Archive for category: Mental Health

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Mental Health in Namibia 

Mental Health In Namibia
Extreme poverty looms over Namibia, negatively affecting its population of 2.6 million and keeping living standards low. These high levels of socioeconomic hardship often cause people to overlook the country’s mental health issues, although illnesses such as anxiety, depression, Post-Traumatic Stress Disorder (PTSD), trauma, bipolar disorders and psychosis affect 25.6% of its population and the number could double by 2025. Here is information about the correlation between poverty and mental health in Namibia.

Poverty and Mental Health in Namibia

Namibia has a poverty rate of 47% and 46% of its youth workforce is unemployed, according to ISS African Futures. These factors contribute to a lack of financial resources and constant pressure to earn more, leading to high stress and anxiety levels. The Namibian reported that “approximately 70% of Namibians suffer from stress and chronic health conditions.” Additionally, people with low incomes often have limited access to mental health services, further worsening their situations.

The country suffers from a traumatic history. From 1915 to 1990, apartheid South Africa occupied Namibia, during which many of the latter’s citizens were killed and displaced. The country only gained independence in 1990, after a long, drawn-out war, which caused 20,000 to 25,000 deaths.

HIV and Psychological Issues

Furthermore, Human Immunodeficiency Virus (HIV) is quite prevalent in Namibia. According to the World Bank, the virus infects 11% of adults aged 15 to 49 years in the country.

Studies have shown that HIV has a direct link to mental health; it causes damage to brain cells and leads to a variety of neurocognitive disorders. Living with HIV also causes acute psychological distress and depression, both for the patient and their loved ones. A 2024 study found that depression affects 24.6% of HIV patients and 17% suffer from anxiety.

Approximately 9.3% of Namibians die from HIV. The burden of carrying the disease and the discrimination against it also increases the risk of suicide. From April 2020 to March 2023, 1,542 Namibians committed suicide, 82% being men. 

Cultural Influences

Another factor that further complicates mental health in Namibia is the stigma and cultural beliefs toward mental health issues. Many Namibians consider mental illness to be a sign of weakness or low willpower. Because of this, people go undiagnosed and there is less availability of treatments. A 2020 study showed that the level of public prejudice against mental health was 41% on the Community Attitudes towards Mental Illness (CAMI) scale.

The country has only two major mental institutions: Windhoek Central Hospital, which dedicates only 220 beds to mental health care, and Intermediate Hospital Oshakati, which offers 60 beds but often deals with 200 patients at once.

Solace in Drugs and Alcohol

Citizens affected by poor mental health in Namibia often cope through substance abuse. However, this can further exacerbate their condition and can result in psychosis, bipolar disorders, and depression, along with a decline in physiological health as well.

 The United Nations Office on Drugs and Crime reported that: “in 2020, the Government of Namibia confiscated 843,892 kg of cannabis, 4,930 tablets of mandrax, 2,922 grams of crystal meth, and 1,072 grams of cocaine.” Also, in 2023, WHO stated that Namibia drinks “2.38 of pure alcohol per capita amongst people aged 15 or above.”

Alleviating These Issues

Despite all these challenges, there is still a ray of hope for Namibians. Countless organizations have stepped up to advocate for mental health awareness and solutions. Established in 1980, Lifeline/Childline focuses on supporting emotional wellness and child protection in Namibia. It now has wide-reaching services all across the country and has gained international recognition from organizations such as USAID and UNICEF.

Lifeline/Childline operates a free counselling helpline that is available 24/7, providing mental health support to individuals suffering from a wide range of issues such as anxiety, depression and trauma. The organization provides counselling via telephone, text message or in person, making them accessible to a large sum of the population. From April 2024 to June 2024, its toll-free helpline answered 10,101 calls.

The non-profit also runs awareness programs that aim to reduce the stigma regarding mental health in Namibia and the importance of seeking help through social media campaigns, educational workshops, community outreach programs and its radio show.

Even though Namibia seems to be struggling in the face of these challenges, it’s important to acknowledge the fact that non-profits such as Lifeline/Childline are making a palpable difference and are changing people’s lives for the better. With more progress from the country’s numerous non-profits and government, mental illness rates in Namibia will likely decline and its citizens will be able to have bright, optimistic futures.

– Mustafa Tareen

Mustafa is based in Lahore, Punjab, Pakistan and focuses on Global Heath and Celebs for The Borgen Project.

