Mental Health In Nepal
Nepal is a country in South Asia with a rich and diverse culture. Most Nepalese people have a perception of the self in which the mind and body are considered to be separate. As a result, they typically attribute mental illness to spiritual dysfunction. People who have mental health problems are also targets of stigma and discrimination. According to the World Health Organization (WHO), more than 1 million people are estimated to currently have mental health disorders in Nepal.

Mental health is a matter of paramount importance. Poor mental health can lead to serious physical and social problems, which impact a person’s quality of life. Mental health issues are often linked to poverty because they lead to problems with maintaining employment and important social relationships. It is common for people who suffer from untreated mental illness to live financially unstable and precarious lives. According to the 2019 UNICEF multiple indicator cluster surveys (MICS) in Nepal, more than 17% of Nepalese people were considered multidimensionally poor. In Nepal, there is a lack of resources and support for people with mental health issues, especially those who experience the struggles of living in poverty.

Nepalese Culture and Mental Health

Nepal spends 7.5% of its GDP on health care, which is far below the global average of 10% of a nation’s GDP. It is common for Nepalese people to visit traditional healers in order to address mental health. However, people in Nepal have limited availability and access to traditional healers, especially in rural areas. Traditional healers that Nepalese people typically rely upon do not have the formal training required to properly identify and treat mental illnesses.

As of 2022, there are 0.36 psychiatrists working in the mental health sector per 100,000 people in Nepal, with a majority of professionals concentrated in urban areas. Low economic prioritization of mental health issues within the country contributes to a lack of public awareness regarding mental health. Furthermore, cultural stigmas have contributed to fears of discrimination and rejection from friends, family and community members. As a result, people become hesitant to seek mental health treatments in Nepal.

A Growing Need

From 1996 till 2006, the people of Nepal endured a violent civil war that killed more than 13,000 people and displaced thousands. The country is still recovering from the violent conflict, which has likely contributed to a growing prevalence of PTSD, depression and anxiety disorders among the Nepalese population. Nepal’s deadly environmental disasters have also affected them. An earthquake in April 2015 killed more than 8,000 people and injured more than 20,000 people.

People that events of this nature affect typically require significant psychological first aid in order to alleviate trauma and other long-term mental health problems associated with emergencies. Survivors of these events usually rely upon international humanitarian NGOs for mental health care and services in large numbers. Nepal’s weak integration of mental health services into primary health care led many Nepalese people to become dependent upon NGOs and international organizations for help in the wake of their suffering and loss.

Advocating for Mental Health

Advocates for mental health in Nepal point to policy change, rehabilitation efforts, and more healthcare infrastructure as solutions for the problems Nepalese people are facing. Nepalese organizations such as KOSHISH are working to promote mental health awareness and psychosocial well-being throughout the country. Established in 2008, the organization is a nonprofit that operates as a national mental health self-help organization and advocacy group. KOSHISH advocates for mental health issues on the national policy level. It aims to promote mental health awareness as well as reduce the stigma and discrimination surrounding these issues. The organization provides psychosocial support programs, treatment, and residential care for women who are victims of gender-based abuse.

The momentum behind mental health advocacy is growing globally and spreading to countries like Nepal. In the past, the law in Nepal equated mental illness to madness and provided no legitimate legislation related to the treatment of mentally ill people. Over the past years, Nepal has significantly increased its political commitment to mental health and psychosocial issues. In 2019, the country expanded its national health policy to include a strategy that incorporates mental health services into its healthcare systems. Nepal now considers mental healthcare a basic health service. The growing progress of mental health literacy and awareness within the country will likely lead to more widespread mental health awareness and support for the people who need it.

– Dylan Priday
Photo: Flickr

Mental Health in Kazakhstan
Many countries, including Kazakhstan, struggle to accept mental well-being as part of a person’s overall health. Many often view mental health disorders with suspicion, and those suffering can become outcasts from their communities and society. Changing the view of mental health in Kazakhstan is difficult, but more important than ever.

In partnership with international organizations, the government of Kazakhstan is fighting to make that change and ensure that mental health treatment is more easily available to everyone. Addressing mental health is critical to addressing poverty as each social crisis feeds and strengthens the other. An article that two psychologists published in the BJ Psych Bulletin emphasizes this connection. “We highlight how mental health problems are related directly to poverty, which in turn underlies wider health inequalities,” authors Lee Knifton and Greig Inglis say.

Imperialism and Mental Health Impacts

The way that some have addressed mental health historically is partly due to long-standing beliefs about mental health — some recognized mental health disorders as a problem in traditional religious practices, where people often attributed suffering to demons or evil spirits. There is also Kazakhstan’s experience with foreign rule. Both Imperial Russia and the Soviet Union actively worked to delegitimize traditional folk religions and healing practices, and import new forms of health care.

