Archive for category: Mental Health

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Mental Health in Georgia

Mental Health in GeorgiaGeorgia, formerly part of the Soviet Union, garnered independence in 1991. From 1991 to 1993, following its break from the communist regime, civil war and unrest had wracked the country; its post-Soviet Union status still had not allowed the state to fully escape the shadow of its political past. PLOS Medicine reports that traditionally inhumane and outdated medical practices, ranging from biological treatment to high rates of institutionalization, heavily characterize mental health services in Georgia.

In 2009, Global Initiative on Psychiatry (GIP) reported that social exclusion, mental ill health and poverty were all correlative; the mental well-being of residents in poorer, more remote regions of the country proves a focal point for discussion. It was not until the Ministry of Labour, Health and Social Affairs (MoLHSA) introduced the 2011-2015 National Health Care Strategy that there was a key turning point in Georgian mental health services. The status of mental health underwent a momentous transformation, both in the realm of primary health care and in the community. This is a chronological breakdown of the reformation roadmap thus far.

1995-2009 Programs and Laws

The establishment of the 1995 mental health assistance program meant that officially registered mentally ill patients, according to the national psychiatric register, received free services, according to PLOS Medicine. These people received treatment at various hospitals as well as outpatient clinics. PLOS Medicine records show that six psychiatric clinics provided hospital care to these patients and have housed and cared for more than 1,000 people.

In 2007, a newly introduced law on psychiatric services resulted in the illegalization of the involuntary hospitalisation of mentally ill patients in Georgia, PLOS Medicine reports. A court decision was mandatory if one viewed institutionalization as the only remaining viable option. The EU has repeatedly berated Georgia on torture for the poor conditions of the country’s mental institutions; the violation of human rights was a huge motivation behind the upheaval of its mental health services.

In 2009, Georgia replicated the 2007 law on psychiatric care alongside several adaptations, carried out by psychiatric experts. This included the proposal of treatment management techniques such as physical restraint as well as treatment options relevant to forensic psychiatric treatment and prison mental health, PLOS Medicine reports.

2011-2015 National Mental Health Care Strategy

In 2010, Georgia announced the 2011-2015 National Mental Health Care Strategy with a specially curated team of psychiatrists prepared to implement these reforms. At the time of the strategy’s introduction, MoLHSA officially recorded approximately 80,000 mentally ill civilians but also admitted that they viewed this as an underestimation, PLOS Medicine reports. The program emphasized the importance of mental well-being; the strategy’s overarching objective was to improve the general population’s mental health by 2015.

By 2013, 18 outpatient psychiatric clinics were already in use but there was a negative correlation between the increased presence of available services and poorer, more remote regions; citizens of poorer regions could not access mental health services of the same quality, according to PLOS Medicine. The principal reform within this entire process was deinstitutionalization which occurred in early summer 2011 via the closing of the largest psychiatric institution at the time, the Asatiani Psychiatric Hospital.

2015-2020 Mental Health Care Strategy Plan

The country announced the plan in 2014 and prioritised the improved accessibility of mental health care services to the Georgian population. Georgia declared its obligations to care for all disabled civilians and safely keep their rights and freedoms. The strategy emphasized the destigmatization of mental health treatment and mental illness. The World Health Organization (WHO) report stated that, at this time, neuropsychiatric disorders were behind 22.8% of the country’s fatalities.

In 2016, there was an increase in funding for more mobile teams; 11 mobile teams received funding for their work across the country by 2018. The implementation of a separate scheme in this same year attempted to ensure the rights of mentally ill Georgian prisoners, specifically. 

2022-2030 National Mental Health Strategy

This national plan aims to emphasize child and adolescent mental health. The strategy further champions deinstitutionalization and the importance of community-based care for mentally ill patients. In 2022, 8.4% of the mentally ill population received treatment in a mental hospital with the remaining populace receiving care at a community-based service.

Moving Forward

Treatment for mentally ill patients has transformed in various manners since the Georgian state obtained its independence. Firstly, however, it appears that treatment is geographically discriminatory with only civilians who reside in the country’s capital being prioritized; citizens who reside in poorer, more remote regions find treatment is less accessible to them.

Secondly, it seems that treatment for mentally disabled prisoners is immensely stagnated, especially in comparison to services which are accessible to non-incarcerated civilians. The Public Defender’s Office (PDO) of 2022 noted the sub-standard conditions available for mentally ill inmates and reported a severe lack of services specifically for those with disabilities. The former Soviet Union state has made major progress since the early 1990s and will hopefully continue to make further steps to ensure all Georgian civilians, irrespective of their geographical location and incarcerated status, can access adequate mental health services.

– Naomi Finapiri

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

Photo: Unsplash

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Poverty and Mental Health in Djibouti

Mental health in DjiboutiIn Djibouti, one of the smallest but geographically strategic countries in the Horn of Africa, the relationship between mental health and poverty presents major challenges to individuals and communities. They are interrelated in such a way that economic deprivation increases mental health struggles, while poor mental health transfers them into cycles of poverty. Given this dynamic, it is clear that this challenge needs interventions that approach the issue with substantial social and health care dimensions.