Photo: Flickr

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IDIL: Mental Health Access for Indigenous People in Oaxaca

IDIL: Mental Health Access for Indigenous People in Oaxaca The United Nations General Assembly (UNGA) has designated 2022 to 2032 as the International Decade of Indigenous Languages (IDIL). The United Nations Educational, Scientific and Cultural Organization (UNESCO) leads global efforts to support this initiative. In Mexico, the project La Enfermedad de la que Nadie Habla en el Pueblo (ENHP) aims to expand access to mental health information and services. It does so by providing resources in Indigenous languages and incorporating Indigenous perspectives.

The International Decade of Indigenous Languages

The UNGA established the International Decade of Indigenous Languages (IDIL 2022-2032) to fulfill the objectives of the United Nations Declaration on the Rights of Indigenous Peoples. Throughout this decade, initiatives focus on preserving, revitalizing and promoting Indigenous languages worldwide. The Australian Government reports that many of these languages have reached a critical level of endangerment.

UNESCO estimates that approximately 40% of languages spoken will no longer be in use a century from now. Indeed, many are likely to be Indigenous languages. During International Decades, global facilitators coordinate action and mobilizations to raise awareness on a particular topic. La Enfermedad de la que Nadie Habla en el Pueblo is one example of coordinated action for IDIL. 

“La Enfermedad de la que Nadie Habla en el Pueblo”

Indigenous youths developed the project La Enfermedad de la que Nadie Habla en el Pueblo (ENHP), which translates to The illness nobody talks about in the village, to make mental health information accessible in Indigenous languages. ENHP successfully provided information in 30 Indigenous languages, addressing a critical gap in health communication. In a UNESCO article, the director of the Network of Interpreters and Intercultural Promoters, Eduardo Ezequiel Martínez Gutiérrez, stated that at least 30% of Oaxaca’s population is not fluent in their doctor’s or government’s language, a key issue ENHP aims to solve. The project also trains interpreters to act as intermediaries in mental health spaces.

According to Socialab, 65% of Indigenous people in Oaxaca, who speak up to 177 linguistic variants, cannot engage with content in Spanish. In response, the ENHP produced short videos with interpreters from various Indigenous communities. These videos discuss the symptoms of anxiety and depression and offer coping strategies. The project’s translation and interpretation efforts exemplify the goals of the International Decade of Indigenous Languages by improving access to mental health care for Indigenous peoples in a culturally relevant context.

Implementation of ENHP

The UNESCO program Impulso Joven, “Because Youth Matter,” awarded $10,000 in startup capital to 20 youth projects across 11 Caribbean and Latin American countries, including ENHP. Impulso Joven also provided practical workshops, training sessions and mentorship. The ENHP project unfolded in four stages. Initially, each interpreter completed a course on emotional disorders and mental health. In the second stage, interpreters adapted the course content to be culturally and linguistically relevant for Indigenous territories. Following this, the third stage involved the creation of audio and video materials. Finally, in the fourth stage, the team distributed these materials to Indigenous communities to help reduce the stigma around mental health.

Importance of Reconceptualization

ENHP’s efforts to reinterpret mental health information plays a crucial role in making mental health resources accessible to more Indigenous Peoples. This approach aligns with the goals of the International Decade of Indigenous Languages. The goals focus on actions supporting the United Nations Declaration on the Rights of Indigenous Peoples. The American Psychiatric Association (APA) has studied the barriers Indigenous Peoples in the United States (U.S.), Canada, the Pacific Islands and Australia face in accessing mental health services. These barriers include mistrust of mainstream services, social stigma associated with seeking help, insufficient awareness to recognize signs of poor mental health and the challenges of accessing mental health services in remote areas.

APA emphasizes that barriers to accessing mental health services for Indigenous populations should be viewed within the broader context of systemic, structural and societal challenges. Sandra García Reyes, an educator with ENHP, told UNESCO that mental health and self-care are integral to community care. ENHP has reinterpreted mental health information from a Western perspective to a holistic and relational approach. Furthermore, they take into account the intergenerational impacts of forced assimilation, relocation and discrimination.

Impacts of the IDIL

IDIL provides a framework for collaboration among diverse stakeholders, promoting coherence, continuity and cross-cultural dialogue in actions taken worldwide. IDIL is a global call to develop policies and make strategic investments to protect and revitalize Indigenous languages and support their speakers. According to UNESCO, IDIL involves 4,213 communities from 60 countries and 1,772 organizations. Across these communities, 202 languages are spoken and 2,635 events have been organized to recognize IDIL. Projects like La Enfermedad de la que Nadie Habla en el Pueblo exemplify how youth-led initiatives can enhance the lives of Indigenous communities by incorporating intersectional, community and cultural perspectives while safeguarding their languages.

