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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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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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Creative Writing Helps Isolated Individuals Find a Community

Creative WritingCreative writing often emerges as a valuable coping mechanism for mental health challenges. With many individuals experiencing situational depression, such as isolation, creative writing can serve as a means to connect and find solace within a community. Writing groups have increasingly become a famous avenue for individuals to gather, share their passions and support one another. In Brazil, where mental health services are overseen by the Psychological Care Network, i.e., Rede de Atenção Psicossocial (RAPS), incorporating creative writing initiatives into existing support structures could offer isolated individuals a pathway to community connection and emotional well-being.

Challenges in Mental Health Care: The Landscape in Brazil

In Brazil, individuals with disabilities are categorized as disability-adjusted life years (DALY), accounting for more than 7.5% of the nation’s mental health patients. Additionally, there are individuals classified as Institute for Health Metrics and Evaluation (IHME), encompassing a range of physical and psychological health conditions. Regrettably, the prevalence of mental health disorders has been increasing by 0.5% annually, resulting in 57.7% of the population experiencing such conditions as of 2023.

With more than half its population grappling with mental health issues, Brazil finds itself among the nations with the most significant challenges in mental health care. Despite efforts such as World Mental Health Day and other awareness campaigns, considerable strides are needed to address the nation’s mental well-being. In 2020, the COVID-19 pandemic profoundly impacted the globe, imposing lockdown measures in many countries and exacerbating isolation for individuals battling depression. Among the people of Brazil, those residing in the northern regions bore the brunt of the pandemic, with around 84% experiencing depression or anxiety induced by isolation.

Strategies for Coping With Severe Depression

Individuals grappling with severe depression are frequently provided with coping mechanisms aimed at alleviating their anxieties. These strategies encompass a range of approaches, including breathwork, engaging in physical activities, practicing mindfulness and seeking support from loved ones or professional therapists.

Many therapists and mental health advocates endorse writing as a means to express and manage emotions, particularly anger or sadness, offering individuals a sense of empowerment over their narratives. The University of Cumbria promotes writing poetry as a therapeutic activity for National Poetry Day, encouraging students to explore a common theme and gather to share their creations.

In the United Kingdom (U.K.), poetry clubs have emerged as popular venues for isolated individuals to connect with like-minded peers and bond over shared literary interests while enjoying tea or coffee. Established organizations like the Poetry Society, which has been operating since 1909, offer platforms for writers worldwide to showcase their work, including through competitions. Notably, the organization has expanded its reach to publish the works of poets from countries beyond the U.K., such as Brazil, featuring poets like Adelia Prado.

Empowering Mental Health Initiatives 

Regrettably, the mental health campaign in Brazil has not reached as many individuals as intended, possibly due to inadequate funding for mental health services and historical reports of patient mistreatment in psychiatric hospitals during the ‘70s and ‘80s, which has left many Brazilians distrustful of such institutions.

Establishing a creative writing society in Brazil is an attainable goal. Taking inspiration from organizations like UK’s Poetry Society, a Brazilian-based website dedicated to creative writing, could gain traction swiftly and independently without relying on government funding.

 With access to the internet and basic computer skills, individuals can learn to set up and publish their websites, showcasing their literary creations to a global audience. Utilizing website builder tools like HubSpot, WiX, Adobe and IONOS, individuals can customize their platforms and even feature works from friends and family. This endeavor can evolve into a prominent creative writing platform, fostering community engagement and artistic expression. Pre-made platforms like YouTube or TikTok dedicated to content creation can be viable alternatives for those hesitant about website creation.

Individuals without internet access or those who prefer in-person interaction can distribute invitations via community boards or public information centers to promote poetry or creative writing gatherings. Numerous community facilities across Brazil offer spaces for both educational and recreational purposes, serving as ideal venues for hosting writing groups.

In 2018, an exceptional community center called Community Center Camburi was opened. It was built entirely from bamboo! Building the center from bamboo it saves Brazilian financial resources. Centers like Camburi can be used to serve as a place for creative writing groups and those artists can use their creative writing skills to influence others to be more environmentally friendly.

Conclusion

Through diligence, commitment and leveraging available resources, individuals in Brazil can unite around a common theme, fostering connections and reducing feelings of isolation as they exchange thoughts and ideas. Socializing can provide a reprieve from negative thoughts for those experiencing depression, igniting their interests and engaging with others, ideally leading to a more optimistic, vibrant and innovative future.