Understanding the Link

Poverty in Djibouti is pervasive and much of the population lives below the threshold level of subsistence. The economy remains unstable, with scarce educational facilities and high unemployment rates. In such conditions, individuals and families have to endure many stressors emanating from lack of access to basic needs, housing insecurity and food insecurity. Stressors of this nature affect not only physical but also mental health.

According to the World Bank, “Using the lower middle-income poverty line, it is found that about two-fifths of the population lives below $3.20 a day. As the pace of economic growth declines due to the spread of COVID-19, the pace of poverty reduction is under threat.” Mental health problems are among the most common in Djibouti. Yet, they are barely noticed: depression, anxiety and trauma-related disorders. Among other causes, it is underreported and underdiagnosed because of the stigma, cultural beliefs and the lack of mental health professionals.

In addition, the deficit of reachable and affordable services for mental health increases the burden on individuals who already bear the burden of poverty. Organizations like the United Nations Children’s Fund (UNICEF) have led by example. According to the organization, in Africa alone, “nearly 37 million adolescents (aged 10–19) live with a mental disorder.” In Djibouti, UNICEF has found that 10.8% of boys and girls aged 10 to 19 are victims of mental disorders.

Multifaceted Approaches

Therefore, approaches that consider the complex interplay between mental health and poverty are essential. Poverty reduction strategies, in particular, reduce stressors that contribute to poor mental health outcomes. Similarly, improved access to education provides the tools for breaking out of the poverty cycle and enhances resilience against mental health problems. Furthermore, opening job opportunities, particularly for the most disadvantaged, improves economic prospects, builds self-esteem and increases the social integration necessary for better mental health.

In addition, social safety nets, which include cash transfer programs and food assistance schemes, make essential support for vulnerable households less burdensome on the pocket and ensure stability. These poverty reduction interventions could actually prevent risk factors that lead to poor mental health. At the same time, cultural sensitivity in mental health services will be supported by investment in the infrastructure for mental health. This will include training and deploying more mental health professionals, such as psychologists, psychiatrists and counselors, to build a strong workforce in the field of mental health.

De-stigmatizing mental illness will also help develop local support systems, including peer support groups and community health centers, helping mental health services reach unserved, far-flung areas. Therefore, the process has to consider reducing the stigma associated with mental illness. This is basically to ensure that people seek help without much stress or feeling embarrassed. Targeted awareness campaigns to dispel misconceptions and increase mental health literacy can reduce stigma and empower people to seek help openly in their communities. It is equally crucial for partnerships between the government, nonprofit sectors and international partners to share resources and expertise and coordinate efforts.

Combating Stigma and Fostering Collaboration

Reducing stigma around mental illness is the foremost strategy for enhancing help-seeking behavior and early intervention. In this regard, awareness campaigns like UNICEF’s #OnMyMind campaign can challenge misconceptions while improving mental health literacy. This can help lower stigma and increase open dialogue at the community level. Moreover, fostering the collaboration of government agencies, nonprofit organizations and international partnerships is vital to pool resources and expertise and harmonize efforts.

Given the strengths of government institutions, civil society organizations and humanitarian agencies, holistic and sustainable solutions can be devised. This collaboration could, therefore, ensure the elaboration of comprehensive policies on mental health, mobilization of resources for mental health programs and setting up mechanisms for monitoring purposes to ensure accountability.

Conclusion

The intricate relationship between mental health and poverty in Djibouti necessitates integrated and coordinated responses that address the social, economic and health aspects of the issue. Combining efforts to reduce socioeconomic stressors with initiatives to increase mental health services and reduce stigma will facilitate a pathway toward holistic and sustainable solutions for Djibouti. Ultimately, by placing human well-being at the top of the agenda, Djibouti can build resilient communities that succeed both economically and in mental health.

– Honorine Lanka Perera

Honorine is based in Highland, NY, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Montenegro’s Mental Health

Montenegro’s Mental HealthThe World Health Organization (WHO) ranks a country’s health not only by the absence of disease but also by a measure of the “physical, mental and social well-being” of its citizens. Mental health is inherently linked to a society’s cohesion and the well-being of its inhabitants. Montenegro’s mental health support infrastructures are historically lacking. However, significant steps have been taken to improve public health care facilities and support services in the last 30 years.

Montenegro is a Balkan country in Southeastern Europe, bordering Croatia, Albania, Bosnia and Serbia. It is situated between the Dinaric Alps and the Adriatic Sea, making it an established tourist destination. Despite its popularity as a place of vacation and relaxation, Montenegro’s socioeconomic difficulties have had an inherent impact on the mental well-being of its citizens.