– Tanisha Groeneveld

Tanisha is based in Leeds, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Initiatives Supporting Mental Health in Zimbabwe

Mental Health in ZimbabweAs of 2024, Zimbabwe’s population stands at approximately 16 million, highlighting an urgent need to support mental health initiatives as more people require access to care. Currently, 54% of Zimbabweans lack access to health care and the suicide rate is 14 per 100,000 people. With less than 20 psychiatrists available for the citizens of Zimbabwe, the mental health care gap is stark.

However, with support from developed countries and effective government programs, Zimbabwe is making significant strides in addressing its mental health challenges. Key initiatives include the World Health Organization’s Special Initiative for Mental Health and the Zimbabwe Life Project. These efforts aim to improve mental health systems, foster successful global partnerships and offer individuals and nations the chance to contribute.

The WHO’s Special Initiative for Mental Health

In 2020, more than 100 stakeholders, including nonprofits and politicians, backed the strategy outlined by WHO’s Special Initiative for Mental Health. These programs provide training to equip mental health professionals and caregivers with the skills needed to offer effective mental health support. Between 2021 and 2022, the WHO’s Special Initiative for Mental Health increased investments in mental health.

Furthermore, it expanded the capacity of general health staff in primary health care centers to identify and assist Zimbabweans experiencing mental disorders. The initiative emphasizes the importance of human rights for those struggling with mental health, including access to information and the right to privacy. This approach fosters a more inclusive and supportive environment.

The Zimbabwe Life Project

The Zimbabwe Life Project (ZLP), established in 2018, is a nonprofit organization that promotes mental health, well-being and resilience in Zimbabwe. The organization seeks to develop a skills exchange program involving mental health professionals in Zimbabwe. This initiative will facilitate participatory exchanges of knowledge, skills and experiences.

A primary objective is to share specialized mental health expertise and foster positive partnerships between mental health professionals in the U.K. and Zimbabwe. Furthermore, ZLP initiatives focus on continuous, comprehensive mental health care in Zimbabwe. In 2019, the organization donated medical equipment worth more than $20,000 to the nation.

Conclusion

Supporting mental health initiatives in Zimbabwe is crucial as the country faces significant challenges in meeting the mental health needs of its population. A combination of limited resources and a shortage of trained professionals has made access to care difficult for many. However, focused efforts are underway to improve mental health systems, foster global collaboration and provide essential knowledge and resources to those in need.

International organizations like the WHO have supported Zimbabwe’s mental health sector. Indeed, programs like the WHO’s Special Initiative for Mental Health and the ZLP have made strides in increasing awareness, training health care providers and integrating mental health care with primary health services. These initiatives aim to treat mental illness and promote long-term resilience and well-being across communities.

– Alysha Miller

Alysha is based in Toronto, ON, Canada and focuses on Global Health for The Borgen Project.

Photo: Flickr

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How Elderly Poverty in Madagascar Impacts Mental Health

Elderly Poverty in MadagascarMadagascar, located off the southeastern coast of Africa in the Indian Ocean, is the fifth-largest island in the world. With a population of more than 30.8 million people, Madagascar is renowned for its rich biodiversity and unique ecosystems, including the infamous lemurs and lush rainforests. Despite its natural wealth, Madagascar faces significant challenges in poverty alleviation, consistently ranking among the world’s poorest countries. Its citizens navigate poverty through various means, including subsistence agriculture, fishing and small-scale entrepreneurship, while also relying on community support networks and resilience in the face of adversity. However, the mental and emotional toll elderly poverty in Madagascar causes heavily disturbs the culture, beauty and essence of its climate and people.

Poverty and Mental Health in Madagascar

When examining the ramifications of poverty on mental and emotional well-being, it is crucial to note its pervasive role among senior citizens. According to “Face of Poverty in Madagascar,” a poverty, gender and inequality assessment that the World Bank created, “Only 2.4 percent of the population in 2010 was 65 and older, and elderly poor represented only 2 percent of the poor population.” According to ScienceDirect, “Antananarivo-Renivohitra, the capital district of Madagascar, had an estimated population of 1,275,207 in 2018 (RGPH-3, 2018), of which only 5.5% were over 60 years old.”