– Phoebe Vaughan
Photo: Unsplash

Social Health Insurance and Health Care in Indonesia

Health Care in IndonesiaIndonesia still needs to improve its health care. Data from the U.N. in 2022 shows that the median life expectancy in Indonesia is 68.25 years, reflecting an increase in life expectancy in the country. However, this figure is still relatively low. The main health problems in Indonesia are rooted in economic issues.

Access to Health Care in Indonesia

The unequal distribution of health services has resulted in an inability to access health services. With 9,599 health centers and 2,184 hospitals concentrated in the city center, rural dwellers face challenges in reaching these facilities. The slow development of infrastructure has a significant role in the need for health facilities. Data from the “Ministry of Health records that 52.8% of specialist doctors are in Jakarta, while in NTT and other provinces in Eastern Indonesia only around 1-3%.” Health funds in the health law must be 5%, but unfortunately, the Indonesian government only allocates 2.4% of the APBN.

Getting To Know BPJS

Indonesia Health Coverage Program, BPJS, was formed in 2014 to provide health and employment insurance for the public, civil servants and private employees. The legal basis for its implementation is Law No. 24 of 2011. Presently, 249 million Indonesians are registered as BPJS members, making it one of the most extensive programs globally.

One of the BPJS programs is the National Health Insurance (JKN), “an insurance system, where people are required to pay a small contribution as savings for treatment costs when they are sick in the future.” BPJS members receive comprehensive health care services, encompassing treatment and prevention. This includes access to necessary drug services based on medical needs and promotive and preventive services. The latter involves health education, primary immunization (BCG, DPT-HB, Polio and Measles), family planning services (including counseling, essential contraception, vasectomy and tubectomy) and health screening for early disease detection and prevention.

BPJS and Mental Health

Mental health is a big issue in Indonesia. According to data from Basic Health Research, in 2018, 19 million people aged more than 15 years experienced emotional disorders and 12 million aged more than 15 years experienced depression. Additionally, data from Litbangkes indicates an annual suicide rate of 1800 people. The government addresses mental health issues through the JKN program, ensuring comprehensive coverage for every member. This includes consultations, therapy, outpatient care and medications, all of which are fully covered by the JKN program.

The Impact of BPJS on Poverty and the Economy

Health is closely related to poverty and the economy, serving as the first energy base for economic development. When individuals are in good health, they are better prepared for work, contributing to increased productivity and a thriving economy. According to BPJS data, JKS-KIN protected 15.9 million people in 2015 and 14.5 million in 2016. The data from BPJS indicates that JKS-KIN has helped poor people in debt get adequate health facilities and reduce the inequality rate.

– Afra Amirah
Photo: Flickr

Mental Health in Monaco

Mental Health in Monaco Monaco, a country hosting the world’s second-highest population density, is strategically positioned in Europe along the picturesque Mediterranean Sea, sharing its borders with France. Renowned for its affluence, this principality proudly claims a staggering GDP per capita of $240,862 as of the year 2022, a figure that notably surpasses the economic indicators of many other nations and maintains a 0% poverty rate. Tourism, banking and real estate largely drive Monaco’s highly developed and prosperous economy. The lack of personal income tax in this small principality attracts wealthy individuals and celebrities, making it an attractive residence. Despite its economic prosperity, the state has made limited advancements regarding its policy concerning mental health in Monaco.

A Brief History

The history of mental health in Monaco reflects a gradual evolution from limited government attention and action to a more comprehensive and proactive approach involving multiple parties. Historically, mental health was not central to Monaco’s policy landscape. Despite this, the majority of people pay nothing for mental health services in Monaco because of full insurance, this is the same with psychotropic medicines.

The care and treatment of persons with mental health conditions including psychosis, bipolar disorder and depression is also included in the national health insurance or is reimbursed. As of 2020 the number of total treatment cases of psychosis, both inpatient and outpatient, was a population of 245. According to the Mental Health Atlas 2020, the government’s most recent legal effort to protect mental health dates back to 1981, which indicates a relatively long period with limited legislative emphasis on an essential aspect of health care.

This stasis changed with the introduction of the “Psychological Stability and Wellbeing” mental health plan in 2022. The government of Monaco, before this initiative, last implemented a mental health policy in 2014, according to the Mental Health Atlas 2020. Its lack of activity in this regard demonstrates a significant gap in addressing the evolving challenges of mental health, especially considering the aftermath of the COVID-19 pandemic. The government’s unveiling of the new plan differed from previous limited approaches, emphasizing a more holistic and forward-looking strategy.

