Archive for category: Mental Health

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Mental Health in the Comoros

Mental Health in the ComorosThe Comoros, an archipelago of three islands in the Indian Ocean located between Madagascar and the southeast African mainland, is facing one of the world’s most silent mental health crises. With only one psychiatrist for 800,000 people, no national mental health strategy and 45% of the population living below the poverty line, access to psychiatric care is minimal. In addition, mental health issues remain heavily stigmatized within Comorian society, often being attributed to supernatural causes, such as jinn (demon) possession or witchcraft.

Lack of Mental Health Policy

The Comorian government has yet to adopt a mental health strategy, legislation or a specific budget for mental health care. This policy vacuum reflects decades of political instability and military coups since the country’s independence in 1975, compounded by pervasive poverty that besets the archipelago. Without a national plan, there is no framework to develop services, train providers or secure international funding for scalable solutions.

Poverty and Mental Health in the Comoros

Mental health care is too costly for most Comorian families. Without insurance systems or government-funded services, families often exhaust their savings on traditional healing or resort to physically restraining relatives with severe symptoms. The economic impact extends beyond individual families, as untreated mental illness reduces productivity, increases school dropout rates and reproduces poverty.

In 2018, the country’s Human Capital Index was only 0.40, suggesting that children born in 2018 will only achieve 40% of their productive potential, a figure partly influenced by preventable health issues, including mental disorders.

Cultural Beliefs and Stigma

Mental illness in Comoros is predominantly attributed to supernatural causes. As a result, many people first seek treatment from marabouts, who use Quranic verses, herbal remedies and amulets. These practices often delay medical treatment and can worsen psychiatric conditions. Women face particular obstacles, as cultural stigmatization often prevents them from seeking help or freely deciding about their treatment. Older people are also vulnerable, with no geriatric mental health support available.

However, organizations like Grand Challenges Canada (GCC) have supported mental health innovation in the Union of Comoros by training community health workers and facilitating psychiatric consultations via mobile phones. To reinforce monitoring and public awareness, the program also deploys tablets for weekly reporting and mobile apps to inform local communities about mental health issues.

Furthermore, youth-led initiatives like the Al Shara Youth Comoros “Moroni hub” based in Moroni, provide safe places for the youth to discuss mental health, challenge misconceptions and empower those affected by mental health issues.

Innoventive Mental Health Alternatives

Several other promising initiatives have emerged in recent years. In 2020, a telepsychiatry project was launched, with three key objectives. First, it helps raise awareness about mental health in Comoros, working to reduce misconceptions and stigma surrounding mental health disorders. Moreover, it also trains health care practitioners to manage conditions, such as depression, schizophrenia and bipolar disorder.

Finally, the project facilitates tele-consultations through Skype/Teams, connecting people and health care providers in remote areas with the country’s only psychiatrist and consultants from Madagascar and France. These tele-consultations provide diagnostic guidance and treatment recommendations, helping to mitigate the scarcity of psychiatric specialists.

E-education platforms are also slowly expanding, providing ongoing psychiatric and psychological training for health care workers. Targeted economic investment, especially from the U.S., could help develop these pivotal initiatives and bring mental health care to thousands of Comorians who currently suffer in silence. Addressing mental health care in Comoros requires sustained efforts, cultural sensitivity and international support to build more resilient communities.

– Juliette Delbarre

Juliette is based in London, UK and focuses on Global Health and Politics for The Borgen Project.

Photo: Flickr

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Zimbabwe’s Friendship Bench

Zimbabwe’s Friendship Bench: Grandmothers, Therapy, and TechnologyIn Zimbabwe, an ongoing revolution is transforming mental health care, driven by an unlikely group: the country’s grandmothers. These women, with little formal training, sit on park benches, offering not just a shoulder to lean on but evidence-based counselling that’s changing lives. Currently, they are using digital tools to extend their reach beyond the benches, bringing support to even the most isolated communities.

Mental Health Landscape in Zimbabwe

Zimbabwe’s road to its current mental health crisis took shape from years of trauma, from colonial history to the long fight for independence. Over time, socio-economic challenges, including hyperinflation, rampant unemployment and a failing health system, have deepened the emotional toll. As of 2021, the country faces one of the highest suicide rates in the world (23.6 per 100,000), alongside widespread depression and post-traumatic stress. With just 18 psychiatrists serving a population of 17 million, mental health care in Zimbabwe has been inaccessible for most and barely recognized. 

The Birth of the Friendship Bench

 The Friendship Bench began with a simple idea. Dr. Dixon Chibanda, a psychiatrist working in Harare, realized that Zimbabwe’s mental health crisis needed something different from more doctors. So, he turned to a deeply rooted tradition in Zimbabwean culture: the matriarchs of the community.