The Balkan War and Montenegro’s Mental Health

The Balkan War is still fresh in the minds of Montenegrins. For a decade, between 1991 and 2001, this violent ethnic conflict presided over the Balkan region and eventually culminated in a split from the former Yugoslavia in 2006. This bloody warfare, only recently resolved, left a legacy of trauma. Politically, Montenegro became a stable, peaceful democracy. However, the brutal civil war and Montenegro’s subsequent sovereignty had a significant impact on the economic development of the country, with its gross domestic product (GDP) falling from 45% in its Yugoslav era (1989) to 12% in 2000.

Historically, Montenegro’s psychological support has centered around patients whose serious disorders have symptoms of aggressive behavior, admitting them to Danilovgrad (Montenegro’s first psychiatric hospital, founded in the 20th century). The remaining nonviolent patients were left to “roam the streets.” A notable milestone in efforts to support community psychiatry and deinstitutionalize mental health facilities began in the early ’90s, with “Centers for Mental Health” inaugurated in 1991. Official mental health policies were implemented as late as 2004.

Mind and Money

Montenegro is ranked as one of the poorest countries in Europe, with a 2022 United Nations Children’s Fund (UNICEF) study declaring that “at least one-third of Montenegro’s children are at risk of poverty.” Economic welfare concentrates in urban and coastal regions, while much of the country struggles under economic pressures with little access to welfare support. A 2019 study showed only 44% of citizens living below Montenegro’s poverty line have access to welfare funds.

The impact of Montenegro’s conservative milieu on mental well-being is accentuated through the knowledge that 78% of those asked reported a complete absence of community mental health campaigns, while 97.2% thought support infrastructures would be a beneficial addition to their locality. This, in conjunction with a recognition of Montenegro’s conservative society that is “deeply ingrained in patriarchy,” provides context for the psychological pressures of its citizens.

Suicide rates in Montenegro can be correlated directly with insufficient support infrastructures and economic pressures. “The average crude suicide rate was 21.06 ‘for males 29.93 and for females 12.42,” with lethal suicide statistics correlating significantly with unemployment rates. In 2018, the rate of fatal suicide in the male population reached 4.29. In addition, Montenegro is recognized as having the highest number of “weekly hours worked [in Europe] at 42.8,” while the average European employee in 2022 worked just 36.2 hours a week.

These figures can be attributed to cultural roles, with men facing more pressures on having to financially contribute to households: an indisputable correlation between poverty and mental stability.

The EU4 Health Program

In January of 2024, the Montenegrin Health authorizations and the wider European health community established an agreement: the EU4Health program. This agreement allows both public and private sector health care entities access to funding and grant opportunities, increasing the accessibility and quality of support across the country. However, despite recent advancements in infrastructure and support, these goals are still recognized as only “partly realized,” with many of its objectives still awaiting accomplishment.

Open Mind

Nongovernmental organizations (NGOs) are working towards the political and social representation of mental health issues in Montenegro. The Open Mind project, co-funded by European Union’s (EU) grants, advocates for the inclusion of mental illness in political agendas, public debates and social sectors. Promoting dialogue for the social reintegration of those with mental health issues combats cultural stigmas.

The campaign aims to sensitize 5,000 individuals, conduct 10 awareness campaigns, train 20 CSOs and establish support groups in multiple communities. This project is one of 20 NGOs working to improve the lives of this target group and represents an optimistic future for Montenegrins suffering from mental health issues.

A Brighter Future

Recent governmental efforts to improve public health care in Montenegro represent a pivotal ideological shift, with Montenegrin citizens forecasted to witness “substantial improvements in their health care services.” Reflecting on the dualism between public mental health and the economy, an optimistic future is evident in Montenegro’s strong economic growth, estimated at 6% in 2023.

Traditionally, policy has neglected the implications of socioeconomic burdens on Montenegrin inhabitants. However, recent years have seen evident improvements in support infrastructures available for relieving the Montenegrin public mental health concerns. The inherent implications of mental health issues on social cohesion make the promotion of these efforts a priority.

– Thea Carter

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

Photo: Flickr

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5 Facts About Mental Wellness in Bulgaria

Mental Wellness in BulgariaBulgaria is a country known for its rich cultural heritage and picturesque landscapes. The population is roughly seven million and the nation is part of the North Atlantic Treaty Organization (NATO) and the European Union (EU). It is a hotspot country for historians and anthropologists alike, as it is one of the first European countries in existence. Bulgaria is dotted with mountains and dense with forests and it borders the sea, so there are several tourist attractions and opportunities for outdoor adventure. Here are five facts about mental wellness in Bulgaria.

