In sub-Saharan Africa — a poverty-dense region blighted by infectious disease — there is a relative lack of mental health services. This is partly because most healthcare resources are allocated to infectious diseases, such as HIV/AIDS, malaria and tuberculosis. Ninety percent of malaria deaths, 70 percent of HIV/AIDS cases and 26 percent of tuberculosis cases occur in sub-Saharan Africa. Against this background, mental health problems do not raise an immediate cause for concern; but, mental illness accounts for 10 percent of the disease burden. Child and adolescent mental health in sub-Saharan Africa rates are just as common; 14 percent have mental health problems and nearly 10 percent have diagnosable psychiatric disorders.

The most common mental disorders in the region are depression and anxiety. The prevalence rates of anxiety and Major Depressive Disorder ranges from 40 to 55 percent.

Poverty, warfare and disease identify as vulnerabilities and risk factors to child and adolescent mental health in sub-Saharan Africa. In one study conducted in southern Sudan, researchers found that 75 percent of children suffer from post-traumatic stress disorder. A lack of evidence-based research on child and adolescent mental health in sub-Saharan Africa exists, but psychological distress and mood, conduct and anxiety disorders are common among children who have experienced armed conflict.

In 2011, an estimated 90 percent of children infected or directly affected by AIDS reside in sub-Saharan Africa. Rates of anxiety and depression are significantly higher in children orphaned by AIDS than in healthy children. One study found that 12 percent of children orphaned by AIDS in rural Uganda had suicidal ideations.

There are several challenges to providing quality mental health services in low and middle-income countries. Two of these include cost and the lack of research and needs based assessments. Of all medical conditions, mental disorders are some of the most expensive to treat. In most sub-Saharan African countries, mental health treatment facilities are limited in number and often inaccessible. But without assessments and research demonstrating the value of providing effective treatments and services in the region, improving mental healthcare and its availability to those who need it remains a relatively low priority.

In recent years, mental health has received increased attention and new efforts have developed to improve mental health research and care in the region. In 2011, an association of research institutions and health ministries in Uganda, Ethiopia, India, Nepal and South Africa partnered with Britain and the World Health Organization (WHO) to research the effect of community-based mental health treatment in low and middle-income nations and to develop mental health facilities and services in these areas.

Another effort is the Africa Focus on Intervention Research for Mental Health (AFFIRM), which is working with several sub-Saharan nations on infrastructure development and has conducted a number of randomized controlled trials envisioned to create interventions for severe mental disorders that are cost-effective and widely accessible.

This is only a small sample of the development efforts addressing mental health treatment and services in sub-Saharan Africa. Recognition of mental disorders significance in national health and more intervention research will go a long way toward bettering child and adolescent mental health in sub-Saharan Africa.

– Gabrielle Doran

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