In 2006, psychiatrist Dr. Dixon Chibanda partnered with local health authorities to train a group of elderly women, many of whom had no formal education in mental health, in a simple yet effective form of therapy called Problem-Solving Therapy (PST). These women, affectionately known as the “grandmothers,” were among the few people with the time and willingness to serve as lay health workers, especially given the country’s severe shortage of mental health professionals. By shifting the model to rely on available, community-rooted personnel, something positive began to take shape.

Sitting on brightly painted benches outside local clinics, these grandmothers became trusted figures in their neighborhoods. They offered more than advice, they listened. Through open, empathetic conversations rooted in cultural familiarity, they used behavioral therapy techniques to address kufungisisa—a Shona term that translates loosely to “thinking too much” and often describes depression or deep emotional distress. Their approach was grounded in traditional values like kusimudzira (to uplift), kuvhurika pfungwa (opening up the mind) and kusimbisa (to strengthen). These weren’t just abstract ideas; they were culturally resonant tools for healing. 

Clinical trials showed that after just a few sessions on the bench, 98% of people who had previously considered suicide were no longer suicidal six months later. People who arrived feeling hopeless left with a sense of dignity, strength and direction. 

Taking a Digital Leap

The pandemic could have halted the progress of the Friendship Bench, but instead, it propelled it into a new era. With Zimbabwe’s already impressive mobile phone penetration (90% of the country has access), the grandmothers began reaching out through WhatsApp and voice calls, extending their therapy services to people who could not make it to a physical bench.

The shift kept the spirit of Zimbabwe’s Friendship Bench intact. This digital pivot meant that counselling could reach those in remote villages, women unable to leave their homes and even young people navigating mental health challenges in crowded urban centers. Unexpectedly, it also helped improve communication between the grandmothers and their supervisors, strengthening the support system behind the scenes. What started as a grassroots intervention under a tree had quietly evolved into a scalable, hybrid model. 

A Model for Accessible Global Mental Health

As of 2025, more than 2,000 grandmothers in Zimbabwe are delivering therapy to at least 500,000 people across the 11 provinces. But the model has not stopped at the country’s borders. It is currently in more than nine countries, including Kenya, Malawi and even the United States (U.S.), with each country tailoring the approach to its own cultural and social contexts. Yet wherever it goes, the core stays the same: community-led care, empathy, accessibility and the belief that healing can begin with a simple conversation.

Scaling Zimbabwe’s Friendship Bench

According to experts, scaling the Friendship Bench model further will depend on strong collaboration between Zimbabwe’s government, local health authorities and international partners. Sustaining the program’s momentum could mean finding smart ways to integrate it into existing public health and technology infrastructures.

The mobile phone industry, for example, offers real potential, not just for reaching clients, but for training grandmothers, supervising their work, collecting data and enabling real-time support through virtual platforms. By continuing to build on what’s already available, the Friendship Bench could go even further, reaching more people, in more places, with the same message: healing doesn’t have to be out of reach. By adapting an age-old tradition of community care to the digital age, Zimbabwe has created a model for mental health that could potentially be replicated globally. 

– Sriya Regulapati

Sriya is based in Vancouver, Canada and focuses on Business and Global Health for The Borgen Project.

Photo: Friendship Bench

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The Hidden Burden of Depression in Africa

Depression in AfricaDepression is a word that embodies profound pain, despair and societal stigma. Despite growing mental health awareness, mental illness remains misunderstood as a sign of personal weakness. The reality is that depression can lead to suicide, which claims more than 700,000 lives worldwide every year. Treatment-Resistant Depression (TRD), a subset of major depressive disorder unresponsive to at least two treatments, affects approximately one-third of depression sufferers, raising suicide risk and posing a global concern.

In Africa, the situation is particularly acute. The continent has the highest suicide rate in the world, at 11 per 100,000 people, compared to nine globally. It is estimated that more than 20 million individuals in Africa have depression, representing 9% of the global burden. North, West and Central Africa are particularly affected, grappling with fragile health care systems, conflicts, stigma and limited mental health services.

The Central African Republic (CAR) has one of the highest suicide rates worldwide, often linked to untreated depression. In contrast, Nigeria has more than seven million sufferers. Even in better-resourced countries like Egypt, Tunisia and Morocco, depression rates remain high.

Africa’s Mental Health Crisis

Mental health systems in Africa are underfunded. African governments allocate less than $0.50 per person annually to mental health. This is far below the recommended $2 per capita for low-income countries. In 2020, only 94 mental health outpatient visits were recorded per 100,000 people compared to 2,001 worldwide, indicating a lack of formal treatment access for most Africans with mental health issues.

In West and Central Africa, psychiatric hospitals are scarce and located in large cities. The situation is further complicated by conflicts in Mali, the Democratic Republic of Congo (DRC), CAR and Libya, where many health facilities have been destroyed or are difficult to access. On average, sub-Saharan Africa has just one psychiatrist per million people. Specialists are often concentrated in capitals or major cities, leaving rural populations underserved. Patients usually face long-distance travel costs to tertiary hospitals, which are cost-prohibitive for many and rely on general practitioners with limited psychiatric training.