“The Kazakh shaman’s figure epitomized the wildness and backwardness of the native population. His healing methods were usually presented as ‘tricks’, ineffective and harmful,” one researcher, anthropologist Danuta Penkala-Gaweka, reported in the journal Central Asian Survey. These beliefs were central to Kazakh cultural identity. Ultimately, this suppression led to a backlash. Practices that some associated with former imperial powers were often regarded with suspicion. This included clinical mental health counseling and psychiatric services. In part due to the stigma, accessing services became increasingly difficult.

Difficulty in access, poorly trained practitioners and social stigma left many sufferers without treatment. Unfortunately, while it is difficult to quantify, the number of people needing support was growing. The Guardian reported the mental health impact of a falling economy, particularly on men. “Psychologists say the economic downturn has proven particularly traumatic for men who are under significant pressure to provide for their families in what is still a heavily patriarchal society,” according to the Guardian. One woman she interviewed said “Our men are embarrassed to talk about problems. While for a [Kazakh] woman the problem is avoiding being abandoned by her husband, for a man the problem is how to support his family.”

In an interview with the World Health Organization (WHO), Dr. Nikolay Negev, a mental health consultant with the organization, explains the real consequences of untreated mental health problems and stigma: “We had several cases where we weren’t allowed to assist or treat, and a patient would die by suicide.” Even those who wanted treatment had difficulty getting it. A report that the Mental Health Atlas 2020 published put the impact into real numbers. According to the United Nations, there are 18,551,428 people living in Kazakhstan. For every 100,000 citizens, there are only 24.13 mental health professionals available. Only 2.86 of those professionals specialized in treating children or adolescents. The numbers look dire, but recent developments point to a real cause for hope.

Overcoming Obstacles

Despite their low numbers, mental health professionals in Kazakhstan are working hard at overcoming the suspicion associated with treatment. After the government partnered with UNICEF and other international organizations to create the AMHSP, or Adolescent Mental Health Promotion and Suicide Prevention Programme, there was a considerable drop in mental health problems among the youth the program reached. “[After the program was introduced, there was a] 36.1% decrease in suicidal ideation among young people, 80.6% decrease in anxiety, 56.1% decrease in depression and 65 per cent decrease in stress,” UNICEF reported in 2021.

The Kazakh government enthusiastically welcomed AMHSP’s success, which increased its funding by 25%. One report emphasized the vicious cycle here but also highlighted reasons for hope. “People are ashamed of going to a psychiatrist, counsellor [sic] or psychologist. But compared to the situation 20 years ago, we can see some changes. Most of the people who understand and want to change resort to them,” one therapist said. She did see room for continued growth, including better education for mental health professionals. “At the same time, I think, too many cases of schizophrenia are diagnosed. I meet patients with dementia regularly, and they have been diagnosed with schizophrenia.”

The fight for access to and treatment for mental health disorders is an ongoing and worldwide challenge. Kazakhstan’s success, however, is a bright light for advocates worldwide. Change can happen, and with continued support, it can flourish.

– Clara Martin
Photo: Flickr

Mental Health in Moldova
With a poverty rate of 26.8% in 2020, Moldova ranks as the fourth poorest country in Europe. Corresponding issues including the difficulty of obtaining employment, harsh living conditions and limited access to already low-quality public services devastate the nation’s quality of life. Compounded by the hardship of socioeconomic stressors and governmental destitution, mental health in Moldova has suffered as a result.

Overview of Mental Health in Moldova

Mental disorders related to systemic issues in Moldova have caused 17.34% of the population to be diagnosed with mental illnesses, according to the Health Policy article. Tragically, these issues go hand-in-hand with Moldova’s comparatively high suicide rate of 14.7 people per 100,000 — 3.4 people more than the EU average of 2019. Another major component of mental illness in Moldova is alcoholism, with one in four deaths in Moldova being attributed to alcohol. In comparison, the world average is one in 20.

Systemic Issues with Moldovan Health Care

Socioeconomic issues within the populace and the government’s mismanagement of resources have exacerbated the mental health situation in Moldova. Mandatory health insurance finances the public health care system. According to a study published in The Lancet “out-of-pocket payments account for 45% of total health expenditure in Moldova,” causing Moldova’s health expenditure to fall behind the European average by 77%.

Management of health care spending is a direct product of corruption within the Moldovan government. “Many things depend on the government and parliament, but we have such a quick turnover, there is no stability,” explains Valeriu Crudu of the Phthisiopneumology Institute Chişinău.