The New Plan

The “Psychological Stability and Wellbeing” mental health plan represents a landmark development, showcasing Monaco’s commitment to addressing mental health challenges comprehensively. Didier Gamerdinger, Monaco’s Minister of Health and Social Affairs, launched the plan in March 2022, according to the Government of Monaco. He presented it as a five-year initiative aimed at providing extensive health, medical and social services to individuals facing mental health challenges throughout their lives. The collaboration between numerous groups in Monaco including the Department of Justice, National Council, Monaco City Hall, Police Department, Department of Education, Youth and Sport, Department of Social Welfare and Social Services, Princess Grace Hospital, Office of Occupational Medicine, health care professionals and various charities, allowed for the creation of this landmark legislation.

This plan introduces a multifaceted approach, consisting of three main components: the promotion of mental health, prevention, and early identification of mental distress and addiction. With 53 actionable points outlined within these components, the plan aims to be a proactive and adaptable strategy to meet the evolving needs of the population of Monaco.

One notable aspect of Monaco’s mental health strategy is its emphasis on children’s health care and the development of expert-patient programs. By prioritizing these areas, the plan aims to empower individuals with chronic conditions, allowing them to take control of their health, improve their quality of life and enhance their understanding and management of their conditions.

In Conclusion

Overall, Monaco’s history with mental health has undergone a transformative shift, from a historical lack of central focus to the implementation of a progressive and comprehensive mental health plan. The recent initiatives reflect a commitment to providing accessible, extensive, and high-quality mental health services, as well as addressing societal challenges such as stigma and social inclusion. The ongoing efforts underscore Monaco’s dedication to fostering a mentally healthy and supportive community for its residents.

– Ani Gonzalez Ward
Photo: Flickr

The New Reform Benefiting Mental Health in Panama 

Mental Health in Panama The COVID-19 pandemic impacted mental health in Panama and quality of life in 2020. There has been a global spike in psychiatric illnesses and overall quality of life since the pandemic. This event has increased the number of laws worldwide for health care and improved living, especially for citizens with no health care, public health care or, in some places, universal health care.

Mental health in Panama took a toll after COVID-19 and the 2020 pandemic; according to a poll of 480 adults living in Panama, 65.2% agreed the pandemic affected them and 62.9% agreed that mental health declined. In the same poll, 80.8% of participants were women and 37.3% checked off as unemployed. In 2021, the OECD published that the poverty rate jumped 3% in 2020 from 14.6% to 17.8%, and extreme poverty dropped 0.2%.

A Law for the People

The new law 364 in Panama from Feb. 4, 2023, established the human right to mental health assistance nationally. This legislation means Panama recognizes mental health as a human right for every person, with no discrimination against medical backgrounds or income. In this new law, there are 15 articles.

According to Article 1, “insurance companies may not discriminate against people who have mental health conditions when they are contracting a life or health insurance policy.” Article 2 states that “Private health centers providing care for people with mental, behavioral or neurodevelopment disorders may not refuse medical/psychological assistance to a person experiencing a mental health crisis.”

These two articles within the legislation could prove vital in the goals to provide national mental health assistance. Since public health care systems do not cover mental health in Panama, many would have needed private health care even to get coverage to attend a facility. Though citizens still do not get coverage through the new law, it allows private facilities in Panama to treat residents with little to no health care coverage. It also allows citizens with mental health disorders or other medical problems to acquire insurance more easily.

The Right Mindset

The legislation passed aims to promote awareness of mental health in Panama and encourage the public to seek help. A couple of essential objectives; “to guarantee access to quality services for mental health care services, reduce suicide rates and reduce the stigma surrounding mental health,” according to Icaza, González-Ruiz & Alemán. These objectives are essential to the goals set out in this new law. Panama also plans to create an educational program for all schools, private or public. That promotes mental well-being, prevention of mental decline, and signs to be aware of when dealing with someone who has a mental health condition.

Determination to Do Good

Panama rose, determined to do good for the citizens. When this legislation passed in February 2023, the executive branch had six months to regulate it and there has been no report of it since. The plan is to battle mental health in Panama and insurance issues for the citizens so everyone, regardless of income or history, has an equal chance of acquiring better health.

– Liam E. McGrenaghan
Photo: Unsplash

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How Access to Haircuts Empowers the Vulnerable

Access to HaircutsIn the complex landscape of socioeconomic disparities, the simple act of getting a haircut might seem inconsequential to many. However, for vulnerable populations in Brazil and beyond, access to haircuts can be a transformative tool in breaking down barriers and fostering empowerment. This article explores how initiatives providing haircuts to the vulnerable not only enhance physical well-being but also contribute to improved mental health, self-esteem and social integration. 