While the population and poverty in Madagascar predominantly have a youthful demographic, this does not mean that poverty affecting the island is not detrimental to the psychological well-being of older Malagasies. Poverty leads to food insecurity, lack of safe housing, limited employment opportunities, reduced social mobility and education disparities. The World Bank reports, “The highest prevalence of illiteracy in 2010 was among the elderly population of 64+ years old (50 percent).” Without academic instruction, obtaining secure employment becomes increasingly difficult, forcing Madagascar’s elders to pursue jobs that require less intellectual prowess and more physical stamina, a skill that diminishes with old age.

The Impact of COVID-19 on Madagascar

SARS-CoV-2 (COVID-19) arrived in Madagascar with airborne passengers traveling from Europe in March 2020. While the country took preventative measures to limit the spread of the virus, illness struck Madagascar’s population predictably targeting those of older age. According to original research conducted by BMJ Global Health, due to COVID-19, life expectancy in Madagascar has dropped by 0.8 years for men and 1.0 year for women, primarily due to increased risks of death among individuals over the age of 60. The National Library of Medicine explains, “The probability of testing positive increases with age with the highest adjusted odds ratio of 2.2 [95% CI: 1.9‐2.5] for individuals aged 49 years and older.”

Not only did the virus risk and claim the lives of Malagasy elders, but dealing with its harshness and the majority of its symptoms, “(The most common symptoms of illness onset among confirmed cases were cough (27.2%), fever (18.7%), weakness (14.7%), runny nose (13.3%), and headache (13.1%))” prevented elders from returning to their jobs and continuing to support themselves and their families. The elderly population in Madagascar, already vulnerable to nutritional issues, faced heightened anxiety due to COVID-19, as concerns about their health, life expectancy, and ability to make a living increased.

Food and Health of the Elderly in Madagascar

A 2023 study by GSC Biological and Pharmaceutical Sciences examined the food and health practices of people aged 60 and over in the urban commune of Antsirabe I and the rural commune of Andranomanelatra in the Vakinankaratra Region. The study found that while the elderly were concerned about their health, hygiene practices—such as treating drinking water and washing hands before meals—were inadequate. The evaluation of nutritional status revealed that 37.5% of elderly individuals in rural areas were underweight (BMI < 18.5), compared to 17.9% in urban areas. Factors associated with poor nutritional status included education level, housing comfort, monthly income, food expenditure, dietary diversity and average energy intake.

The MDGs

While the intersection of poverty and psychological distress presents a formidable challenge for Madagascar, addressing this issue necessitates not only measures to alleviate poverty but also immediate, sustainable solutions to safeguard emotional and mental health. The Millennium Development Goals (MDGs), as outlined in the UN’s Millennium Declaration, represent a global commitment to eradicating extreme poverty, particularly in resource-limited countries like Madagascar.

One of the key focuses of Madagascar’s efforts to meet these goals is the conservation of its natural resource base and promoting sustainable development, as emphasized in the Madagascar Action Plan. This approach acknowledges that poverty reduction is not just about economic growth but also about protecting the environment, which many rural elderly Malagasy depend on for their livelihoods. As the government has pointed out, “Madagascar cannot do it alone and should not do it alone,” underscoring the need for international collaboration to address both poverty and environmental degradation in tandem. The global partnership called for in the eighth MDG reflects the notion that overcoming poverty will require support from multiple sectors and countries, aiming for sustainable development that benefits current and future generations.

The Madagascar Action Plan

The government of Madagascar has taken strides in linking health improvements with economic growth, as outlined in the Madagascar Action Plan. The commitment to improving access to health care, especially in rural areas where elders reside and elderly poverty in Madagascar is prevalent, plays a crucial role in enhancing productivity and reducing the pressure on natural resources. With the president’s “Madagascar Naturally” vision, the country emphasizes biodiversity conservation, protect the environment and reduce poverty. Through such initiatives, Madagascar is working to ensure that its population can both thrive economically and sustain its natural resources. As highlighted, “Developing countries’ debt problems” and the need for “sustainable access to safe drinking water” are critical components that will drive Madagascar’s progress toward achieving the MDGs and alleviating poverty.

Through techniques like observing the country’s natural resource base, the effect of demographic trends on development, and the importance of health as a prerequisite for development, it fosters adaptive coping strategies and enhances mental well-being. Implementing MDGs offers promise in improving the lives of Malagasians, potentially breaking the cycle of poverty and mental health challenges, providing those of older age peace and fulfillment when dealing with mental turmoil alongside impoverishment.

– Ryley Anthony

Ryley is based in Grand Prairie, TX, USA and focuses on Good News for The Borgen Project.