5 Facts About Mental Wellness in Bulgaria

  1. Historically, Bulgaria has not prioritized the mental health of its citizens, with very few mental health facilities in existence before the ’50s. After the regime change in 1944, psychiatrists in Bulgaria began to advocate the “dispensary system,” which meant to integrate and normalize psychiatric intervention in the broader citizen sphere. This mentality was born at a time when psychiatrists began to see the direct influence of “social conditions” on the mental well-being of citizens. Thus, psychiatry and outpatient treatments were introduced more readily to accommodate mental wellness in Bulgaria.
  2. Social stigma is a significant barrier to addressing mental health in Bulgaria. Despite psychiatric efforts in the 20th century to incorporate psychiatric care into society, attitudes surrounding mental illness and disabilities in Bulgaria do not reflect these efforts. Seeking help can often target individuals and warrant social scrutiny – “Mentally ill are socially discriminated.” It is believed that the mentally ill themselves are guilty of their doom and they should not expect society to share the burden of disease with them.”
  3. Regardless of rampant social stigmas, mental illness is highly prevalent in Bulgaria. According to the United Nations Children’s Fund (UNICEF), about 20% of children and adolescents experience mental health complications each year. Bulgarian youth are also ranked number one in Europe for unhealthy coping mechanisms, such as nicotine intake and drug/alcohol abuse.
    Though many doctors are not readily diagnosing mental health disorders in Bulgaria, it is estimated that nearly one in five Bulgarians experience depression to some degree: “People are told to just snap out of it and get on with their lives and are branded as sensitive and fragile.” Every year, nearly eight hundred Bulgarians succumb to suicide.
  4. Several factors contribute to poor mental health in Bulgaria, the foremost being the lack of assistance for those in need, as previously mentioned. The health care system in Bulgaria does not prioritize mental wellness, which is often seen as separate from physical well-being and not as immediate. Additionally, though substance abuse is usually a result of mental health disorders, it can also be an instigator of such ailments.
    “According to data from the Bulgarian Methadone Association and the Bulgarian Institute for Addictions, there are more than 300,000 drug addicts in Bulgaria.” Health care is also widely inaccessible, with almost half of all medical payments requiring “out-of-pocket” compensation. Finally, nearly 40% of the population is impoverished to some degree, which amplifies mental health struggles disproportionately.
  5. Luckily, steps are being taken to combat social stigmas around mental health disorders and provide resources to those affected. In 2018, the World Health Organization (WHO) implemented mental wellness interventions in Bulgaria. These interventions included providing mental health training to medical professionals, donating funds to support mental health services, creating programs to raise awareness and collaborating with policymakers to establish sustainable solutions. 

WHO’s initiative made a sizeable impact: “In 2018 and 2019, the suicide rate in Bulgaria decreased by 7% compared to the previous biennium.” Similarly, UNICEF is creating an app for young Bulgarians to provide information about mental struggles, personal care advice, links to mental health resources and more. It also strives to create a website that connects Bulgarian youths with mental health professionals.

Though efforts are being made to promote mental wellness in Bulgaria, more can be done to address the ongoing mental health crisis. Government intervention, as well as assistance from WHO, UNICEF and related organizations, is essential in steering the population to a more healthy and optimistic future. With the reduction of social stigmas, a decrease in barriers to health care and the integration of psychiatric care into everyday medicine, Bulgarians can begin to heal themselves holistically for years to come.

– Anna Williams

Anna is based in Burlington, VT, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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Mental Health in Angola

Mental Health in AngolaAngola is a small country situated on the western-central coast of Southern Africa. Generous petroleum and mineral reserves support its fast-growing economy. Collectively, Angola shares a crucial concern for mental health with all 54 countries in Africa. However, the treatment of mental health in Angola has been neglected.

Angola’s Health Care Challenges

Limited funding, inadequate mental health care policies, shortages of health care personnel and deficient training of health care workers are some of the health care challenges in Angola. In terms of health care facilities, there are approximately 3,000 people per facility, indicating a strain on accessibility. Moreover, with only 1.01 beds available per 1,000 patients, there’s a concerning shortage of hospital beds.

The physician-to-patient ratio stands at 0.3 per 1,000 patients, equivalent to around 14,000 physicians, which falls below the World Health Organization’s recommended level. Similarly, the nurse-to-patient ratio is 1.1 per 1,000 patients, suggesting further strain on health care resources. These statistics highlight the urgent need to address funding limitations, reform mental health care policies and invest in health care personnel and training to ensure adequate health care provision for the population.

Further, Angola’s 2023 budget allocated 23% of all government expenditures to the social sector, with health care receiving approximately 7%. However, it falls short of supporting the health care needs of 34.5 million people. For the health development plan to be effective, current statistics and comprehensive data could be utilized to upgrade existing priorities. Comprehensive data would include current population growth, distribution of population, infrastructure needs, financial models and human resources that would upgrade priorities.