Furthermore, antidepressants and psychotropic drugs are often out of stock or unaffordable for many patients. According to the WHO, more than 75% of people with mental disorders in low- and middle-income countries, including most of Africa, receive no treatment for depression. Second-line TRD treatments, such as atypical antipsychotics and dopaminergic drugs, are rarely stocked in public health facilities or private clinics in Sudan, South Sudan, Niger, Mali and CAR. Even in Nigeria, Uganda and Ghana, which have better health care infrastructures, access to these treatments remains limited to tertiary referral hospitals in major cities, with frequent shortages.

Initiatives Addressing Mental Health in Africa

Despite challenges, promising efforts are underway, from policy reforms to community-led interventions.

  • Policy Reforms. Several countries have begun updating policies to prioritize mental health. Nigeria, for example, passed its first national Mental Health Act in 2023, replacing the colonial-era lunacy law. The legislation aims to improve access to mental health services and protect patients’ rights. It includes the creation of a Mental Health Department within the Ministry of Health and integrating mental health services into primary care. The Act also prohibits discriminatory and outdated practices like chaining or arbitrarily detaining individuals with mental disorders.
  • Community-Led Initiatives. StrongMinds, an NGO operating in Uganda and Zambia, uses group interpersonal therapy led by trained lay counsellors to address depression, particularly among women in low-income communities. Since 2013, StrongMinds has treated more than one million people. Addressing untreated depression helps break cycles of poverty, food insecurity, trauma and disruption. Strongminds also works with governments and other NGOs to incorporate mental health services into food security, health care and education programs. It intends to expand across Africa over the next decade. The International Medical Corps (IMC) also plays a crucial role. In Mali, IMC supports more than 100 health facilities and mobile clinics across northern and central regions. The IMC provides primary and mental health care. It offers psychosocial support alongside services for gender-based violence and nutrition. In CAR, IMC provides mental health consultations through health centers and mobile clinics in underserved areas, trains local health workers and community leaders to support those in distress and publishes educational booklets on mental health. IMC also collaborates with National Ministries of Health and Community-Based Organizations, ensuring its integrated Mental Health and Psychosocial Support (MHPSS) efforts respond to crises and build long-term resilient communities.

Conclusion

Depression in Africa is not just a personal struggle but a public health emergency driven by limited funding, poor access to care and deep-rooted stigma. With suicide rates among the highest globally and millions untreated, the call for action is urgent. Expanding community care, improving mental health training and ensuring access to essential medications are critical.

– Juliette Delbarre

Juliette is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Addressing Mental Health in Guinea-Bissau

Mental Health in Guinea-BissauIn the small West African country of Guinea-Bissau, rich culture and strong tradition mask a growing crisis, mental health neglect. Among the most prevalent conditions are depression and anxiety, often left unaddressed due to systemic gaps and social stigma.

A System Without Specialists

As of 2017, Guinea-Bissau had zero practicing psychiatrists. The country’s ratio of just 0.13 doctors per 1,000 inhabitants falls far below global standards for basic health care. This shows that mental health support is almost absent from the primary care setting. Additionally, a screening of adults attending general health facilities in Guinea-Bissau revealed that at least 12% had a diagnosable mental disorder. This shows the urgent need for integrated mental health services in the nation’s fragile health system.

A baseline study found that general practitioners correctly diagnose only one in three patients, meaning that the people in Guinea-Bissau’s rural communities are unknowingly struggling with mental disorders. They carry a silent weight that forces them to push through each day with far greater effort than others, struggling in isolation just to survive.

Poverty and Psychological Strain

Things such as rising climate anxieties and pandemic poverty are worsening mental health in Guinea-Bissau. In 2021, the poverty rate was reported to have increased by 2.8 percentage points, adding an additional 80,000 poor. Research shows that mental illness reduces employment and therefore income.

Cultural Beliefs and Stigma

Mental health in Guinea-Bissau is often interpreted through a spiritual lens. Communities blame mental issues on things like curses and ancestral wrath. As a result, individuals often look down upon seeking help from medical professionals. Sixty-three percent of rural mothers go to the witchdoctor, and 65% believe that curses have the power to kill. While traditional healers play a vital role in this community, their methods can delay access to cures. Stigma remains a barrier to those suffering silently.

Lending a Helping Hand

This West African nation faces a mounting crisis that demands international attention. Every person deserves access to necessities like mental health care. Guinea-Bissau’s struggle is a global problem; poverty, trauma and neglect reflect broader challenges that low-income countries face worldwide.

Progression Efforts

Mental health in Guinea-Bissau is beginning to see a glimpse of hope in this landscape. International organizations such as the World Health Organization (WHO) have stepped in to support the country. Guinea-Bissau’s fragile health system has improved as groups are working to train general health workers in basic psychiatric care.