Recent Reforms

The Moldovan government has shown a willingness to implement reforms to the situation of mental health within the nation, such as by adopting the Mental Health Declaration for Europe and the Mental Health Action Plan for Europe, and developing a national mental health program in 2005. However, actual “community-based mental health services” have been difficult to implement.

According to an International Journal for Mental Health Services article, for one, a lack of access to resources, largely based in district centers and cities in the north, continues to prevent rural and impoverished Moldovans from obtaining help due to distance and travel costs. There has also been a notable lack of collaboration between medical and social services, producing confusion among service providers concerning psychiatric, neurologic and addicted patient treatment. Professionals in the health workforce argue that the knowledge gap between medical and social workers should be filled with specialized education regarding mental illness, especially in rural regions.

Looking Forward

Despite persistent obstacles, the National Mental Health Programme of 2014 — renewed in 2017 — continues to work towards reform through the development of a new legal framework for care and support for educational programs for professionals, according to the Health Policy article. Though policy change ultimately lies in the hands of the government, several organizations are also working simultaneously to ameliorate the mental health situation in Moldova.

For instance, the Open Society Mental Health Initiative is working towards improving the quality of living for Moldovans with mental illness or intellectual disabilities by relocating them to family-style living spaces where they can obtain comprehensive and stable care.

The organization also ensures that community efforts toward mental health improvement are sustainable and financially provided for. While organizations and government reforms have paved the way for gradual improvements in the mental health of Moldovan citizens, the fight toward a system of mental health care for all continues.

– Alisa Gulyansky
Photo: Flickr

Syrian Children Refugees
Since the Syrian civil war began in 2011, there have been mass casualties, millions of displaced citizens and uncertainty about the country’s future.  According to the UNHCR, the war has forced nearly 5.7 million Syrians to find refuge in Lebanon, Egypt, Iraq, Turkey and Jordan, more than half of whom are children. In total, the UNHCR estimates that more than 13 million Syrians have been displaced or forced to leave the country. With the disruption of the war, Syrian children refugees are at a higher risk for mental disorders like depression, anxiety and post-traumatic stress disorder (PTSD).

Psychosocial Problems

A 2015 UNHCR review suggests that Syrian refugee children have heightened psychosocial problems such as fear, grieving, withdrawal, hyperactivity, warlike play and behavioral problems. According to a UNICEF report in 2019, there were 8 million Syrian children in need of resources and 10,000 unaccompanied or separated children.

Providing mental health treatment for Syrian children refugees is no easy feat. With refugees spread out among several countries such as Lebanon, Jordan, Germany and Turkey and with some still residing in Syria, it is difficult to know just how many children need help.

However, providing mental health treatment for Syrian children refugees is a necessary and time-sensitive issue. The disruptions of the war have created barriers to physical and mental health and could affect generations to come.

Current Treatments and Organizations

As of now, countries around the world offer mental health support for Syrian children. For example, the UNHCR uses a community-based approach to provide the most helpful mental health treatment for Syrian children refugees in different areas. Its child protection programming assists Syrian children in counseling, recreational activities and life skills.

Syrian non-governmental organizations (NGOs) also provide care, although they mostly operate outside the country. Syrian American Medical Society (SAMS) provides mental health and psychosocial support in Syria and in host countries, such as Jordan and Turkey. It manages eight safe spaces for women and girls in northwest Syria, where counselors provide support for those gender-based violence affects.

However, despite efforts at the local, national and international levels, many Syrian children refugees lack mental health resources. There are many overlapping reasons for the lack of resources, ranging from burnout among mental health officials to financial barriers, medication or supplies.

What Experts Recommend

Experts in medicine, psychosocial support and individuals working closely with the Syrian mental health crisis have proposed several new avenues for helping Syrian children. Isra Hussain, a research assistant and program coordinator with the Global Health Policy Center, pushes for a “multilayered system of response.” Instead of only providing basic mental-health resources, Hussein suggests a coordinated approach involving local officials, public and private organizations and humanitarian agencies.

The American Psychological Association proposes a three-step intervention for Syrian refugee children: culturally and linguistically appropriate mental health services, providing services at the client’s preferred location and having trained professionals who can detect mental health difficulties in refugee children.

Apart from direct mental health counseling, Michelle L. Burbage and Deborah Klein Walker with the National Academy of Medicine urge more social and community support for Syrian refugee children. In addition to adjusting support according to different cultural backgrounds and social influences, Burbage and Walker emphasize community outreach and health education to engage Syrian children refugees in mental health programs.

Looking Forward

As the Syrian war continues, more children will undergo life-changing events and potentially traumatizing experiences. It could eventually fall upon the children now to sustain the country’s economy and infrastructure. As many health experts have suggested, it is imperative to address the humanitarian and mental health crisis at hand and look for possible solutions.