Programs Tackling Mental Health in Angola

  1. African Center for Disease Control (CDC): In March 2024, the CDC launched a new Mental Health Leadership Program (AMHLP) to address mental health challenges in several African countries, including Angola. Wellcome, whose mission is to “support discovery research into life, health and well-being,” funded the program. The program aims to “mobilize decision-makers to support countries in reforming services and advising on public health measures to promote and protect mental health and well-being.”
  2. Education: Doctor Alisha Moreland-Capuia is a leading trauma-informed care expert. Her nonprofit, The Capuia Foundation, is constructing the Institute for Trauma-Informed Systems Change in Angola. Counseling and educating the people of Angola about mental health will help them develop a realistic understanding of mental illnesses.
  3. Kassai: Kassai is an eLearning platform funded by the United States Agency for International Development (USAID) and the President’s Malaria Initiative (PMI). This program trains health care workers in malaria, family planning and maternal and child health. By the end of 2022, the Kassai platform had 6,600 unique users and 31,000 course enrollments.

Mental health illnesses are a present-day concern in Angola. However, several programs are being initiated by both the Angola government and nonprofits to address mental health challenges in Angola.

– Pamela Fenton
Photo: Unsplash

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Addressing Mental Health in Lesotho

Mental Health in LesothoThe Kingdom of Lesotho is located in South Africa and has a population of two million. Right now, the country is facing its own unique set of struggles and issues. Concentrated areas are often poverty-stricken due to limited employment opportunities, lack of access to necessities and services, as well as high vulnerability to environmental and economic crises. About 24% of citizens in Lesotho live in extreme poverty, while around 580,000 citizens suffer from food insecurity. Additionally, Lesotho has one of the highest HIV prevalence rates in the world at 22.7% as of 2023, as well as a high rate of tuberculosis, which is greatly affecting the health of the country’s already limited health care workers.

These problems compromise the state of mental health in Lesotho. In fact, the latest report shows that the country had one of the highest rates of suicide in the world for that year, with 87.5 suicide-related deaths for every 100,000 deaths. These numbers are alarming and justify claims that state that there is a mental health crisis in Lesotho. The existence of such a severe mental health crisis serves as a testament to the challenges and stressors endured by the Basotho people.

Despite the acknowledgment of such a crisis, many Basotho will not seek help, whereas many others cannot afford to do so. Lesira Rampa, a Lesotho native, wrote, “Unfortunately, there are numerous challenges in accessing mental health treatment in Lesotho, as evident from the alarming suicide statistics. Despite facing stigma, we encounter several problems, including a shortage of mental health care services and limited financial resources to afford expensive treatments.” In light of these obstacles that prevent Lesotho citizens from accessing mental health services, many organizations such as Help Lesotho, Dolen Cymru and Sentebale are working within the country to assist those in need.

Increasing the Number of Mental Health Care Providers

Lesotho has been suffering from what experts call a “brain drain,” which is the emigration of trained professionals from their country of origin to other countries in order to find jobs. This brain drain has made it difficult for Lesotho to retain a stable number of health care workers, causing a great amount of strain on the physicians and nurses who choose to stay. This shortage has detrimentally impacted the quality and quantity of mental health services available to those suffering from mental illnesses.

Paul Myres, Vice-President of the nonprofit organization Dolen Cymru, told The Borgen Project in an interview that, currently, there are no psychiatrists in Lesotho. In order to remedy this issue, Dolen Cymru administers mental health training, which was developed by the World Health Organization (WHO), to upskill general health care providers within the country. Myres describes the training program as a WHO-designed, multi-professional training program that Dolen Cymru was tasked with implementing. It involved just five days of instruction and relied heavily on algorithms, with a structured approach of asking questions to gather patient information and proceeding accordingly based on the responses.

More than 100 health practitioners received this training, which has aided in improving the understanding of mental health among general Lesotho nurses and doctors. Myres says that the philosophy of Dolen Cymru is to capacitate rather than to provide direct care. Such a unique and innovative philosophy can prove effective in empowering citizens to seek out more information on mental health concerns while preserving their dignity.

One-On-One and Group Counseling

There are a generous number of organizations working in Lesotho to provide help during this mental health crisis, each with its unique approach. Help Lesotho is an organization that focuses on providing one-on-one and group counseling to those in need. Help Lesotho offers a range of non-intensive and long-term intensive self-help and life-skills programs. Its variety of programs is designed to benefit parents, children and communities. These programs address mental health concerns stemming from issues such as poverty, grief and loss, HIV/AIDs and much more.

In 2023, Help Lesotho’s long-term intensive programs had more than 2,000 participants and the organization had one-on-one psychosocial support conversations with more than 960 people. Those who received assistance and guidance from Help Lesotho noticed an increase in confidence, a new-found sense of belonging and a desire to inspire others.

Stigmas: Obstacles To Providing Mental Health Support

Although several organizations are addressing the need for mental health services in Lesotho, certain obstacles can stand in the way of their efforts. It is especially difficult to reverse the effects of the social stigmas surrounding mental health in Lesotho. Meyers mentioned in his interview with The Borgen Project that mental health issues are often seen as a punishment in Lesotho, either for the individual or even their parent’s behavior.