Photo: Pixnio

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How Inequality and Mental Health Fuel Global Poverty

Inequality and Mental HealthInequality is not just an economic challenge; it’s deeply psychological, influencing how individuals perceive themselves, others and society. Disparities in living conditions and opportunities profoundly affect mental well-being, leading to cycles of marginalization that erode trust, weaken social cohesion and harm mental health. This acceptance of inequality can become entrenched in societal norms, making it harder to challenge. However, understanding these psychological dimensions also reveals avenues for political and social change, as shifting perceptions can fuel efforts to reduce these disparities.

Understanding Global Inequality

Global inequality is marked by the uneven distribution of resources, opportunities and power, leading to significant differences in living standards. This issue is not only global but also deeply rooted within nations where social stratification creates rigid hierarchies based on power, status and wealth. For instance, the bottom 50% of the global population controls just 2% of the world’s wealth, while the top 10% commands 76%. Although global inequality between countries has slightly decreased, internal disparities within nations have widened, revealing an alarming trend of growing inequality even as some global measures improve.

Psychological Dimensions of Inequality

  1. Perceptions and Their Impact: How people perceive inequality is crucial in understanding behavior and societal cohesion. Perceptions, shaped by relative or absolute measures, influence how individuals view their place in society and their potential for upward mobility. Misjudgments in these perceptions can obscure or exaggerate the true extent of inequality, affecting personal choices and reinforcing societal dynamics that perpetuate the status quo.
  2. Mental Health Consequences: tyle=”font-weight: 400;”>>The psychological toll of inequality is profound, particularly when it comes to mental health. Dr. Greig Inglis from the University of the West of Scotland, who has extensively researched poverty stigma and its mental health effects, explains, “The most commonly discussed form of poverty stigma is discrimination, where people living in poverty are treated unfairly because of their financial situation. However, there are other forms of stigma, such as the anxiety about how others might treat them in the future due to their financial difficulties.” Inglis further notes that “the evidence is clear that poverty stigma is detrimental to mental health, often leading to low self-esteem, depression and other signs of mental ill-health.”

This stigma often traps individuals in a cycle where mental illness and poverty exacerbate each other, particularly in low- and middle-income countries (LMICs). Mental health struggles can lead to exclusion from economic opportunities, further deepening poverty. Moreover, poor mental health is closely linked to other health problems, reducing productivity and economic stability. Addressing mental health in these populations is essential for breaking the cycle of poverty and inequality.

Mechanisms Perpetuating Poverty

  1. The Role of Perception and Self-Interest: People’s perceptions of inequality are shaped by their environment and personal interests, with social and media cues playing a significant role. These perceptions can lead to biased views that reinforce existing inequalities, as individuals support policies that align with their interests, often benefiting the wealthy at the expense of the poor.
  2. Income Disparities and Social Stratification: Income inequality is a major driver of poverty, creating entrenched cycles that are difficult to break. Social stratification further solidifies these disparities, limiting social mobility and trapping those born into poverty. Overcoming these barriers requires systemic change that addresses the root causes of inequality rather than just its symptoms.

Global Efforts to Tackle Inequality

The Business Commission to Tackle Inequality (BCTI) and the International Monetary Fund (IMF) have launched significant initiatives to address global inequality. BCTI’s 10-point action agenda focuses on embedding social performance and accountability into business practices. At the same time, the IMF has expanded its efforts to include fiscal redistribution, social spending and inclusive growth.

In response to COVID-19, the IMF doubled access to emergency financing, approving $116 billion for 85 countries, provided debt relief grants through the Catastrophe Containment and Relief Trust (CCRT) and collaborated on the Debt Service Suspension Initiative (DSSI) for low-income countries. Additionally, the IMF allocated $650 billion in Special Drawing Rights (SDRs) to bolster global economic stability during the crisis. These initiatives highlight the importance of addressing both the economic and psychological dimensions of inequality as part of a comprehensive strategy to reduce global poverty.

Conclusion

Addressing mental health and emotional barriers that sustain inequality can create more just and equitable societies. While economic growth is necessary, it alone may be insufficient; changing perceptions and breaking down psychological barriers are vital for fostering sustainable development and global social equity.

– Sandeep Kaur

Sandeep is based in Manchester, UK and focuses on Good News for The Borgen Project.

Photo: Pexels

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Improving the State of Mental Health in Suriname

Mental Health in SurinameSuriname, ranked second by the Pan American Health Organization (PAHO) for its high suicide mortality rate (exceeding 10 deaths per 100,000 people), has only recently begun to address its mental health challenges. It wasn’t until 2015 that the first epidemiological research effort on depression and anxiety in the country’s population was conducted. This delay highlights the lack of attention previously given to mental health in Suriname. However, in recent years, there has been more focus on this issue and solutions are beginning to take shape.