– Anna Lee
Photo: Flickr

Mental Health in Zimbabwe
The Friendship Bench has revolutionized the field of mental health in Zimbabwe and beyond. Due to its great localized success, 32 Friendship Benches have undergone installation around stadiums at the FIFA World Cup in Qatar.

Mental Health in Zimbabwe

Zimbabwe is a landlocked country in southern Africa, with 70% of the population living below the poverty line. This economic state has caused many struggles for the citizens, such as inadequate nutrition and the prevalence of diseases. Mental health is also a major issue, but many often neglect it. Legislation regarding mental health policy is outdated, and the World Health Organization (WHO) has reported that “There is a shortage of human resources for mental health in Zimbabwe, in part a result of the emigration of locally trained professionals due to economic instability.”

Mental health is an important issue for the citizens of any country. Therefore, mental health care and support are a necessary part of a nation’s health system. UNICEF Zimbabwe has called for more assistance for youth and adolescents in the wake of the COVID-19 pandemic. Still, the country lacks the resources to address the issue in its entirety. This challenge has required creative solutions from local NGOs, an example being the Friendship Bench Project.

The Birth of the Friendship Bench

Since 2006, the Friendship Bench has trained more than 600 mentors to offer support on benches in communities around Zimbabwe. These volunteers offer assistance using techniques based on cognitive behavioral therapy and are often from the communities in which they practice. This connection allows a deeper understanding of the struggles that community members face. Citizens engage in positive dialogue with these volunteers, usually in 45-minute segments. In the past 16 years, the project has extended to Malawi, Zanzibar and New York City. In the future, it plans to expand in order to offer more care for youth and adolescents.

Proven Success

In 2016, JAMA Network produced a clinical trial regarding the potential impact of the Friendship Benches and the care they provide. Results indicated that “the group from the Friendship Bench had a significant decrease in depressive symptoms, compared to the control group.” These impacts on mental health in Zimbabwe prove that projects like this may be effective in countries with poor mental health resources.

The 2022 FIFA World Cup

Due to the success of the Friendship Bench in Zimbabwe, several groups have worked together to install 32 benches at the 2022 FIFA World Cup in Qatar. They will be located around the different stadiums, and will each represent a different participating international team. Organizers hope that the benches will spark a conversation around the importance of mental health care and focus. The colorful details of these benches are an added feature to catch the attention of players and spectators to spread awareness in a creative and positive format.

The success of the Friendship Bench Project on mental health in Zimbabwe is clear, and its impacts internationally suggest a positive future for growth in mental health care, even in nations with limited resources.

– Hailey Dooley
Photo: Wikimedia Commons

Mental Health Inequality in SwedenWilliam Russell, an international health insurance company, ranks Sweden as the best country in the world in terms of mental health care. Green spaces, work-life balance and generous government spending on mental health are just some of the contributing factors. Yet, a study by Kinza Degerlund Maldi and others, published in 2019, reveals a socioeconomic divide in the distribution of mental illness. Both educational and income disparities had an impact on mental health, but low income posed a higher risk for susceptibility to mental illness, especially among women. Another study by S Fritzell and others underlines job status, economic strain and enduring harassment as risk factors. Socioeconomic status has the most significant impact on mental health inequality in Sweden, more so than “demographic factors and psychosocial factors.”

Unemployment and Mental Health

The Centre for Global  Mental Health highlights that there are links between mental health and poverty. Unemployment contributes significantly to economic vulnerability. In particular, psychological distress is common among those without stable employment, more so than for those with secure jobs, and this is consistent regardless of gender and age bracket. Women are most impacted by economic disparities, suggesting that focusing on the gender wage gap and equal employment opportunities could help Sweden progress toward easing inequality.

The Impact of Education

The Public Health Agency of Sweden says that a “positive learning environment in school” is possibly the most important way to ensure good mental health among young people. Studies demonstrate this, with positive relationship building and maintenance in school and holistic care within these institutions shown to be integral to students’ well-being.

While education can positively benefit mental health, poverty still plays a role in educational outcomes and future prospects. Swedish children living in poverty generally have lower academic achievements in comparison to their wealthier peers and are more likely to drop out of school. This leads to reduced opportunities for employment and further education, meaning that the cycle of poverty and mental health inequities can continue in a generational capacity.

It is integral for the government to provide additional support to young people who are living in poverty and ensure children are in positive school environments to prevent further mental health inequality in Sweden. This is especially crucial considering that the suicide rate in Sweden for those aged 15–29 has shown no significant decline in 23 years, averaging between 8–14 suicides per 100,000 young people.