Ms. Mota, a psychiatric nurse at Mohlomi Hospital, has spoken out about these stigmas, stating that “Because of misconceptions and stigma surrounding mental health issues, people sometimes suffer in silence and do not seek treatment for their conditions.”

Thankfully, training and programs such as the ones offered by Dolen Cymru can help reduce the influence of such stigmas. Meyers says that when trainers ask doctors to come up with a list of words describing their initial response to mental health, fear is always at the top of the list. “The good news,” he says, “is that by the end of the week, we ask the same question and that’s all gone.”

Conclusion

Lesotho, just like any country, has its own unique set of stressors and difficulties. Fortunately, organizations such as Dolen Cymru and Help Lesotho are going to great lengths to provide Lesotho with the assistance it needs. However, there is definitely still work to be done.

– Kimber Peters
Photo: Pexels

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Addressing the Homeless Crisis in Slovakia

Homeless Crisis in SlovakiaThe picturesque landscapes and rich cultural heritage of Slovakia often belie the social issues simmering beneath its scenic veneer. The country is grappling with a homelessness problem that demands a compassionate, multifaceted response. This article addresses the homeless crisis in Slovakia in this in-depth exploration of the underpinnings of this societal challenge. Additionally, it provides information about the ongoing efforts to address homelessness.

Understanding the Homeless Crisis in Slovakia

While it is easy to dismiss homelessness as a problem limited to urban centers, the issue is pervasive across various regions of Slovakia. The causes have layers, from economic downturns and job loss to mental health issues and lack of affordable housing. The data is disheartening, with numbers showing an upward trajectory in homelessness, particularly in urban areas. For example, the 2022 population census for Slovakia recorded 71,076 people without homes versus the 23,483 homeless population recorded in the 2011 census.

Exposing the Challenges

Life on the streets is an unimaginable struggle. The lack of a stable home is just the tip of the iceberg for those experiencing homelessness in Slovakia. Affordable housing is scarce, and the domino effect includes limited health care provisions and the perpetual struggle to access social services. For example, according to World Habitat, the limited access to affordable housing in Slovakia is largely due to the fact that there is a shortage of rental properties. Since buying homes is more common than renting in this nation, those who cannot afford to purchase a property are left with limited affordable renting options.

Not to mention, the stigma attached to being homeless exacerbates the challenges of reintegrating into society. Life is incredibly challenging for those living without a stable home, and the men, women and children have access to limited resources.

Government and Community Initiatives

Fortunately, the response to this crisis has been a mix of official and grassroots efforts. The Slovakian government has implemented certain policies aiming to provide shelter and support services to people without housing. Alongside these, non-governmental organizations (NGOs) and community-led initiatives have sprung up to provide practical aid and reconnect people experiencing homelessness with society.

NGOs have led several campaigns to help bring awareness and improve the response to homelessness in Slovakia. For example, NGO volunteers have partnered with STOPA Slovensko to record the population consensus for Slovakia more accurately. A local campaign known as “We Are Not Invisible” also helped bring more awareness to the growing number of homeless individuals needing assistance housing.

Final Thoughts

Homelessness is not an intractable issue. Building a safety net for those who have fallen on hard times is possible with sustained effort. Addressing the homeless crisis in Slovakia has shown promising signs of a society willing to grapple with this crisis. The act of helping is not just about charity but also about justice and societal progress.

Brainstorming quality ideas can help this country, and others experiencing mass homelessness can help solve this issue more quickly. For example, they can build yurt communities for those without housing to live in. Yurts have a long lifespan and are relatively inexpensive shelters. Together, it is possible to create a home for all in Slovakia.

– Kelly Schoessling
Photo: Pexels

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Mental Health Crisis in Irish Travelers Community

Irish TravelersIrish Travelers, also known as Pavee or Mincéirí, are a peripatetic indigenous ethno-cultural population from Ireland. Approximately 0.7% of the total population of Ireland encompasses Travelers, with an estimated 31,000 calling the country home. Historically, Travelers are skilled craftsmen, traders and entertainers, traditionally engaging in tinsmithing, horse trading and storytelling.

This historic and culturally rich population continues to face some of the worst discrimination and poverty of any ethnic group in Europe. Their ongoing struggle, in turn, has engendered a widespread mental health crisis among Travelers groups. In a 2021 report conducted by an Irish parliamentary committee, it was found that 11% of all Travelers die from suicide and have a suicide rate six times higher than their stationary counterparts.

Life expectancy among the Travelers community is up to 15 years shorter than that of the wider population and only 3% live past age 65. These statistics, compounded with an alarming 80% unemployment rate, societal discrimination and lack of education, make the mental health struggles of Irish Travelers a glaring issue that has only been more thoroughly addressed in recent times.