The Power of a Haircut

Beyond the aesthetic aspects, self-grooming practices contribute significantly to a person’s overall well-being and sense of identity. Maintaining personal hygiene and appearance can boost self-esteem, fostering a positive self-image and confidence in one’s abilities. Personal hygiene and grooming, including haircuts, can significantly impact a homeless person’s ability to secure employment. In the competitive job market, first impressions matter, and a clean, well-groomed appearance signals professionalism and self-care. 

Maintaining good personal hygiene demonstrates to potential employers that individuals value themselves and respect the workplace environment. Unfortunately, for those experiencing homelessness, access to regular grooming facilities may be limited, making it challenging to present themselves in the best light during job interviews. The lack of proper grooming can reinforce negative stereotypes and prejudices, potentially hindering their chances of employment.

Access to Haircuts and Mental Health

Homelessness often exacerbates mental health challenges, as the harsh realities of life on the streets or in unstable living conditions can lead to increased stress, anxiety and depression. The lack of a stable home environment and support systems can further impede access to mental health resources, creating a cycle that underscores the intricate relationship between homelessness and mental well-being. 

The connection between appearance and mental health is also well-documented. For vulnerable individuals, the ability to maintain personal grooming routines, including regular haircuts, can have a profound impact on mental well-being. Feeling clean and presentable contributes to a positive self-image, boosting confidence and self-esteem.

Community-Based Initiatives in Brazil

Brazil has seen the emergence of several community-based initiatives addressing the grooming needs of vulnerable populations. One such initiative is run by Henrique Campos, a local barber co-owner of The Great Barber Shop, in São Paulo, who provides free haircuts to men with scheduled job interviews. Inspired by a friend’s need for a haircut before an interview, owner Henrique Campos decided to extend the offer to others in need. To avail themselves of the service, individuals only need to email evidence of their upcoming job interview. 

Leandro Matias, a hairstylist from Votorantim, São Paulo, has also gained attention for offering free makeovers to boost the confidence of homeless individuals. He has helped over 30 homeless people by offering free makeover services. 

This includes Bruno Henrique Cassimiro Ramos, 33. Leandro, who himself has been helping homeless people for over five years, emphasizes the emotional impact of the makeovers, often bringing clients to tears with gratitude. Bruno’s dramatic transformation, shared on social media, not only led to job offers for him but also garnered support from a dentist and local residents offering clothes and donations, indicating a positive turn in his life.

Access to haircuts might seem like a small step, but for vulnerable populations in Brazil, it can have an enormously transformative impact on empowerment and social inclusion. Initiatives providing grooming services go beyond the superficial, addressing fundamental aspects of well-being and identity.

– Genevieve Martin
Photo: Flickr

Mental Health in Oman

Mental Health in OmanThe Arabian country of Oman is considered a highly developed country, with 0% of its population living below the poverty line. The country, whose primary income is from oil and gas production, reduced the number of those living in poverty by more than half from 1990 to 2015. While Oman remains a luminary in economic diversification and poverty reduction, social stigmas still stunt further development. Mental health treatment in Oman is inaccessible for most.

The Current State of Mental Health

Public Health in Oman has been on a healthy increase for the past four decades, with infrastructure keeping in demand with Oman’s steadily growing population. That being said, mental health facilities are rarely incorporated within comprehensive medical services. 

One impediment to accessing mental health services is the apparent lack of mental health facilities. Oman’s geography consists of sprawling deserts with concentrated pockets of civilization. Subsequently, facilities are often lacking in rural or less populated areas, with an influx in major urban areas. Even when mental health services are available, many people are hesitant to seek help. There is a belief in many Middle Eastern countries that mental health issues are borne of spiritual evils and acts of the devil. As a result, many Omanis prefer to seek traditional healers rather than mental health professionals. 

The Practice of Shackling

Pervasive stigmas in Omani society lead to abhorrent practices, especially in rural areas, known as “shackling.”

Stigma and superstition about mental health in Oman are the reasons why hundreds of men, women and children are confined to filthy, locked rooms. Shackling occurs when people with supposed mental health issues are trapped in a room, often lacking sanitation services and proper nutrition, in an attempt to expel said mental health issues. These appalling practices are ineffective and induce further stress among patients and their families. 

Efforts To Provide Help and Destigmatize Mental Health Services

The Omani government has made minor efforts to improve the public perception and accessibility of services regarding mental health in Oman. Regardless, mental health services are still difficult to find. Certain hospitals such as Al Hayat International Hospital and the Muscat Private Hospital offer mental health services. 