Migrant Vulnerabilities

Some regions are more prone to wealth inequities and mental health inequality and it is not coincidental that these regions are often densely populated by migrants. One example is Malmö, a city in Southern Sweden where around a third of children live in poverty.

Here, increased rates of poverty among migrant families have led to vulnerabilities in various aspects of life, including well-being. Migrants are more likely to suffer from both mental and physical illness due to increased difficulties securing financial independence, employment and satisfactory work, educational stability and positive social conditions. Analysis of the specifics of this inequality reveals that lack of access to social activities and support makes the largest contribution to the mental health discrepancies between natives and migrants. However, unemployment and money troubles also significantly impact the well-being of migrants living in Sweden.

Targeted Support

The 2019 Poverty Report Sweden highlights the fact that asylum seekers only have the right to emergency health services, which does not include mental health care. The institutional prioritization of mental health equality in Sweden, specifically targeting vulnerable regional areas, migrants, adolescents and low-income families, must materialize in the form of holistic structural support changes. Rather than attributing poverty and inequality to lifestyle choices, the government can look to understand the cycles of inequality that those in disadvantaged communities face.

Additionally, on an individual basis, the value of specifically targeted support is demonstrated by research on community health worker-led programs offered to migrants. Sweden’s ‘Hälsostöd’ (Health Support) program used data gathered from questionnaires to measure psychological distress. Results showed that migrants participating in health promotion programs experienced positive mental health impacts.

On the Right Path

The Swedish government took positive action in 2020 by commissioning the Swedish National Agency for Medical and Social Evaluation to assess efforts to address mental health well-being and reduce suicide among young people. This report was scheduled for completion in October 2022.

Sweden’s leaders are prioritizing young people and established five focal areas to center mental health strategies around, one of these priorities being a “focus on vulnerable groups.”

Over time, the Swedish mental health system has considerably improved and this is visible in numerous areas, including the decrease in suicide rates from 1997 to 2020. This reduction is visible among the majority of age groups, except those aged 15–29. For example, suicide rates among people 85 and older have reduced from 29 per 100,000 in 2000 to 18 in 2020.

Sweden’s government and public health agencies show commitment to improving mental health. Further focus on the mental health of those from disadvantaged backgrounds will reduce mental health inequality in Sweden.

– Lydia Tyler
Photo: Unsplash

Mental Health in Chile
Depression and anxiety have risen in post-COVID-19 Chile. Prolonged confinement, uncertainty and lack of social contact triggered a dramatic increase in these pathologies. However, these frightening figures have made these diseases visible at levels never seen before, which is the first step to achieving important changes.

Depression and Anxiety on the Rise

Mental health is often a silenced topic in Chile, as well as in most parts of the world. One can see the unequal treatment that patients suffering from mental illness compared to physical illnesses received by the lack of services dedicated to these and the discrimination that mentally ill individuals have suffered. These are diseases that the media has traditionally not highlighted and that many treat as minor problems. Undoubtedly, this generates mistrust on the part of the affected person when seeking help.

Due to the COVID-19 pandemic, depression and anxiety are some of the most worrying results of the lockdown. A study that the Catholic University of Chile conducted, in collaboration with the Chilean Safety Association (ACHS), indicated that mental health issues were among 35% of respondents by 2020. While, in 2020, the number of people that some symptoms of depression affected was 13%, in 2022, it rose to 16% due to unemployment and economic instability due to the COVID-19 pandemic. Meanwhile, as many as 28% suffered from anxiety.

Despite the problems with mental health in Chile, the total budget dedicated to mental health is currently at 2%, which is the lowest among all OECD countries. Without a doubt, this situation requires governmental action to achieve a change in strategy and an increase in the budget.

Mental Health: Challenges and Solutions

The impact that mental instability has on one’s performance and on society reaches consequences that affect the whole country. Giving these illnesses the importance they require and establishing a prompt response can have a positive impact on society’s well-being but also on reducing poverty. For example, mental issues have massive indirect costs that have links to the lack of productivity and motivation of the affected person. According to the Pan American Health Organization (PAHO), mental health problems are the main cause of disability in Chile. Chile is also one of the Latin American countries with the highest depression rates, especially among the lowest-income groups. This suggests that chronic depression or severe anxiety disorders cause the inability to perform well in society, increasing the possibility of unemployment, drug addiction, and therefore, the risk of poverty.

Thus, mental health problems increase the levels of poverty while poverty increases the chances of suffering from mental issues. In order to break this vicious cycle, mental illnesses ought to receive treatment in time. Accepting the reality that mental health is equally important to physical health and making this reality visible, not only brings urgency to the matter but also incentivizes people to reach out without being scared or shameful to do so. Breaking the social stigma that mental instability is a symbol of weakness or insanity is the first step toward an effective response.