Causes

One of the primary origins of this mental health crisis is the negotiation Travelers must have between assuming their cultural identity and adhering to settled Irish societal norms. This complex and often unbalanced dynamic is exacerbated by legislative measures that impinge upon Travelers and their traditional lifestyle. This includes making it illegal for Travelers to camp on land where they have been for generations and forcing them to rest in halting sites and purpose-built residential accommodations for travelers. Furthermore, economic shifts have rendered traditional Traveler employment scarce, heightening stress and anxiety within the community.

There have even been cases of physical segregation being put into effect, such as walls to separate Travelers from settled people, further symbolizing their social marginalization and actively deepening the population’s feelings of exclusion. Furthermore, pervasive prejudice and discrimination against Travelers persists and profoundly impacts the mental well-being of this group.

The complex and systemic marginalization of this indigenous Irish population by their government and their settled counterparts demands further attention. It calls for a more excellent representation of Travelers in legislative spaces where they can actively challenge the discriminatory practices they are facing.

Efforts

Recognizing the disparities Travelers face, the Minister for Health, Stephen Donnelly, along with other government officials and the Health Service Executive (HSE), unveiled the National Travelers Health Action Plan (NTHAP) 2022-2027. This initiative marks a significant step towards addressing the mental health crisis the Irish Travelers population faces.

In line with the broader objectives of enhancing healthcare accessibility, the plan underscores the importance of preventive measures, promoting healthcare and fostering collaborative engagement with Traveler communities. The comprehensive inclusion of various mental health interventions and robust monitoring mechanisms within the NTHAP can address the vulnerability and risks that Travelers encounter in their efforts to maintain their traditional way of life for hundreds of years.

Final Remark

Through sustained collaboration and investment, the NTHAP represents a landmark initiative fostering mental health resilience and inclusivity within the Travelers community. By addressing systemic factors perpetuating mental health challenges, the plan heralds a future of improved outcomes and greater societal equity for Irish Travelers.

– Ani Gonzalez Ward
Photo: Pexels

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3 Initiatives Improving Mental Health in Kuwait

Mental Health in KuwaitIn the past, much of the stigmatization around mental health in Kuwait has stemmed from the idea that parents are to blame for the mental illnesses of their families and that those seeking help and relief have done so at the cost of their reputations. However, in recent years, Kuwait has been doing much to reframe this narrative in three major ways:

Kuwait’s First Mental Health Law

The Kuwait government issued Law No. 14 in February 2019 to protect individuals with mental health issues. This marked a major stride in the country’s efforts to improve its response to mental health concerns, mainly because there was no previous law governing mental health in Kuwait. Before the implementation of the Mental Health Law, individuals experiencing mental health challenges couldn’t be held at a facility, even if leaving posed a risk of harm. However, Article 11 of the Mental Health Law grants physicians the authority to detain patients for up to 72 hours during an evaluation period (the “Assessment Period”). This detention protects patients and others around them from danger. It also provides a clear guideline for what to do when one is incapable of self-care or consenting to voluntary assessment or treatment.

Additionally, the law sparked the creation of the Mental Health Coordinating Council (MHCC), whose members are responsible for following up on the application of the law and its regulations. The implementation of the MHCC means that for mental health in Kuwait, there is a body of individuals dedicated to protecting the rights of mental health patients by developing policies in their best interests. One of these rights includes the fact that, under the Mental Health Law, those with mental health conditions should not be prohibited from obtaining a job, marking the law’s intent to prevent stigma and isolation for mental health patients in the workforce.

Kuwait’s Response to the Impact of the COVID-19 Pandemic

As a result of the pandemic, rates of anxiety and depression, especially among the elderly and those with disabilities, increased, possibly due to fears about harboring the disease in conjunction with isolation and lockdowns limiting access to medical support. In response, the Kuwait Ministry of Health, through the country’s Center for Mental Health and Central Administration for Primary Care, launched several new initiatives to both improve health care access and overcome the limitations of isolation and lockdowns:

  • The Kuwait Center for Mental Health launched a hotline (+965 2462 1770) that operates daily from 9:00 AM to 5:00 PM.
  • The Ministry of Health launched an interactive platform called “Shlonik,” which provides health information to patients, monitors their safety and provides psychosocial support.
  • Specialized psychiatric clinics delivered psychotropic medicines to patients’ homes, allowing for the continued progress of their treatment.
  • Mental health care providers working in the private sector utilized social media, newspapers and TV channels to provide education regarding coping with psychological problems. Some providers even offered frontline workers free remote psychosocial support.

Nonetheless, it’s crucial to acknowledge that migrant workers and stateless individuals residing in Kuwait, often living in close-knit communities, have disproportionately felt the impact of COVID-19. This is due to their disadvantaged position, as they do not have access to free secondary health care. Access to mental health services remains a significant issue for this demographic, given the steep costs associated with diagnosis, psychiatric consultations and therapy sessions, which are considerably higher than those for Kuwaiti nationals.