The NOVAFRICA Knowledge Center is working to strengthen health care in Guinea-Bissau through an inclusive and culturally sensitive approach. Its model brings together modern medical practitioners and traditional healers, including witchdoctors, to bridge trust gaps and improve access to care. By acknowledging and respecting spiritual traditions deeply embedded in the community, NOVAFRICA promotes the acceptance of modern medical practices and helps lay the groundwork for more effective health interventions, including in mental health.

The Path Forward

In collaboration with NGO VIDA, NOVAFRICA supported the launch of a community health insurance program that allows residents to pay affordable premiums in exchange for access to medical care, transportation and essential medicines. Though the country still lacks a national suicide prevention strategy, collaborative efforts between NGOs and local health authorities are laying groundworks for a future policy reform.

Guinea-Bissau’s challenges are steep, but the people are resilient. With continued international support and growing local engagement, the nation is taking its first steps toward a future where the silenced have a voice. Acknowledging, treating and respecting mental health is not just the goal, it is the path to a future defined by dignity and resilience.

– Marissa Schoth

Marissa is based in Benton, LA, USA and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Poverty and Mental Health in São Tomé and Príncipe

Mental Health in São Tomé and PríncipeSão Tomé and Príncipe is a small island located off Central Africa’s west coast, near the equator, with a population of roughly 230,000. Nearly 60% of the population lives below the national poverty line and there are numerous health inequities. Mental health is an ongoing crisis in São Tomé and Príncipe, negatively impacted by poverty, a lack of services and limited infrastructure.

Challenges Facing Mental Health Services

There is a lack of awareness and data surrounding mental health in São Tomé and Príncipe. However, many residents face common mental health issues such as anxiety, depression, substance use and, in some cases, trauma from poverty and isolation.

Barriers to care include a severe shortage of mental health professionals. There are only 4.6 doctors per 10,000 residents, with even fewer trained in mental health. Infrastructure is weak and there are no specified mental health facilities or consistent and constant access to medication. Stigma also plays a major role, leaving many affected individuals misunderstood and unsupported.

The public health care system offers limited mental health support through a few hospitals. Only one outpatient mental health facility is linked to a hospital and just one psychiatric unit exists within a general hospital. As of 2017, there were 706 treated cases of severe mental disorders nationwide, equivalent to 361 cases per 100,000 people.

How Poverty Fuels Mental Health Challenges

Poverty also takes a toll on the mental health of São Tomé and Príncipe’s residents. Around a quarter of the population lives on less than $1.90 daily, one of the highest poverty rates among comparable countries. This is due to unemployment and low labor force participation. In 2020, the unemployment rate jumped from 13% to 20%.

Living in poverty often means daily stress over essentials like food, water and housing, things that can trigger or worsen depression and anxiety. With a chronically underfunded health care system, there is limited access to mental health professionals and affordable support remains extremely limited for those in need.

Women and children in São Tomé and Príncipe are especially vulnerable to mental health challenges due to limited economic and educational opportunities. In 2018, the birth rate for girls aged 15–19 was 0.4 per 1,000, an indicator of deeper social and health disparities. Mental health struggles among these groups are often linked to substance abuse and domestic violence. Yet, access to mental health services remains limited, further compounding the crisis.

Support From International Organizations

The United Nations Children’s Fund (UNICEF) is one of the organizations working to combat the poverty and mental health crisis in São Tomé and Príncipe. One serious problem in the country is violence against children. This occurs frequently; about 70% of children are exposed to psychological aggression and one in seven experience severe physical punishment. To address this, UNICEF developed a protocol for care and follow-up for adolescent victims of violence, sexual abuse or mistreatment. Indeed, this is a major factor in the mental health struggles many residents of São Tomé and Príncipe face.

The World Health Organization (WHO) is also working to strengthen health systems in São Tomé and Príncipe by improving working conditions and boosting staff motivation. Its efforts have significantly impacted both the more than 9,000 island residents and the 97 professionals working at the hospital. While emphasizing preventive health, the organization focuses on reducing deaths from preventable diseases and promoting long-term care and sustainability.

Conclusion

Mental health in São Tomé and Príncipe is often overlooked, yet neglecting it undermines education, productivity and overall well-being. Breaking the cycle of poverty requires addressing mental health. Spreading awareness is essential to ensure local communities can access the necessary services.

– Madyn Lewis

Madyn is based in Chicago, IL, USA and focuses on Good News and Global Health, Celebs for The Borgen Project.

Photo: Wikimedia Commons

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Recent Innovations in Mental Health Care in Africa

Mental Health Care in Africa According to the World Health Organization (WHO), Africa has the highest suicide rate in the world. The continent’s suicide rate stands at 11 people per every 100,000, which is higher than the global average of nine people per every 100,000. Approximately 29 million Africans suffer from depression.

Despite these staggering statistics, Africa spent less than $1 per capita on mental health. The continent also has an average of one mental health worker per 100,000 people compared to the global average of nine.