The Mental Health of Indigenous Peoples

The Suriname Herald highlights the correlation between the effects of changing climatic conditions and the decreasing mental health of Indigenous populations is often overlooked. The article shares an interview with an Indigenous Surinamese woman who explains how varying weather conditions have affected the practice of traditional knowledge that was passed down through generations. As weather patterns change, drought causes some agricultural land to become infertile. In contrast, flooding causes harvests to fail in others. The stress and loss of centuries-old ancestral traditions that are tied to the well-being of the land is taking a toll on the mental health of Indigenous people.

In response, a joint effort between a Dutch and Surinamese University and the psychiatric center in Suriname launched the Suriname Indigenous Mental Health Study (SIMH) in 2023. The study aims to bridge the gap in understanding the mental well-being situation among the Indigenous population. With the knowledge gathered from the study, a framework can be built for mental health treatment that implements traditional Indigenous health care systems.

Youth and Women

The COVID-19 pandemic revealed the concerning state of mental well-being among children and youth. In 2023, the United Nations Children’s Fund (UNICEF) reported that 36.2% of youth in Suriname aged 16 to 25 years old have struggled with suicidal thoughts. Additionally, UNICEF found that about 75% of the youth experienced symptoms of stress or depression in 2022.

BMC Public Health’s 2022 study suggests that female respondents in the districts of Nickerie and Paramaribo were at a higher risk of developing depression and anxiety disorders. Researchers found possible cases of depression in 11.5% of male participants. This is in comparison to 19.4% of females from the population of Paramaribo. The cause of the difference between genders in the results is not yet determined. Possible factors contributing to poor mental health for women include limited economic opportunities, a lack of (financial) autonomy, domestic violence and limited family support.

Supporting Mental Health Services

UNICEF recently launched a one-year pilot program to improve mental health in Suriname, beginning in October 2023. The program focuses on the rural district of Nickerie in the Northwest and spans from October 2023 until October 2024. The issue is approached on three fronts:

  • Decreasing the stigma of mental health
  • Strengthening mental health services
  • Equipping parents with information regarding the psychosocial upbringing

The program aims to reach 25,000 people in Nickerie through a media campaign. Additionally, it aims to engage 500 children and 500 parents in an initiative to teach mental health skills. UNICEF shared the program’s accomplishments through March 2024:

  • Social media content and television broadcasts have been developed to raise awareness about mental well-being.
  • Progress has been made in setting up a helpline for mental health-related issues and self-harm prevention.
  • A program to teach children mental health skills is in development. It is expected to launch in the summer of 2024.
  • The first in a series of sessions to educate parents on mental well-being and how to support their children’s mental health was launched in May 2024.

Conclusion

Socioeconomic and climate-related issues impact mental health in Suriname. Studies have shown that women, youth and Indigenous people are disproportionately affected. The good news is that when the numbers are clear, solutions can start to take shape. UNICEF’s educational approach to positive mental health and the SIMH study that collaborates with Indigenous communities will positively impact mental health in Suriname for future generations.

– Tanisha Groeneveld

Tanisha is based in Leeds, UK and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Mental Health in India: Community-Based Care

Mental Health in IndiaIt is estimated that 13.7% of the people living in the Southeast Asia region suffer from mental health conditions. When zooming in on India, the number rises to 15%, showing the need for reform for mental health in India. Most people suffering remain untreated in the country’s current mental health infrastructure. This contributes to the high suicide rates in Southeast Asia. When individuals remain untreated, personal and interpersonal relationships are negatively impacted. Furthermore, there are documented consequences at the individual’s socioeconomic level.

Mental Health in India

India lacks a unified health infrastructure, leading to exorbitant prices and unequal access to mental health care. High treatment costs have a detrimental effect on vulnerable populations, pushing some families into poverty as they seek treatment. While the country provides free health care to the most impoverished 40% of its population, significant gaps in coverage remain. Many people are left to pay out of pocket for up to 50% of their healthcare needs, including prescriptions.

This inconsistency in healthcare contributes to the 55 million people who are pushed back into poverty every year in India. Despite these numbers, India, the most populated country in this region, spends less than 2% of its gross domestic product on health care. Low spending has resulted in a shortage of medical staff and resources. To combat this mental health epidemic, leaders are looking toward implementing more community-based care models.