The Improvement of Mental Health and Wellness Services in Kuwait

The Fawzia Sultan Health Care Network (FSHN), founded in 2006, is Kuwait’s first and only nonprofit mental health provider. It has been providing many health care services, including family medicine, cardiology, physiotherapy, occupational therapy, speech therapy and psychological services in research and education settings.

While it started as a specialized physiotherapy clinic, the organization soon realized that the health care needs of Kuwait ran much deeper. So, its approach expanded and became much more multidisciplinary. This expansion marked a shift in attitudes regarding mental health in Kuwait and is likely one of the factors that ultimately led to the creation of the Mental Health Law in 2019. The early efforts of FSHN and the later development of the Mental Health Law serve as evidence of the impact that dedication to a specific cause can have, even if that impact is only realized years later.

Final Remark

In a region where mental illness is still considered taboo, the Mental Health Law, along with the impact of health organizations and wellness services, highlights a continuous effort in Kuwait to improve protections for patients with mental illnesses.

– Avery Fuller
Photo: Pexels

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Mental Health in the Gambia

Mental Health in the GambiaManagement of mental illnesses represents a significant challenge yet to be adequately addressed in numerous low and middle-income nations. Such conditions not only escalate the expenses of health care and social support but also correlate with diminished quality of life, unemployment, heightened disability risk and premature mortality.

The Gambia has long marginalized and stigmatized mental health, leading to a gradual rise in mental wellness crises within the nation. With a population nearing 2.8 million as of 2023, the Gambia possesses only one psychiatric hospital in the capital city of Banjul, referred to as Tanka-Tanka, alongside a singular psychiatric outpatient clinic catering to the entire populace. The Tanka-Tanka mental hospital accommodates 100 beds and employs 58 practitioners. These facilities shoulder the responsibility of addressing all documented cases of mental illness throughout the country.

Mental Health in the Gambia Is Still a Major Issue

Widespread societal attitudes that downplay or disregard mental health issues are pervasive in deeply religious nations, perpetuating stigma and discrimination against individuals grappling with such conditions. This trend notably occurs in the Gambia, a predominantly spiritual country. According to the Central Intelligence Agency World Factbook’s (CIA) 2022 publication, approximately 96.4% of the population identifies as Muslims, underscoring the notion that prevailing social perspectives have adversely impacted mental health perceptions in the Gambia.

In Gambian tradition, manifestations of mental disorders frequently get ascribed to spiritual assaults or alleged demonic possession. Unorthodox healing modalities address the presumed “Spiritual Root Cause” through religious and traditional approaches, such as herbal remedies or ceremonial purification rituals. Among these methods, traditional healers also practice soaking and ingesting Quranic verses inscribed on paper. Regrettably, these treatments often disregard the effectiveness of medical interventions.

In a 2015 paper authored by A. Sulaimon and published in the Journal of Health Care for the Poor and Underserved, The paper highlighted how cultural beliefs perpetuate myths suggesting that mental illness is contagious or that individuals struggling with such conditions are inherently violent and unstable. Consequently, this leads to the social ostracization and mistreatment of affected individuals, as families often conceal afflicted relatives to evade community stigma.

Additionally, there is a troubling surge in substance abuse among urban youths, primarily rooted in mental health challenges. The absence of specialized services for addressing drug and alcohol addiction exacerbates this issue. Furthermore, the prevalence of prostitution among young and underage girls, coupled with the underreported and unaddressed problem of sex trafficking, collectively compound the societal challenges impacting mental health.

Initiatives Addressing Mental Health Challenges

The World Health Organization (WHO), through its Mental Health Gap Action Programme (mhGAP), initiated in 2008 and the Mental Health Leadership and Advocacy Programme (mhLAP), introduced in 2010, has emphasized the necessity of expanding mental health services within the country. WHO acknowledges that the presence of sufficient mental health professionals and facilities is essential to address the needs of existing mental health patients adequately. Additionally, such expansion is crucial for implementing an effective early intervention and preventive care strategy.

Mobee Gambia, a Non-Governmental Organization (NGO) dedicated to assisting individuals with mental health challenges, has undertaken initiatives to address mental health concerns in the Gambia. In February 2024, the organization orchestrated an educational event and mental well-being promotion involving a cohort of young individuals. The event centered around the theme of drug and alcohol issues impacting the mental well-being of young people in our communities.

Mobee is currently in the planning stages of establishing offices for administrative purposes to facilitate the implementation of psychoeducation programs to enhance individuals’ physical, social, psychological and emotional health. Additionally, discussions are underway with the Gambia Red Cross and Wyce.org.uk. The collaboration aims to deliver mental health services and programs geared towards enhancing cognitive health in the Gambia.

Conclusion

The involvement of international organizations and government initiatives signifies a positive shift towards addressing mental health in Gambia. While progress may be gradual, the collective impact of various programs and assistance is poised to become increasingly evident over time.

– Olusegun Odejobi
Photo: Pixabay