Within the last few years, the need for mental health services in Africa has risen. Luckily, organizations and platforms around the world have begun to recognize this demand. Here are three recent innovations to improve mental health care in Africa.

Supporting Mental Health Care in Africa

At its inaugural Digital Well-Being Summit, social media giant TikTok discussed plans for improving in-app support for users struggling with mental health, with a focus on sub-Saharan African users. The summit in Johannesburg brought together policymakers, industry leaders and mental health experts from South Africa, Nigeria, Kenya, Ghana, Zimbabwe and beyond. The event acted as a platform to discuss enhancing online safety tools, providing users with reliable information, and expanding user access to experts on the app.

TikTok announced that its $2.3 million global Mental Health Education fund will now be expanded to encompass sub-Saharan African organizations for the first time since its establishment. The selected organizations include the South African Depression and Anxiety Group, Mentally Aware Nigeria Initiative, and Kenya’s Mental360. They will be provided with funding and support from TikTok to create relevant, evidence-based content that discusses mental health in African communities.

TikTok has committed to expanding its in-app mental health helplines to the continent. African users will now be able to easily access helplines that will connect them with expert support and mental health resources such as counselling and psychological support. It will also be easier for African users to report harmful content related to bullying, hate, self-harm, and other topics that violate TikTok’s community guidelines.

The summit also introduced TikTok’s new Mental Health Ambassadors. In a partnership with the WHO, TikTok’s Mental Health Ambassadors will use their platforms to give guidance and advice to users. The inaugural group of verified healthcare professionals from the WHO Fides Network includes Sanam Naran and Dr. Siya from South Africa, Dr. Claire Kinuthia from Kenya, and Dr. Wales from Nigeria.

“Weaving Lives Together” Helps Communities Recover

The Weaving Lives Together project in Northern Nigeria aims to provide support to violence victims. It introduces creative interventions to fill the gaps left by other mental health resources. Its goal is to bring together mental well-being and economic opportunities to support both psychological recovery and socio-economic livelihoods.

Weaving Lives Together is the result of a partnership with the Neem Foundation, Creative Women in Lagos, and fashion house Ituen Basi. People, especially women, are given a creative outlet to turn their artistic expression in fashion and textile arts into opportunities for economic independence.

The initiative received funding through the One King’s Impact Fund at the School of Global Affairs at King’s College of London, a fund to support interdisciplinary solutions to global challenges. They are committed to fighting for whole-life health, peace and justice, and gender equality worldwide.

Digital Innovations in Mental Health Care in Africa

King’s College of London is also sponsoring and funding a new digital platform for depression intervention in African countries. This initiative expands upon the success of Zimbabwe’s Friendship Bench project, a model that has provided Zimbabweans with therapy for common disorders such as anxiety and depression by trained health workers.

Led by Dr. Gabrielle Samuel of the Department of Global Health and Social Medicine, the new platform will make mental health support more accessible, especially to those in underserved communities. People will be able to access self-guided therapy via their mobile phones, which will expand the reach of health workers and reduce wait times for those seeking help.

Mental health care in Africa has long needed improvement, with suicide and depression rates higher than global averages, especially in males. These three new innovations are only part of the efforts to bring better mental health counselling, resources, and education to the continent.

– Hannah Fruehstorfer

Hannah is based in Pittsburgh, PA, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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The Positive Situation for Mental Health in San Marino

Mental Health in San MarinoRecent statistics show that the country of San Marino has a suicide rate of 7.59. In comparison, the worldwide average suicide rate as of 2021 is 8.9. Additionally, suicide rates have also dropped in the country, with an 8.01 rate in 2020 and a 7.59 rate in 2021, showing that mental health in San Marino receiving attention on a considerable level.

After the COVID-19 pandemic, San Marino experienced a concerning decrease in the mental health of its citizens and faced hard decisions on how to reintegrate citizens into a post-pandemic lifestyle. Over the last five years, San Marino has found that deteriorating mental health has links to stress, economic pressure and social isolation.

Community-centered environments are a strong deterrent against declining mental health and offer relief from stress, pressure and isolation. Because mental health decreased at the same time social isolation increased during the pandemic, the country focused on creating suitable community-based programs for citizens young enough to be in middle school, and old enough to be in retirement homes.

Mental Health for Old and Young Citizens

To specifically address mental health concerns in younger citizens, San Marino employs many awareness programs that work directly with public education in the country. These awareness programs started in 2021, prompted by COVID-19. The awareness programs involve partnering with police and substance abuse facilities for events to educate students and create environments where they can easily talk about depression and mental strain. Negative mental health for young citizens has almost always had links to academic pressure; citizens who could not perform well in school often felt frustrated and stuck. Interestingly, to San Marino, this meant that if public education could be improved upon and more accommodating for different students, then overall mental health in young citizens would generally increase.