Further development in mental health destigmatization is actually brought by students in Oman. In 2023, students in Oman developed a mobile phone application called Chillax, which helps users assess their mental health needs, book short sessions and learn about mental health conditions. 

There is still much to be done about the public perception and state of mental health in Oman. Following the COVID-19 pandemic, many health care workers experienced mental health issues such as depression and anxiety. Women in Omani society are also especially vulnerable to mental health issues as institutional negligence is often perpetuated by a lack of legal protections for victims of abuse. The confluence of social inequity and perceptual stigma has obstructed access to mental health services in Oman. Hopefully, as awareness is raised by hospitals and the people of Oman, further developments are made possible.

– Inaya Lala
Photo: Wikimedia

Improving Mental Health in Tunisia

Mental Health in TunisiaWith more than half a million of its inhabitants suffering from depression in 2019, the North African country of Tunisia has seen a rise in mental health conditions in recent years. Based on data compiled between 2018 and 2020, the 2021 World Happiness Report ranked Tunisia 122 out of 149 countries in terms of citizens’ overall happiness. Unfortunately, stigma and discrimination surrounding mental health in Tunisia deter those in need from seeking help and treatment, a problem exacerbated by a lack of mental health services and facilities. However, the Tunisian government and several national and international organizations are taking action to improve mental health in Tunisia and ensure its citizens have the resources necessary to lead happy, fulfilling lives.

Factors Impacting Mental Health in Tunisia

Over the last 10 years, Tunisia has been hit by social, economic and political turmoil that has led to a decline in mental health. Mental disorders are responsible for 98% of extended sick leaves among public service sector employees in the country. Yet, many Tunisians suffering from mental illnesses and disorders do not seek help due to persistent “stigma and discrimination against people with mental disorders,” which the WHO has identified as “a significant public health issue in Tunisia.”

Such stigma is prevalent, not only among the general public but also across the country’s health care systems and among health care providers, who receive limited training in mental health diagnosis, treatment and recovery. Similarly, there are limited public programs in place to raise awareness of mental health disorders and promote intervention, prevention and treatment, causing many to feel shame for seeking help for themselves or their loved ones.

Additionally, there are limited resources for those struggling with mental health issues in Tunisia. For instance, as of 2020, Tunisia had only 2.89 psychiatrists, 3.36 mental health nurses and 0.23 social workers for every 100,000 Tunisian citizens, according to the WHO’s 2020 Mental Health Atlas report. The lack of mental health care workers has been compounded by a lack of mental health care facilities across the country, which has only one mental health hospital and 10 psychiatric units in general hospitals.

Consequently, even those who want to seek help often lack access to it. Untreated mental illness can have detrimental consequences for individuals, families, communities and societies as a whole. It often results in unemployment, homelessness, substance abuse and incarceration, profoundly diminishes the quality of life and increases the risk of suicide.

Current Solutions

Fortunately, there is hope for strengthening mental health care in Tunisia and eradicating the barriers that prevent people struggling with mental illness from obtaining help.

With support from the WHO, a group of psychiatrists from Razi Hospital is now working to implement changes that will advance mental health care in Tunisia to a level consistent with its general health care system.

The only public hospital completely dedicated to mental health in Tunisia, Razi Hospital has launched the country’s first anti-mental-health-stigma training for medical students at Tunis Medical School. Introduced in 2017, the program called Responding to Experienced and Anticipated Discrimination (READ), centers on educating future doctors about mental-health-related stigma in order to reduce it and improve the quality and accessibility of mental health care. The program has already shown positive results. In Tunisia, the number of mental health workers per 100,000 citizens increased from 0.20 in 2017 to 8.77 in 2020. Additionally, there was a 1.31% increase in expenditures on mental health research between 2016 and 2019.

The Tunisian authorities are stepping in to improve mental health in Tunisia, as well. In 2020, at the height of the COVID-19 pandemic, the government implemented a Psychological Assistance Unit to address the growing need for mental health support. It also established a toll-free hotline that allowed people struggling with mental health issues to remotely access the services of 240 mental health professionals.

Looking Ahead

In the face of rising mental health challenges, Tunisia is taking significant steps to improve mental health care and reduce stigma. The implementation of the Responding to Experienced and Anticipated Discrimination (READ) program at Tunis Medical School has shown promising results, increasing the number of mental health workers and research expenditures. Additionally, the government’s establishment of the Psychological Assistance Unit and toll-free hotline during the pandemic demonstrates a commitment to providing accessible mental health support to those in need. These efforts offer hope for a brighter future where mental health resources are readily available to all Tunisian citizens.

–Paige Falk

Photo: Pxfuel