The First Signs of Grass Shoots

Fortunately, there is a change for the better. The World Health Organization (WHO) has stressed the importance of mental health in a series of guidelines that it published earlier in 2022. These are in the Comprehensive Mental Health Action Plan 2013-2030. In fact, the WHO argues that every country can move towards progress simply by making the problem visible. It promotes:

  • Raising awareness about mental health so that everyone understands the importance of it.
  • Eliminating the stigma of mental illness.
  • Improving access to mental health treatment.

Mental health in Chile became more visible since COVID-19. In 2021, Chile increases its budget by 310% compared to the previous year. The funds go toward:

  • Strengthening the human resources in mental health care for children and teenagers.
  • Improving primary health care in mental health.
  • The introduction of the Remote Brief Psychological Intervention Program, which people can use to communicate with a doctor through a video call.

Some of the most recent updates in Chile show even more positive progress. The national budget for public spending in 2023 that the President of the Republic, Gabriel Boric, announced dedicated more than $18 billion to strengthen Chile’s response to mental diseases.

As Boric stated “mental health matters and we are not going to leave them alone.” Meanwhile, global mental health day was celebrated on October 10, 2022, and the Health Minister from Chile, Ximena Aguilar, reaffirmed the same idea stating that people will no longer have to face their mental health issues alone. The Government of Chile establishes as a priority to advance the improvement of the treatment of mental illnesses while protecting the rights of the people who suffer from them.

– Carla Tomas Laserna
Photo: Unsplash

Mental Health in the United Arab EmiratesOn October 9, 2022, the Department of Community Development of Abu Dhabi (DCD) released a “Parents’ Guide on Mental Health” to commemorate World Mental Health Day. The guide counsels parents on day-to-day stressors, mental health care, interpersonal relationships, lifestyle changes and external pressures on their children’s mental health. This initiative is one of the many steps taken to improve mental health in the United Arab Emirates. Below are some of the UAE’s concerted efforts to expand the conversations around mental health, promote public support services and systems and counter years of stigmatization and silence.

Mental Health in the United Arab Emirates in Numbers

Despite the country’s high-income status, scholars of the UAE have also detected a lack of reporting and a failure to address mental health in their national database. A report by Effective Altruism, NYU Abu Dhabi, which summarizes the data from WHO and the 2019 GBD Report, notes that there are approximately 24,000 cases of mental health disorders in the UAE. It observes that the most prevalent conditions among the population are depression, anxiety and substance abuse.

On the other hand, access to health care workers like psychologists, social workers and occupational and speech therapists is low, with a ratio of 7.5 workers per 100,000 of the population in 2016 (the global median is nine). Notably, feelings of hopelessness and panic have only worsened during the pandemic, as documented in a study by UAE scholars in Frontiers in Psychiatry. According to their analysis, more than one-third of the participants experienced stress from work, home and financial matters during the coronavirus pandemic. Changes like lack of physical activities were also significant factors behind the deteriorating mental well-being of people in quarantine.

The UAE’s Efforts to Mitigate Mental Health Crises

Despite the known stigma around mental health care due to cultural values like masking familial distress in public, privacy, shame or beliefs in destiny, the UAE has implemented several policies to destigmatize and support the improvement of mental health care resources in the country. Some of the most notable initiatives include:

  1. Since 2019, the Ministry of Health and Prevention launched numerous digital resources as part of the “National Policy for the Promotion of Mental Health.” The policy identifies five key strategic objectives to promote awareness of mental health. It guarantees the provision of mental health services to outpatients, the development of mental health units for inpatients in mental health hospitals and the establishment of community mental health services, including outreach services, care, home support services and community rehabilitation.
  2. MOHAP also organized awareness lectures in English and Urdu to raise awareness about mental disorders among Sharjah taxi drivers.
  3. The Abu Dhabi Public Health Centre launched a public mental health program to promote projects and resources for community mental health care and tackle the internalized and social stigma around mental disorders and treatments. It also provides emergency, non-emergency and on-demand confidential psychological support contacts, including a free-of-cost “Estijabah” crisis number.
  4. To advocate for informed quality discourses on mental illnesses and stigma, the Al Jalila Foundation has awarded one-year fellowships to 181 journalists to research, discuss and report on mental health issues.
  5. As a response to the increased stressors during the coronavirus pandemic, the Federal Authority for Government Human Resources instituted the “Hayat” or Employees Assistance Program, which gave all employees of the federal government access to social and psychological support for their mental and moral health. They provide many communication channels that employees can contact for free consultations or 30% discounts for themselves and their families.
  6. Finally, in 2021, the UAE passed its mental health care draft law which aims to protect the rights and dignity of people who seek mental health care, reduce the negative effects of mental disorders for individuals and society and promote successful rehabilitation of psychiatric patients in the community.