Similar to young citizens, the country found that most of its older citizens over the age of 60 suffer from low mental health, largely due to social isolation. After partnering with the regional office of the Parliamentary Assembly of the Mediterranean (PAM), San Marino addressed many concerns with the mental health of older citizens. The country was able to employ more social services for older citizens, and further partnered with the World Health Organization (WHO) to allow community-based help. The country originally partnered with the WHO in 2013, but after the COVID-19 pandemic in late 2020, the country and the WHO made additional projects and plans to facilitate positive mental health.

Since 2020, San Marino’s citizens over 60 years old have had stable and improving mental health. Instead of the majority of elderly people living in retirement homes, the WHO has made it so that systems of care are in place where the majority of elderly citizens can grow old without leaving their original homes. Lowering feelings of depression among the elderly and promoting community-based involvement in neighborhoods due to the system of care in place.

Efforts To Address Mental Health in San Marino

Organizations like the WHO and PAM go to great lengths to ensure that countries like San Marino are well equipped to give citizens an environment that promotes mental well-being. The country also adopted the philosophy of “Parlare Aiuta” or Talking Helps, a national campaign promoting the openness of receiving care for poor mental health and quality conversations around the subject with the correct tones and vocabulary.

San Marino found that in many ways, at least for a small country, the best way to encourage positive mental health is to have productive conversations around the topic. Raising awareness with statistics is not enough; poor mental health has a connection to social isolation, so one of the best ways to help is to encourage citizens to educate themselves on the issue so they can have meaningful conversations when necessary.

Poverty is a contributing factor to poor mental health, but it has remained stable in San Marino over the last several years. The overall poverty rate in San Marino has stayed below 8%. In contrast, the average poverty rate worldwide is about 8.5%.

– Russell Bivins

Russell is based in Phoenix, AZ, USA and focuses on Good News for The Borgen Project.

Photo: Wikipedia Commons

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TikTok Is Addressing Stigma Around Mental Health in the Arab Gulf

Mental Health in the Arab GulfMental health awareness has become increasingly prevalent in the modern day. A study made by the World Health Organization (WHO) in 2019 found that worldwide, 970 million people suffer from mental health issues, predominantly anxiety and depression. Mental health has become a well-discussed issue for much of the Western world. The existence of schemes such as mental health days and mental health first-aiders in the workplace demonstrates many businesses’ commitment to improving their workers’ mental health.

In the Arab Gulf, mental health is often considered a taboo subject. Issues such as depression or trauma can be perceived as shameful and shouldn’t be discussed with others. However, TikTok is now being used as a medium to address this stigma around mental health in the Arab Gulf states.

Perception of Digital Mental Health Campaigns in the Arab Gulf

A 2024 study analyzing responses to a digital mental health awareness campaign in the Gulf Cooperation Council (GCC) demonstrated that mental health remains an incredibly stigmatized topic. The study highlighted prevalently-held beliefs that mental illness does not exist and that such personal issues result from a lack of willpower, laziness or that it is a personal choice to be depressed or anxious.

Many in the survey also asserted beliefs that mental illness holds ties with religious and spiritual deficiencies, proclaiming that issues result from the influences of “Jinn” (evil spirits) or the “evil eye.” They often quoted practices of religious devotion, reciting the Qur’an or regularly praying as the solutions to these problems.

The widespread denial of mental illness throughout the GCC leads to a domino effect of issues, both socially and economically:

  1. Awareness and education around mental health is poor.
  2. Those suffering from issues of anxiety, depression or untreated trauma are unlikely to seek help from either professional services or to confer with others in their communities about their problems.
  3. Without seeking help or as a result of being criticized by others, these issues will likely exacerbate, potentially leading to emotional burnout, job loss, social exclusion or suicide.

Using TikTok To Breach the Stigma Around Mental Health

A few TikTok-based initiatives are currently being used to address the stigma around mental health in the Arab Gulf. As a free and popular digital platform, TikTok is a powerful tool for reaching those without access to formal mental health services. It uses approachable, entertaining ways to promote understanding and communication. Saudi Arabia and the United Arab Emirates (UAE) are the top two countries where TikTok has the most reach, with virtually 138.2% of Saudi Arabia’s population using the platform.

In 2024, TikTok began the “Change-Makers Program.” This initiative promoted creators’ and NGOs’ endeavors using the platform to prompt beneficial community changes. At the program’s launch, TikTok announced a list of 50 of these “Change-Makers,” including the first Change-Maker of UAE, Dr. Jana Bou Reslan. A Lebanese educational psychologist and professor, Bou Reslan has been posting TikTok content since 2022 and has garnered more than 220k followers.

Bou Reslan’s content offers Arabic-language education on how to tackle mental health issues such as high-functioning anxiety and low self-esteem. She also encourages well-being practices and open discussion of mental health. “Good mental health is of utmost importance for thriving communities, influencing everything from education to workplace productivity. Social media has been playing a vital role in reaching out to different audiences and promoting positive and relatable topics within our community,” she said.

