental health and groups affected, including adolescents and individuals from disadvantaged backgrounds. Agencies are more equipped to appropriately treat and care for their patients. As of June 2023, policymakers are continuing to strengthen mental health initiatives in Sweden in the hopes of maintaining positive mental health trends in the future.

– Nicholas DeLuca
Photo: Unsplash

Mental Health in the EmiratesThe Emirati government is investing considerably in its domestic interests and this is visible in its efforts toward improving its national mental health services to advance mental health in the United Arab Emirates (UAE).

Reluctancy to Seek Help

Despite the record domestic financial investment, the UAE populace suffers from depression and anxiety disorders. A 2022 study by Gabriel Andrade and others sampled 385 English-speaking individuals in the UAE and drew the conclusion that many of the woes with mental health services in the nation stem from a personal reluctance to seek help largely due to the stigma surrounding mental health issues.

While services in the country are improving at a record-breaking pace, data suggests that mental health is neglected and that disorders often go untreated simply due to an unwillingness to seek help when needed.

The World Health Organization’s (WHO) Mental Health Atlas 202o highlights that while the UAE has a “stand-alone policy” for mental health, it lacks one for suicide prevention. The country also has a suicide mortality rate of roughly 5.24%, and while the majority of mental health patients are able to get the care they require at no additional cost to them, must pay at least 20% toward the costs of their medications. It also maintains just two individual, dedicated mental hospitals, though it has 27 psychiatric units within more general hospitals.

Mental Health Challenges in the United Arab Emirates

Mental health in the country faces some self-recognized problems when it comes to improving available mental health services. Notably, an internal review from the National Policy for the Promotion of Mental Health in the UAE identifies that these issues include:

  • A lack of unified national policy on mental health. Though there are different authorities working on it, there is “no unified national policy to unify such efforts.” This lack of unified effort also leads to poor communication between those different authorities, furthering difficulties in developing a national response regarding mental health policy.
  • There is a lack of financial resources the government directs to mental health services. Specifically, there is no clear budget that it allocates to mental health services.
  • Social stigma against mental disorders heavily impedes treatment for psychiatric patients. Recipients of psychological services tend to suffer from a host of discrimination in various aspects of society, especially those such as work and education. This isolation can often further worsen the very mental disorders that psychiatric help hopes to treat.

Applied Solutions

Even with the associated societal and organizational issues complicating efforts into improving mental health in the United Arab Emirates, the government continues to push efforts to help the situation. It has already implemented and continues to implement a host of initiatives intended to strengthen its mental health care systems within the country. Especially notable examples include:

  • A draft law passed in 2021 aims to help improve the rights of mental health care patients. Specifically, it ensures that patients with mental illnesses are to be treated fairly, “with respect and dignity” and enforces privacy protections as well as a more robust understanding of treatment options available to them.
  • A partnership in 2019 with the makers of virtual reality headsets Oculus. The ministry intends to use virtual reality technology as an assistant in diagnosing and understanding schizophrenia.
  • The establishment of a dedicated mental health program at the Abu Dhabi Public Health Center. The program focuses primarily on promoting domestic community mental health and reducing the self-blame and social stigma around mental illness and associated treatments via community outreach and social service programs.

The Future Potential

The social stigma around mental health and seeking treatments for it remains in the UAE, and with only one mental health center in the nation, it remains difficult for people with mental illnesses to truly find the help they need. However, the nation is putting dedicated effort into improving its mental health services and removing some of the social barriers that continue to prevent access.

– Marc Federici
Photo: Flickr

Mental Health Illnesses
As the number of people with mental health illnesses increased in recent years, mental health has become the center of much discussion, with the highest rate among lower-income countries. A World Health Organization (WHO) report found that more than 80% of depressive disorders occurred in low to middle-income countries. Poverty, unemployment and other factors that people commonly associate with poverty, such as alcoholism, make the risk of depression higher. Many who develop mental health struggles go on to seek appropriate treatment for their symptoms from doctors and medical professionals, where available. On the other hand, treating the cause of their distress would arguably be more effective.

Living in Poverty: The Biological Stress Response and the Effects on Mental Health 

The neurological effects of poverty are already visible in infancy, with diminished brain development seen among children from low-income households. Meanwhile, the Anxiety and Depression Association of America (ADAA) reported that poverty can lead to ample detrimental physiological responses, including increased blood pressure and cortisol levels. Over time, a build-up of these responses can disrupt brain function, prompting long-term physical and mental health ramifications.

A 2015 report by the Joseph Rowntree Foundation (JRF) found that schizophrenia and depression have a higher prevalence amongst those with lower socioeconomic status. Alcoholism and other substance abuse had a stronger association with those who lived in poverty for a long time.  

Mental Health in Low-income Countries 

What many may consider a disease that plagues the wealthy, the largest proportion of global mental health sufferers resides in the countries with the lowest incomes. Those living in poverty, with less educational access, and who struggle to acquire basic needs are at a greater risk of developing mental disorders. This means that the relationship between poverty and mental disorders resembles a vicious cycle in low to middle-income countries.