The Road Ahead: Speedbumps and Potentialities

As noted, conversations around mental health in the United Arab Emirates have made huge strides in destigmatizing and propelling a more comprehensive understanding of mental illnesses and the rights of those affected by them. Yet, research has shown that the high cost of mental health services is the next impending barrier for struggling individuals in the country. A German market analyst, Kenkou, noted that the UAE has the second most expensive therapy sessions.

While digital access to mental health support has improved considerably, there is a need for more comprehensive insurance coverage of diagnostic assessments, treatments, psychotherapy and medications. Ultimately, mental health in the United Arab Emirates holds the possibility of going beyond the stereotypes, if it continues to expand its focus on the accessibility of care and dignity of service seekers.

– Saumya Malhotra
Photo: Flickr

Mental Health in Jordan
The World Health Organization (WHO) has determined Jordan’s mental health system needs significant restructuring, estimating that more than 25% of Jordanians experience mental health symptoms. Increased poverty rates due to conflicts in neighboring countries impacting the social climate have affected Jordan’s ability to cope with mental health in Jordan. Out of 100,000, only 305 Jordanians seek help for mental health symptoms, a problem needing a resolution.

The Current State of Mental Health in Jordan

When discussing the challenges the Jordanian government must address, there are preexisting strengths to build on. The fact that the Jordanian government has acknowledged the problem is a small leap in the right direction, especially in a predominantly Muslim country.

As of 2020, the WHO observed that Jordan’s mental health care system had a solid psychiatry program, a community that wants reform and affordable mental health that is free or inexpensive. The Jordanian Ministry of Health supports implementing the WHO’s mental health action program (mhGAP).

Aside from programs and affordability, mental health in Jordan has a low budget designated for facilitating mental health programs. In 2021, the annual budget reserved 6.1% for health services, and there needs to be more information on how that funding impacts mental health care. Known usages of Jordan’s health funding supported long-stay psychiatric facilities.

Psychiatrists and medication availability are scarce. Before the expansion of mental health in Jordan, there was less than one psychiatrist per 100,000 Jordanians, an unbalanced ratio showing a shortage of resources. In addition, medications, even for common disorders such as depression and anxiety, are sparse, and regulations make it harder to receive medication if available.

Possible Setbacks

The coronavirus pandemic has increased stress levels and poor mental health among adolescents, especially those living in poverty. In an international survey that UNICEF conducted, one in five young people between 15-24 said they had feelings of depression. Therefore, creating an environment where youth can learn about mental health and feel comfortable seeking help is vital.

Many Syrian refugees are in Jordan, with 86% living below the poverty line. Amman, Irbid and Zarqa are the governorates with high refugee populations most vulnerable to poverty, mental health issues and lack of resources.

The traumatic and stressful experiences endured when escaping from a country with political or social instability put many Syrians at risk of contracting mental health conditions. Including Syrians in the conversation is essential to ensure all Jordanians and its refugees have access to effective mental health care. 

Potential Progress with the mhGAP Program

Jordan is the first of six countries that the WHO chose to participate in the mental health action program. The mhGAP program works to introduce mental health care into public health care. The introduction would strengthen early detection, diagnosis, pharmaceutical treatment, therapist interventions and recurring follow-ups.

Eighty new primary healthcare clinics and centers are necessary to meet the goal of improving the state of mental health in Jordan. The country has also introduced new small-scale mental health inpatient units in general hospitals and universities, further increasing accessibility to resources.

In Amman, Irbid and Zarqa, three of the most vulnerable, impoverished areas in Jordan, healthcare practitioners received training and supervision on proper mental healthcare procedures. As a result, three new outpatient centers focused on mental health in Jordan have opened in Amman, Irbid and Zarqa to ensure bountiful resources are available to the public.

The Jordanian Ministry of Health must rework the National Mental Health and Substance Use Action Plan for 2022 to 2025 to ensure the government makes life-saving changes. Developing and finalizing mhGAP plans for mental health in Jordan are the next steps to creating a well-rounded healthcare system.

– Mikada Green
Photo: Flickr

Mental Health in Africa
Recently, doctors have been sounding the alarm bells on the ongoing global mental health crisis, going as far as to describe the worldwide support for mental health as “pitifully small.” When there is support for mental health issues, the spotlight is centered largely on more developed nations, leaving mental health disorders to be untreated and thrive in developing countries where healthcare systems are generally weak and inaccessible to the general population. However, nonprofits and NGOs are now refocusing their efforts on creating better outcomes for people suffering from poor mental health in less-acclimated nations. Mental health in Africa requires attention, but luckily, some organizations are working there to make a difference.

Mental health support across the continent of Africa, in particular, is notably poor. In 2022, Lesotho, a small country surrounded by South Africa, had the most suicides per capita in the world at 72.4 per 100,000, with surrounding countries displaying similar statistics. The high suicide rate and lackluster mental health across Africa stem from issues such as the prevalence AIDS, widespread poverty, conflict and general lack of resources.

Support for People in Africa

When people living in Africa face these struggles, they seldom receive support. In 2015, Sierra Leone, a nation of 7 million, had only one mental health facility which was to support 104 patients. In Nigeria and South Africa, two of the continent’s more affluent nations, only 10% and 25% of mentally ill citizens have access to a psychiatrist, respectively.

Poor mental health can have dire outcomes for those who do not receive help. While many acknowledge the correlation between mental illness and suicide, lesser emphasis has been placed on the association between subpar mental health and poverty. According to the Substance Abuse and Mental Health Services Administration, poverty can intensify the symptoms of mental disorders and increase the likelihood of the onset of illness. Moreover, mental health issues can also increase the odds that someone falls below the poverty line. Here are five organizations fighting global poverty by improving mental health in Africa.

5 Organizations Improving Mental Health in Africa

  1. StrongMinds: Concentrated in Uganda and Zambia, Strongminds provides mental health care to impoverished women living in Africa. It specifically helps treat depression in women by organizing group talk therapy sessions for underprivileged women delivered by community health workers. According to the organization, it has served more than 140,000 women and has an 80% success rate in helping patients recover from their symptoms. In July 2022, the organization received donations from The Inner Foundation, an organization that has raised more than $100,000,000 to support different mental health initiatives.
  2. Sentebale: Prince Harry, Duke of Sussex, and Prince Seeiso of Lesotho founded Sentebale in 2006 to support the children of Botswana and Lesotho in response to the countries’ AIDS epidemics. Sentebale means “forget-me-not” in the Sesotho language, which relates to the organization’s mission of not forgetting some of Africa’s most vulnerable children. Sentebale delivers sexual education, proposes improvements to the country’s healthcare system and provides psycho-social support to the children of Lesotho and Botswana. The organization works directly with communities to help children that the epidemic affected become more “empowered, healthy and resilient.” It also works to gather support from the governments of Lesotho, Botswana and the United Kingdom to support their mission of improving mental health across Africa.
  3. Dolen Cymru: Founded in 1985, Dolen Cymru is a Welsh organization supporting the nation of Lesotho. It has established various programs, but its core project has been developing Lesotho’s mental healthcare system. Uniquely, Dolen Cymru works primarily with the actual doctors and health educators of Lesotho through the country’s Ministry of Health, providing them with WHO-developed training. According to the foundation, it has trained more than 100 healthcare professionals using an innovative program including discussions about “human rights, stigma and cultural beliefs.”
  4. African Mental Health Research and Training Foundation (AMHRTF): AMHRTF is an NGO based in Kenya that focuses on mental health research and treatment. Its headquarters are located in the Kenyan capital, Nairobi. The organization directly serves the urban population, though it also operates a phone line and telehealth services for people located in more isolated regions that are unable to visit in person. The organization treats a wide variety of mental illnesses, helping patients with mental health issues including substance abuse disorders, PTSD and depression. In 2019, AMHRTF began supporting the CREATE Kenya project. CREATE Kenya is focused on forming a successful social business that provides Kenyans dealing with mental illness an “evidence-based Recovery-Oriented Psychosocial Rehabilitation Toolkit” to help them gain employment and support their wellbeing.
  5. IOM Libya: IOM, or the International Organization for Migration, is an agency of the U.N. operating in numerous countries to support migrants and refugees throughout the world. IOM Libya is the organization’s branch operating in Libya, focusing on the nation’s migration crisis. Libya is an especially popular location for refugees because of its treacherous sea route to Italy through the Mediterranean Sea. Recently, the organization has helped 12,000 stranded migrants return to their homes. For these refugees and migrants that remain in the country, IOM Libya also provides mental health support because it recognizes the tremendous stress that migrants may face on their journeys. Since 2011, the IOM has been providing counseling, group support and other activities in eight Libyan cities to help migrants recover from their traumas. The organization also trains first responders to better understand mental health issues.

Looking Ahead

These five organizations have been beneficial to communities in Africa by improving mental health care. Through their continued work, Africans should be able to receive the support they need.

– Ryan Morton
Photo: Wikipedia Commons