Furthermore, in February 2024, TikTok MENAT hosted a Youth Mental Health Awareness Summit in Dubai. The event featured discussions by mental health professionals and TikTok’s safety experts. It focused on how social media can better equip young people in GCC with critical-thinking skills, promote media literacy and strive to build supportive digital communities. These strategies aim to improve the mental well-being of young people while also encouraging the building of digital skills that will improve future job prospects.

Improving Mental Health Awareness Can Help Alleviate Poverty

On the face of it, addressing the stigma around mental health in the Arab Gulf might not appear impactful when it comes to fighting poverty. However, the WHO notes that improving mental health care is inherently linked to reducing inequality and poverty across nations. One of the clearest ways this link manifests is through employment and income potential. Improving employment and income potential. Mental health can have a direct impact on individual employability and the economy as a whole.

According to the 2022 WHO World Mental Health Report, approximately 12 billion workdays a year are lost due to issues associated with anxiety and depression. By promoting open discussions about mental health, introducing workers to stress-reducing techniques and better equipping people for emotional regulation, people are less likely to burn out and hence not lose pay and/or their jobs. Unemployment can also be seen as shameful or indicative of personal failure in the Arab Gulf, especially for men and poor mental health also impacts the ability to find new work.

Another way mental health awareness can contribute to poverty alleviation is by supporting young people. It is estimated that worldwide, one out of seven adolescents exhibit symptoms of mental disorders. In the UAE, 17% to 22% of young people exhibit signs of depression and 28% show symptoms of anxiety. Better mental health awareness and support reduce school dropout rates. Also, by encouraging the diversification of skills in young people into digital literacy, generational poverty can be reduced through new fields of employment. Finally, improving skills in stress management can help with school and work pressures and improve coping skills in economically unstable households.

Final Remarks

In low-income countries, there is roughly one mental health professional per 100,000 persons. With such critically low access to services, free digital-based platforms such as TikTok provide easily accessible education on mental health and culturally appropriate content made in local languages.

They are a good entry point for NGOs looking to help communities. TikTok creators are busy addressing the stigma around mental health in the Arab Gulf to help people learn skills for personal empowerment, provide the means to form digital support networks and give access to advice where formal psychological services are unavailable.

– Reuben Avis-Anciano

Reuben is based in Oxfordshire, UK and focuses on Technology and Global Health for The Borgen Project.

Photo: Unsplash

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Youth Mental Health in Nepal: A Collaborative Push for Support

Youth Mental Health in NepalAmong the 29.7 million people who live in Nepal, 340,000 adolescents have made suicide attempts. Furthermore, in 2020, UNICEF reported that 470,000 teens had contemplated suicide. These figures position Nepal as having the second-highest youth suicide rate in South Asia, indicating a pressing crisis in youth mental health in Nepal that necessitates immediate intervention.

Background

The 2015 earthquake had a profound impact on Nepal, exposing children to severe psychological stress and long-term emotional strain. It added another layer of trauma to a nation already struggling with poverty and inadequate mental health care. Anxiety, grief and other forms of distress were among the many mental health challenges children faced in the aftermath.

A large-scale epidemiological study reported a prevalence of 19.1% for emotional and behavioral problems in children, indicating that it approximately affects one in every five children in Nepal.

The 2020 National Mental Health Survey indicated a 5.2% prevalence of diagnosable mental disorders among teenagers aged 13 to 17 in Nepal, with 2.8% attributed to neurotic and stress-related conditions.

Availability of Services

The pervasive stigma and insufficient comprehension of mental health are resulting in a high percentage of children and adolescents, particularly in remote locations, being unable to access essential care.

Since its establishment in 2015, the Child and Adolescent Mental Health (CAMH) unit at Kanti Children’s Hospital has remained Nepal’s only full-time outpatient clinic for child and adolescent psychiatry up until 2020.

As of 2022, Nepal had just three outpatient mental health facilities dedicated to children and adolescents, and no inpatient units in the public sector. Additionally, the country’s mental health workforce included approximately 144 psychiatrists, of whom only three specialized in child psychiatry.

When children needed hospitalization for psychiatric issues, they had to go to adult psychiatric facilities, which represents a breach of children’s rights and failed to meet international standards.

Collaborating for Change

In response to these pressing needs following the 2015 earthquake, UNICEF, Save the Children, World Vision, and Plan International initiated a collaborative initiative to enhance children and adolescents’ mental health.

Following the Inter-Agency Standing Committee (IASC) Guidelines on Mental Health and Psychosocial Support, their efforts concentrated on establishing secure and uniform environments for children to initiate emotional recovery, UNICEF reports.

The initiative established child-friendly spaces, and trained 512 community members to facilitate children’s emotional expression through play, routine, and peer contact. Through receiving training in psychological first aid, 3,395 educators and 20,000 community members learned to identify signs of distress and provide basic support, according to UNICEF.

Youth activities had a goal for adolescents to restore confidence and foster connections, while instituting support programs to enhance caregivers’ capacity to care for their children under significant demand.