Community-Based Care

Traditionally, institutionalization has been the mainstay in treating people with mental disorders. This was first thought to provide people with a safe place to heal while struggling with a mental disorder. However, new research has shown that it is not the most effective method. New understandings push public health leaders to advocate for and develop a new community-based care system. The care system will center the individual and their community at the core of treatment. The Southeast Asia Director of the World Health Organization (WHO), Ms. Saima Wazed, explains how “as our understanding of mental health has evolved, so too must our methods of care.”

As WHO Southeast Asia transitions to a community-based care model, it is emphasized that this shift will reduce the negative impacts of institutionalization. It will provide more community support for individuals with mental disorders. This new model of care will increase the number of people with access to mental health care and offer improved treatment outcomes. In March 2024, a three-day meeting was held in Bangkok, Thailand, to discuss how best to implement community-based care in the region.

Those working to create more awareness and implement community-based care are also fighting the deep stigma that surrounds mental health in India. Often fueled by misinformation, the stigma prevents many people from accessing the care they need for fear of social marginalization. This is contributing to an underutilization of available resources.

Final Words

India, having one of the highest percentages of individuals affected by mental health disorders, stands to gain the most from implementing community-based care as a pillar of mental health treatment. This new development from WHO Southeast Asia will aim to eliminate institutionalization as the region’s focal form of therapy and instead explore community as a highly researched alternative.

– Carlee Unger

Carlee is based in Pembroke, NC, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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How Poverty in India Makes It Difficult to Seek Support

Poverty in IndiaAcross the globe, the discussion surrounding mental health has become more accepting in recent years. By reducing stigma and increasing access to potentially life-saving care, people are now more than ever encouraged to get the help they need. India is no exception to this. The Indian government launched the National Mental Health Program (NMHP) to improve mental health services in 1982 and aims to provide community-based mental health care.

A watershed moment in awareness for those struggling with their mental health in India was the Mental Health Care Act 2017. The act ensured that every person has the right to access mental health care and treatment from services run or funded by the government; this treatment must be of good quality, affordable and available without discrimination.

The Role of Poverty in India

These acts alone cannot overcome the exceptionally disadvantaged position impoverished individuals in India face. People experiencing poverty in India often reside in rural or underserved urban areas where mental health services are scarce or nonexistent. Even these government-run mental health facilities are limited and unevenly distributed around the country. According to a National Mental Health Survey (NMHS) conducted in 2015-16, about 70-80% of those suffering from mental disorders in India did not receive treatment, an unsettlingly high statistic.

Additionally, communities are unable to band together to support these individuals, with almost half of persons surveyed by the NMHS attributing mental health struggles to personal weakness. This deep-seated stigma surrounding mental health is prevalent in India, which leads struggling children and adults to blame themselves for disorders rather than seeking the help necessary. In these areas, school systems also tend to have less information to speak about mental health, unknowingly allowing deep-seated cultural beliefs and superstitions about mental health to persist to the detriment of struggling citizens.

In fact, the literacy rate in rural India stands at around 68.91%, compared to 84.11% in urban areas. This disparity limits the dissemination of mental health information. Even online means fail, with those in poverty-stricken areas only accounting for about 25% of the country’s total internet database, hindering access to online mental health resources and telehealth services.

Perseverance

Because of India’s shortage of trained mental health professionals, telehealth services are absolutely vital yet inaccessible to those who need them. Despite the government’s attempts at change, their reach has been limited; however, this isn’t to say that all hope is lost. Mental health services are currently being integrated into primary health care to ensure that mental health assistance is accessible at a base level.

The Central Board of Secondary Education has made another example of the attempts to raise support. Schools are essential in shaping children’s foundational beliefs, which is why discussing mental health topics in the school curriculum and providing training for teachers to identify and support students with mental health issues is the best way to bring change to the country.

– Abby Collins

Abby is based in Westwood, MA, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Mental Health in Tonga

Mental Health in TongaAccording to the World Health Organization (WHO), as of 2022, one in every eight people globally suffers from mental health disorders and diseases. However, the effects are seen disproportionately, as developing countries face higher rates and poorer treatment options than more developed countries. A look into Tonga highlights this.

Causes

Mental health challenges that people in Tonga face mainly stem from difficulties or trauma, even from natural disasters. Tonga’s Prime Minister Hu’akavemeiliku Siaosi Sovaleni, in 2022, tells of the trauma people faced during the aftermath of the volcano and tsunami attacks on their motherland. Disasters have resulted in destroyed homes and infrastructure, leading to a significant toll on mental health.