The lack of available mental health resources only further exacerbates this problem, with less than 1% of these countries’ budgets invested in mental health. Moreover, in the communities, there is a higher level of taboo surrounding mental health illness, leading to a lack of clarity and understanding.

Treatment: The Symptom, Not the Cause 

Low-income communities have a higher proportion of antidepressant users in comparison with those of higher income. A U.K. study that the DeStress Project conducted revealed that individuals living on Universal Credits and struggling with the distress from poverty reported resorting to medication as a means to legitimize their suffering, as well as being made to feel as though the cause of their grief was pathological, not systemic. Despite prescribing antidepressants, one doctor reported knowing in their “heart of hearts that it’s not a medical problem.” 

CBM UK: The Mental Health Charity Helping the World’s Poorest 

CBM U.K. has been working to help the lives of those suffering from mental health illnesses in the world’s poorest countries for more than 15 years. In 2017, CBM merged with the mental health charity BasicNeeds which only increased its technical capacity and reach. The charity aims to improve access to mental health resources such as therapy and medication, eradicate stigma and taboo surrounding mental health as well as train local communities to support those with mental health illnesses in rural and non-developed areas. In 2022, CBM U.K. gave 27,000 people support for mental health conditions, and the pandemic has enabled 2,500 medical professionals to provide support.

Looking Ahead

Nonetheless, treating mental health illness in poorer communities only addresses the symptoms rather than the cause. Solving poverty would reduce the number of cases of mental disorders and consequently eradicate the need for the unnecessary cost of prescriptions.

Genevieve Lewis
Photo: Flickr

Mental Health in Argentina
Effects of the COVID-19 pandemic have intensified mental health problems worldwide. The World Health Organization (WHO) published a scientific brief in 2022 showing a 25% increase in global anxiety and depression in the first year of the pandemic. Government response to mental health in Argentina during the pandemic reveals a crucial transitioning of its medical system.

Mental Health in Argentina – The Numbers

In 2015, Argentina’s Ministry of Health funded a survey that found that only about one in three people above the age of 18 with mental disorders receive treatment. The Ministry of Health administered approximately 4,000 household surveys to adults with fixed residences in Argentina’s largest urban areas. Researchers conducted the survey using the World Mental Health Composite International Diagnostic Interview, a comprehensive assessment of mental health that WHO designed. Individuals with low education and income were the least likely to receive treatment, according to the survey.

The COVID-19 pandemic has generated higher levels of stress and anxiety for many. A 2020 study by researchers at the University of Buenos Aires focused on the effects of Argentina’s mandatory quarantine on mental health in the wake of the pandemic. Researchers studied participants using online surveys on days 7-11 (from March 27 to 31, 2020) and days 50-55 (May 8 to 12, 2020) of the nationwide quarantine. The survey results indicated a rise in the percentage of participants with symptom indicators and suicidal thoughts between period 1 and period 2.

The relationship between poverty and mental health in Argentina is bidirectional. Just as mental health problems increased in the last couple of years, Argentina’s poverty level rose to 42% in 2020 according to The World Bank. Since 2018, the nation has been facing a severe recession that has led to a steep devaluation of the Argentine peso. The uncertainty surrounding this economic crisis and the ongoing pandemic draws concern for the mental and physical well-being of the approximately 11.7 million citizens who live in poverty.

Developments in Mental Health Care

Support for mental health in Argentina has been undergoing a transformation following the approval of the Mental Health Law in 2010. Argentina’s health care system is gradually transitioning from hospital-based to community-based care, placing focus on human rights and patient protection. The government implemented this law when public psychiatric hospitals still made up 89% of available in-patient beds, according to a study by the Ministry of Health.

The Mental Health Law is beneficial as it offers a shift from psychiatric hospitalization to community care, but certain socio-economic disparities exist between urban and rural areas that hinder some from getting the support they deserve. Argentina has the highest number of psychologists per capita in the world, but nearly half of them live in Buenos Aires, Argentina’s capital city. Many rural residents have less access to support systems or health professionals than those living in the cities.

Argentina’s New Mental Health Strategy

In April 2022, President Alberto Fernández addressed the effects of COVID-19 on mental health and offered a solution. Fernández and health minister Carla Vizzotti announced the implementation of the National Mental Health Strategy, aiming for an all-inclusive “recovery of society.” The plan includes major health care budgetary raise from 3.7 to 7.7 billion pesos, a 107% increase. The National Mental Health Strategy aims to expand Telehealth and community-based programs to serve the public. Fernández’ presented The National Mental Health Strategy alongside the inauguration of the Bonaparte Children’s Hospital and Adolescent’s Service.

Following the conference, Vizzotti met with the Federal Council of Mental Health and Addictions (COFESAMA) to address the federal strategy. Leaders from around the country analyzed the pivotal goals of the strategy, such as a “nationwide territorial operation for the promotion, prevention and care of community mental health.” The Ministry of Health has not yet announced when it will implement these plans and policies.

Looking to the Future

Argentina’s progressive outlook on mental health has led to some crucial developments for its medical system. Still, the Argentinian government needs to make efforts to breach disparities that exist for those with low income and low access to treatment, especially in Argentina’s rural regions. The National Mental Health Strategy’s emphasis on diversity and inclusion sets a hopeful precedent for Argentina’s future in health care.

– Evan Lemole
Photo: Pixabay

Mental Health in Burundi
The aftermath of the long-lasting Burundian Civil War manifests as poverty, trauma and inequality in Burundi. These factors devastate the mental health of people in Burundi; depression, anxiety and PTSD are common in adults and children alike.

An Overview of Burundi

From 1993 to 2005, the Republic of Burundi, a country located in East Africa, endured a violent civil war stemming from ethnic conflicts between the Hutu majority and the Tutsi minority. Although the civil war officially came to an end 17 years ago, ethnic violence and injustice persist, causing many to live in fear or flee as refugees. Furthermore, the long-term impacts of the civil war linger in the form of poverty and mental illness.

According to the World Food Program U.S.A, Burundi ranks as one of the most impoverished nations globally, with a staggering poverty rate of 65%. Furthermore, on the 2019 Human Development Index (HDI), Burundi ranks 185th out of 189 nations. “The HDI is a summary measure for assessing long-term progress in three basic dimensions of human development: a long and healthy life, access to knowledge and a decent standard of living.” Burundi’s ranking places the nation “in the low human development category.”

With 12.2 million citizens crammed into 9,920 square miles, overpopulation and food insecurity are major problems. Malaria, measles, HIV/AIDS and tuberculosis are common causes of death in Burundi. COVID-19 and a lack of adequate medical care exacerbate poor living conditions within the country. These factors push mental health treatment to the back burner.

Case Study

The aftermath of the war created a ripple of trauma for many citizens. A 2018 study by Nkengurutse and Bitangumutwenzi illuminates the severity of mental health in Burundi. The study included 120 subjects from ages 15 to 55. The results were frighteningly dire: 100% of patients had some form of moderate to severe mental illness. About 57% suffered depression, 20% had “psychotic features,” 13% had bipolar disorder, 8% received a schizophrenia diagnosis and 65% were victims of trauma.

Subjects remained as inpatients for about 20 days. Mental health stigma (60%) and “poor economic insertion” (90%) stood as barriers to full recovery. After a year, 30% of treated patients reported a full recovery while 42% went into relapse. This study illustrates the sheer volume of Burundians that struggle with mental illness and the factors presenting barriers in mental health recovery.

The Good News

Sports unite warring factions of Burundi, reducing the ethnic tensions prevalent across the nation. Burundi recognizes sports as an outlet, never missing a Summer Olympic Game since its first debut in the Olympics in 1996. Athletes from Burundi also compete in the African Wrestling Championship, winning gold and silver medals. Among women, soccer offers many females a source of income, providing a way to use their talents to make a living, the Guardian explains. Soccer also grants these girls and women independence and freedom, a rare commodity for many Burundian females who often face parental pressures to marry as teenagers. Athletes provide role models for young Burundians and boost morale throughout the country, directly improving mental health and confidence.

Why Mental Health Matters

Poor mental health directly correlates with poverty. The Psychiatric Times observed that childhood poverty may lead to depression and anxiety, a decline in school performance and an increased rate of “psychiatric disorders in adulthood.” This impact on education is evident in Burundi as the nation’s literacy rate stood at about 68% in 2017, well below the world average of 86%.

In addition, poverty has direct links to depression, anxiety, psychological distress and suicidality. This causal relationship between poverty and mental illness creates a constant loop that is especially dangerous in Burundi where it is extremely difficult to escape the cycle of poverty. Poverty leads to poor mental health, which impedes the ability of individuals to pull themselves out of the depths of poverty, thus worsening their mental states. In 2019, the Mental Health Innovation Network stated that “90% of people with mental illnesses have no access to treatment, especially in [impoverished] and rural areas.”

Organizations Assist

While UNICEF’s mental health services in 2020 gave 160,000 Burundian children access to mental health resources, partially alleviating the issue, there are still millions of Burundians in need of mental health treatment.

Human Health Aid–Burundi (HHA Burundi) is a nonprofit that “medical students, psychologists and social workers” established in 2005. The organization works with Burundian communities, “especially children and women who suffer from anxiety, depression, trauma and other psychosocial consequences of their war experiences,” to improve “access to mental health care and psychosocial support.” HHA Burundi also provides direct aid to refugees by sending clothing, food and other necessities. Through programs such as Health School and Sanitation Training in Burundi, HHA Burundi transforms lives.

In addition, UNICEF secured $9.8 million worth of funds for Burundi in 2020 for the provision of education, food, medicine and other humanitarian needs. Aid lessens the economic and emotional strain in Burundi, therefore, contributing to positive mental health.

While addressing mental health in Burundi is a matter of urgency, several organizations are stepping in to assist. Furthermore, sport provides citizens an outlet for trauma, giving Burundians a source of hope in a war-torn country. As organizations strive to push mental health to the forefront of foreign aid, the hope is for Burundians to receive the mental health assistance they require to thrive.

– Mariam Abaza
Photo: Flickr