Jo Malone London and UNICEF

Jo Malone London, in partnership with UNICEF and the Government of Nepal, is undertaking initiatives to improve youth mental health in Nepal by teaching health professionals to better comprehend and treat the mental health requirements of adolescents. The objectives of these trainings are to identify mental health issues, offer counselling, and link patients with specialized care via tele-mental health services at Kanti Children’s Hospital in Kathmandu, UNICEF reports.

This partnership is a component of UNICEF’s overarching strategy to strengthen mental health systems in marginalized regions by addressing challenges such as stigma, awareness, and the scarcity of mental health professionals in rural areas. This ensures that children and adolescents receive the necessary care they need.

UNICEF–Z Zurich Initiative

UNICEF combined global best practices with locally adapted approaches to promote the mental health of Nepal’s adolescents and their caregivers through socio-emotional learning (SEL) tools, with the support of the Z Zurich Foundation. Karnali Province, one of the most disadvantaged regions in the nation, was the primary focus of this initiative. The resources, which include stress management techniques and feelings charts, aim to assist students in identifying their emotions and coping with challenges.

The impact of the UNICEF–Z Zurich Foundation helps students increase comfort in expressing their emotions and their growing willingness to seek help across Western Nepal.

Youth Mental Health in Nepal

The youth of Nepal are starting to articulate what was previously concealed. From classrooms in Karnali to clinics in Kathmandu, transformation is occurring via skilled health professionals, emotional learning resources, and programs founded on trust. The upcoming difficulty is scalability. With sustained dedication, these initial advancements can evolve into enduring advocacy for youth mental health in Nepal, ensuring no child is left unheard.

– Imge Tekniker

Imge is based in London, UK and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Mental Health Support in Gaza: A Growing Humanitarian Priority

Mental Health Support in Gaza: A Growing Humanitarian PriorityAs the war in Gaza continues, about 2 million people have been displaced, many without access to essential services. While humanitarian organizations continue trying provide deliveries of food, clean drinking water and sanitation supplies, one critical need remains under-addressed: mental health support. A 2024 Lancet Psychiatry article reported that more than 50% of Gaza’s children showed signs of post-traumatic stress disorder (PTSD) even before the recent conflict. Prolonged exposure to trauma, displacement and instability has intensified mental health challenges across all age groups.

Mental Health in Gaza

During emergencies, mental health support often receives less attention than physical needs. However, psychological trauma, if left untreated, can have long-term consequences for individuals and communities. According to the United Nations Office for the Coordination of Humanitarian Affairs (OCHA), more than 495,000 children in Gaza are currently dealing with mental health issues. Without access to support, these issues may worsen and contribute to a cycle of poverty, as shown in a 2023 World Bank report that linked untreated mental health conditions to reduced economic opportunity in conflict zones.

Several barriers hinder access to care in Gaza. Health infrastructure has been severely damaged, psychiatric services are limited and stigma continues to discourage people from seeking help. Years of underinvestment and cultural misunderstanding have made it difficult for many to recognize mental health as a critical component of well-being.

The Gaza Community Mental Health Program

While organizations like WHO and Médecins Sans Frontières (MSF) have expanded mental health support, the Gaza Community Mental Health Programme (GCMHP) remains the only NGO in the region dedicated solely to mental health. Since 1990, GCMHP has provided community-based psychological services, working to break stigma and improve access.

The organization continues operating despite the destruction of several facilities. Its hotline offers free phone consultations, while field workers travel between camps to provide counseling. GCMHP has already delivered psychological first aid to more than 12,000 individuals affected by the conflict. Its teams report symptoms consistent with complex trauma, including emotional numbness, dissociation and social withdrawal. These conditions often worsen as people remain surrounded by reminders of their trauma in destroyed neighborhoods and overcrowded shelters.

What Success Looks Like

GCMHP’s impact becomes clear through individual stories. A case involved a six-year-old named Mohammad, who witnessed multiple bombings and suffered nightmares, anxiety and bedwetting. GCMHP diagnosed him with PTSD and designed a recovery plan involving drawing therapy and family sessions. Mohammad’s symptoms improved over time, reflecting the power of early intervention and consistent care. GCMHP continues helping survivors rebuild emotional stability, one patient at a time.

The Road Ahead for Mental Health Support in Gaza

Mental health recovery requires sustained commitment. Short-term interventions cannot fully address long-term psychological distress. Aid organizations aim to integrate mental health services into all levels of humanitarian response. GCMHP and UNRWA have both urged greater investment in mental health and psychosocial support (MHPSS) as part of emergency relief programs. Expanding access to these services not only reduces suffering but also supports long-term recovery and resilience. Ensuring mental health remains a central part of aid in Gaza could play a vital role in helping communities rebuild after conflict, both physically and emotionally.

– Collier Simpson

Collier is based in Savannah, GA, USA and focuses on Global Health for The Borgen Project.

Photo: Pexels