Another major cause is substance usage and abuse. The Guardian, in 2022, talks about the drug crisis in Tonga, where between 20% to 70% of hospital admissions are because of drug usage and abuse. It further says that drugs have now become a major contributing factor to the onset of mental illnesses and the frequent relapse of individuals with chronic psychiatric disorders like schizophrenia and bipolar disorder.

Stigma

There is a great stigma around receiving mental health treatment in Tonga, a major reason why many who suffer from mental health conditions choose to keep the illness to themselves and don’t seek help. That’s because of Tongan traditional views of being possessed by spirits or cursed if one has a mental illness. Moreover, Tongan culture has a larger role in this in that family image is very important. Ali Latsu, in a Medium article, explains that Tongans rarely embrace an individualistic mindset, if at all. For Tongan parents, hearing their child confess to mental illness can feel like a veiled criticism of their parenting.

Services

Tonga lacks the extent of resources needed to support the growing population of people who are increasingly struggling with mental health challenges. Besides that, instead of resources increasing and progressing, they are decreasing and regressing. The Mental Health Atlas in 2020 found that the number of mental health workers per 100,000 population decreased from 21.62 in 2017 to 17.23 in 2020. Similarly, the number of community mental-based mental health services per 100,000 decreased from 5.67 in 2014 to just 3.83 in 2020. This downward trend is alarming.

Efforts

In 2022, the University of Auckland announced a groundbreaking partnership. This partnership involves researchers from the university, Te Poutoko Ora a Kiwa I Center for Pacific and Global Health and the Tonga Ministry of Health. The New Zealand Ministry of Health Polynesian Health Corridors supports it. The partnership aims to provide essential population-level insights into mental health and mental health services in Tonga. This information will offer much-needed insight and information to improve the mental health resources available in Tonga.

Furthermore, in March 2024, Tonga’s Minister for Mental Health, Matt Doocey, announced the launch of a new initiative to implement mental health and addiction peer support services in hospital emergency departments. The initiative aims to improve outcomes for individuals seeking crisis help while enabling clinical staff to concentrate on clinical work.

– Shreyan Singha

Shreyan is based in Coral Springs, FL, USA and focuses on Global Health for The Borgen Project.

Photo: Wikimedia Commons

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The Impact of Mental Health in Czechia

Mental Health in CzechiaThese days, the mental health landscape of Czechia is undergoing significant changes. Recognition of mental health issues has increased, and efforts to improve services and support are expanding. According to the World Health Organization (WHO), mental health disorders are very common worldwide: one in every eight people is suffering from a disorder. In the Czech Republic, trends are highly comparable to the worldwide situation, but specific problems and developments well deserve to be addressed.

Causes

These include socioeconomic conditions, lifestyle changes and the historical context. Approximately one-fifth of the population suffers from mental-health-related issues and problems, according to the National Institute of Mental Health in the Czech Republic. Depression, alcohol-related disorders and anxiety are the leading disorders reported or diagnosed in this area. Indeed, many more people could be silently suffering from these mental health disorders during times like this.

The economic transformation after the fall of communism also contributed to this factor here. As a result of rapid changes in society, increased stress levels have been created among people, which can further give way to mental health complications. Additionally, poverty strongly correlates with mental health challenges, where those in lower economic strata experience higher rates of mental health disorders and face significant barriers in accessing mental health care.

Stigma

Despite increasing mental health awareness worldwide, stigma remains a significant barrier in Czechia. According to a report by the European Union Agency for Fundamental Rights, many individuals with mental health problems in Czechia experience discrimination, particularly in employment and interpersonal relations. Cultural factors and historical contexts contribute to feelings of isolation, making it challenging for people to seek support and discuss their mental health openly.

Services

Czechia had made plans to develop and improve its mental health services, although gaps still exist. The Mental Health Atlas of WHO in 2020 indicated that approximately 30 mental health professionals per 100,000 population in the Czech Republic. The government has responded by initiating various programs to strengthen the mental health infrastructure, such as the integration of mental health services at the primary care health services and expansion at the community level.

Recent initiatives in Czechia’s mental health care include efforts to improve access to services for children and adolescents, enhance mental health education and reduce stigma. International cooperation has also facilitated the exchange of best practices, contributing to the development of mental health services in the country.

Czechia is at a critical stage in managing mental health, with significant strides being made in reducing stigma, enhancing services, and integrating mental health into broader healthcare.

– Ansha Gupta

Ansha is based in Apex, NC, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr