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Street Children in the Comoros

Street Children in Comoros

When one thinks about the issue of street children, the Comoros rarely, if ever, come to mind. Yet, the visibility of children working and living on the streets is a growing reality across the country’s three islands: Anjouan, Mohéli and Grand Comore. For many Comorians, encountering groups of children selling goods or soliciting money and cigarettes on the streets has become increasingly common.

Despite this, institutional policies, government data and international reporting on these vulnerable children remain absent. Although a few governmental programs were implemented in 2021 targeting child labor and education, they remain insufficient and fail to address the increasing phenomenon of street children. Similarly, international organizations are predominantly directing their efforts toward combating child labor and addressing de-schooling, leaving street children, especially those without family support, largely overlooked.

Street Children and Poverty

The causes behind the issue of street children in the Comoros are multifaceted. However, extreme poverty stands out as the main factor. In a country where more than 40% of the population experiences poverty, many children resort to street work to secure basic subsistence or help feed their families. Most of them have left the school system, which, although compulsory until age 15, lacks strong enforcement mechanisms to check and enforce school attendance. In 2023, more than 20% of primary school-aged children were out of school in the Comoros, excluding the high absenteeism rates.

Street Children and Parental Migration       

Another major cause contributing to this problem, closely linked to extreme poverty, is the migration of many Comorian parents to the French-administered island of Mayotte. This mass migration leaves many children homeless as their parents seek better economic opportunities.

Street Children and Mental Health

Children with disabilities and mental health conditions face higher risks of living and working on the streets. This is due to a lack of proper psychiatric care, exacerbated by the presence of only one psychiatrist in the country and the high cost of medications, alongside educational exclusion. According to the most up-to-date UNICEF report from 2015, 73% of these children did not attend secondary school and only 2.9% progressed beyond secondary education, illustrating the exclusion children with disabilities encounter.

Gender-Based Vulnerabilities

Girls and young women are disproportionately affected by educational exclusion and societal norms that promote submission to male authority. This often leads to mistreatment, sexual abuse, early sexual activity starting as young as 12 and unwanted pregnancies. These factors contribute significantly to the increasing number of young women living on the streets, as some parents repudiate their daughters who have terminated unwanted pregnancies.

Life on the Streets Equates Survival

Once children are on the streets, whether they return home after working or both work and live there, survival becomes the primary goal. The lack of reliable housing exposes youth to physical, sexual and emotional abuse. Health issues such as parasitic diseases, pneumonia, sexually transmissible diseases and HIV are common, compounded by past and present trauma. Without adequate support, children become the perfect targets for drug dealers, both as consumers and sellers.

The absence of comprehensive systems and official data exacerbates their plight. The Comoros lacks social structures to shelter street children, with few competent host families. Children’s judges rarely place them under those families and there are not enough inspectors to follow up. The lack of official and international data on the number of children living and working on the street in the Comoros also worsens the situation, as their abuses remain undocumented and unacknowledged, leaving children vulnerable to aggressors who can commit crimes with impunity and many disappearing without anyone noticing.

Efforts Toward Empowerment

Despite the alarming situation, some organizations like Ticket to Life and MAEECHA are working to address these challenges, offering hope for street children in the Comoros. Ticket to Life provides vocational training and education to street children, children with disabilities, refugees and all of those who suffer from poverty. Since its creation in 2022, it has helped 400 children through scouting and sewing training. It enabled some students to open their sewing shops and become an integral part of their local communities, transforming their future. By 2026, Ticket to Life intends to assist another 2,000 children.

MAEECHA operates in Anjouans and focuses on education equality and support for isolated children through its Education, Care, Support and Inclusion (ECMA) program. Its center of professional insertion helps out-of-school children, including those at risk of street involvement due to family breakdown or abandonment. It provides professional vocational training in several fields, such as agriculture, sewing, electronics, carpentry and culinary arts, targeting about 60 children annually. It is supported by partnerships with French and European organizations promoting apprenticeships and certifications.

Conclusion

The phenomenon of street children in the Comoros is a multifaceted issue rooted in systemic poverty, inadequate social structures and violence. Working and/or living on the streets exposes children to sexual, physical and emotional abuse. While Ticket to Life and MAEECHA are making strides in providing support and comprehensive governmental action, the involvement of international organizations focused on this issue and American aid would help address the root causes of street children. It would also help protect the rights and futures of the Comorian children, especially as an increasing number of them attempt to join the French-administered island of Mayotte, often at the peril of their lives.

– Juliette Delbarre

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

Photo: Pexels

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The Positive Situation for Mental Health in San Marino

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

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

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

Mental Health for Old and Young Citizens

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

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

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

Efforts To Address Mental Health in San Marino

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

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

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

– Russell Bivins

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

Photo: Wikipedia Commons

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TikTok Is Addressing Stigma Around Mental Health in the Arab Gulf

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

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

Perception of Digital Mental Health Campaigns in the Arab Gulf

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

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

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

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

Using TikTok To Breach the Stigma Around Mental Health

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

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

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

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

Improving Mental Health Awareness Can Help Alleviate Poverty

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

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

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

Final Remarks

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

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

– Reuben Avis-Anciano

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

Photo: Unsplash

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Youth Mental Health in Nepal: A Collaborative Push for Support

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

Background

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

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

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

Availability of Services

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

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

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

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

Collaborating for Change

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

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

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

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

Jo Malone London and UNICEF

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

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

UNICEF–Z Zurich Initiative

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

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

Youth Mental Health in Nepal

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

– Imge Tekniker

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

Photo: Flickr

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Mental Health Support in Gaza: A Growing Humanitarian Priority

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

Mental Health in Gaza

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

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

The Gaza Community Mental Health Program

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

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

What Success Looks Like

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

The Road Ahead for Mental Health Support in Gaza

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

– Collier Simpson

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

Photo: Pexels

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Addressing Mental Health in Mauritania

Mental Health in MauritaniaMauritania is a country located in northwestern Africa and it severely lacks mental health care. The absence of basic necessities, ongoing economic instability and weak social support systems contribute to the development of mental health issues. Additionally, existing vulnerabilities such as discrimination and social stigma often intensify these struggles.

As of 2025, there is no publicly available data more recent than the 2004 joint study by Mauritania’s Ministry of Health and the World Health Organization (WHO). According to The New Humanitarian, the study found that approximately 34% of the country’s population had experienced a mental health issue. This encompasses a range of conditions including stress, depression and schizophrenia.

Poverty’s Effect on Mental Health

According to the United Nations Children’s Fund (UNICEF), as of 2022, one in four children lives in extreme poverty and 80% are exposed to some form of violence. This contributes to chronic stress and a heightened risk of mental health disorders.

Poverty remains one of the most significant barriers to both physical and mental health in Mauritania. According to the World Bank, rural areas bear the brunt of deprivation due to underdeveloped infrastructure and limited access to essential services. Many Mauritanians rely on informal or subsistence work, which offers little to no financial security, health insurance or protection against job loss.

This instability contributes to chronic stress, especially in households already dealing with illness, trauma or displacement. According to the World Bank, in these communities, even basic health services can be financially and geographically inaccessible, making mental health in Mauritana support a distant priority. The lack of income, combined with social stigma and institutional neglect, keeps many individuals trapped in a cycle where untreated mental health in Mauritania conditions both stem from and contribute to extreme poverty.

Having only one psychiatric hospital, the Nouakchott Centre for Specialised Medicine, with a limited number of beds, the population of Mauritania has very limited access to mental health care. According to Radio France Internationale (RFI), most patients only stay for a few days due to there being a limited number of beds and staff. The hospital only has 20 rooms, according to RFI.

Economic Toll of Untreated Mental Illnesses

The consequences of untreated mental illness in Mauritania extend far beyond individual suffering. They create a significant, long-term burden on the nation’s already fragile economy. Mental health disorders often limit a person’s ability to attend school, maintain employment or care for family members. In a country where 90.9% of Mauritania’s total employment is informal as of 2017, according to the Global Economy, any loss in productivity can have immediate and devastating effects on household income. This is especially damaging for families living at or below the poverty line, who lack savings, insurance or access to consistent medical care.

According to the National Institutes of Health (NIH), it is estimated that depression and anxiety cost the global economy more than $1 trillion each year in lost productivity. Individuals experiencing mental illness often drop out of school or are unable to secure jobs, reducing their lifelong earning potential. According to the United Nations Foundations, in many cases, caregiving responsibilities fall to women and girls, who may leave school or the workforce to support relatives, further entrenching gender and economic inequalities.

Long-Term Impact

According to a study conducted by the Tacoma-Pierce County Health Department in 2016, untreated mental illness can lead to higher health care costs in the long term, as conditions worsen and require more intensive interventions.

Untreated mental illnesses can also lead to social issues such as homelessness. The NIH reported that in 2021, more than 20% of people who experience homelessness also have a mental illness.

Expanding access to mental health care in Mauritania, training professionals locally and integrating psychological support into primary care could reduce long-term public spending while improving workforce participation and overall quality of life. According to the WHO, “every $1 invested in scaling up treatment for depression and anxiety leads to a return of $4 in improved health and productivity.”

Voices From Nouakchott

Despite limited staff, visitors and patients of the Nouakchott Centre for Specialised Medicine are satisfied with their visits. For example, in 2007, according to TNH, Dianaba Dia took her child to see a psychiatrist at the hospital for violent seizures.

“He was a doctor just like any other,” Dia told TNH. “What counts for me though is that since we saw him my daughter has got better.”

Additionally, the scarcity of mental health resources also profoundly affects individuals like Sidi Lemen after a failed attempt to emigrate to the United States in 2025. According to RFI, this setback led to depression and subsequent substance abuse. He sought help from the Nouakchott Centre for Specialised Medicine. However, due to limited resources, he was only admitted for a few days, highlighting the pressing need for expanded mental health services in Mauritania.

“We need to increase the number of beds,” Dr. Mohamed Lemine Abeidi told RFI. “Lots of patients travel long distances to come here, and there’s no other psychiatric care infrastructure.”

Mauritania faces significant challenges in providing mental health care not only because of the limited number of beds, but also due to a scarcity of trained professionals. According to France 24, all of the country’s psychiatrists have received their training abroad, highlighting the absence of local educational programs in this field.

Hope for Health Care

Mauritania’s mental health crisis is deeply intertwined with poverty. However, recent initiatives offer a glimmer of hope. The World Bank has launched a national program aimed at improving health services for approximately 2.5 million people, focusing on women, children and adolescents in underserved communities. This program aims to improve primary health care and increase access to mental health services.

Additionally, the United Nations High Commissioner for Refugees (UNHCR) is working closely with the Mauritanian government to integrate refugees into national healthcare systems, including mental health support. These collaborative efforts aim to build a more inclusive and resilient health infrastructure.

Despite these promising developments, significant challenges remain. According to Alima, the Mbera refugee camp is operating beyond its capacity, housing more than 116,000 refugees in a space designed for 80,000. This overcrowding exacerbates the strain on already limited mental health resources.

– Clarissa Dean

Clarissa is based in Bowling Green, KY, USA and focuses on Good News and Celebs for The Borgen Project.

Photo: Pexels

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Shifting Focus on Mental Health in Saint Kitts and Nevis

Mental Health in Saint Kitts and NevisMental Health in Saint Kitts and Nevis, formally known as the Federation of Saint Christopher and Nevis, has become a growing concern in recent years. A lack of prior funding and persistent cultural stigma around mental illness have left behind limited infrastructure for the country’s mental health care. Recently, however, the federation announced a shift in strategy, dedicating greater focus and more resources to mental health in Saint Kitts and Nevis. This new approach can potentially redefine how the developing world addresses mental health concerns.

Global Trends in Mental Illness

Mental illness is a growing concern globally, particularly in the developing world, including Saint Kitts and Nevis. According to the World Health Organization (WHO), in 2019, approximately 970 million people had some form of mental disorder. While still a global minority, this accounts for more than 10% of the population who had to deal with additional barriers in their day-to-day lives.

It is also important to note that mental illness does not affect all equally. Other negative situations in life, such as poverty or violence, can cause or worsen mental illness. This makes developing nations particularly vulnerable as they have larger impoverished populations. On top of that, many nations have limited support systems and cultural stigmas on the topic, which prevent many of their citizens from getting the care they need.

Challenges to Mental Health in Saint Kitts and Nevis

The Islands of Saint Kitts and Nevis have historically struggled with limited funding for mental health services. In 2007, the Federation raised its spending on mental health services to just 1%. While this was still an increase from even lower rates, which had not been adjusted since 1956, the country still lacked major infrastructure to offer help. Limited resources, including needed medicine and trained staff, mean that only the most severe cases in patients receive treatments. Approximately 1% of the population of Saint Kitts and Nevis has been diagnosed with some form of mental illness.

Poverty has also been a significant barrier to accessing mental health care in Saint Kitts and Nevis. In 2008, about 21.8% of the population was below the poverty line. However, due to increased government response, this percentage began to decline slowly but surely. The government sped this up by simultaneously funding public health, so potential patients did not have to pay out of pocket.

Not only can poverty lead to or worsen mental illness, it can also impact a patient’s ability to get care. Research shows that those living in impoverished conditions are less likely to seek help and less likely to receive it if they do.

Mental Health Initiatives in Saint Kitts and Nevis

On November 27, 2024, the Ministry of Health in St. Kitts and Nevis launched its Mental Health Service Systems Enhancement Project. The project, supported by the government and funded in part by Taiwan, aims to expand access to mental health services by increasing funding and strengthening mental health infrastructure. The nation’s Prime Minister and head of the health Ministry, Terrance Drew, also emphasized the importance of this initiative and the nation’s renewed focus on improving the mental health of Saint Kitts and Nevis.

The most prominent counseling center, known as the Dr. Arthur W. L. Lake Mental Health Day Treatment Centre, offers high-quality mental health services and follows a patient-centered approach. For instance, it aims to fight the stigma around mental illness in Saint Kitts and Nevis by providing home-like and comfortable conditions, and some patients even shared their stories and how the center helped them.

The Future of Mental Health Care in the Developing World

While Saint Kitts and Nevis still have a long way to go, its new focus on mental health care is a refreshing step in the right direction. Despite limited infrastructure and combating a cultural stigma, the islands have been making positive steps towards better care. In particular, increases in government funding and foreign aid have given the country more resources in its fight. If the country sees positive results with this project could serve as a blueprint for effective strategies to address and improve mental health in other developing nations.

– Jesse Correll

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

Photo: Unsplash

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Mental Health in Saint Vincent and the Grenadines

Mental Health in Saint Vincent and the GrenadinesSaint Vincent and the Grenadines (SVG) is a 389-square-kilometer, multi-island country in the Caribbean. SVG achieved full independence from the United Kingdom on October 27, 1979. The population is 104,300, with 30% living in poverty. Poverty, lack of mental health professionals and social stigma impact mental health in Saint Vincent and the Grenadines. La Soufriere volcano erupted in 2020 and 2021 while the country was still reeling from the impact of the COVID-19 pandemic. About 22,400 people were evacuated. The devastation of the pandemic and volcanic eruptions has further impacted the mental health struggles of Vincentians.

The government of SVG continues to make efforts to advance treatment for mental health conditions. Although increasing care and resources for the mental health community in SVG has been difficult, it has made improvements.

Mental Health and Post-Colonialism

Colonialism has had a long-lasting impact on trauma-based mental health struggles. The legacy of colonial-era psychiatry shaped social stigmas around mental health diagnosis and care. For example, enslaved Africans brought to the Caribbean were diagnosed as mentally ill if they tried to escape their masters. Post-abolition psychiatric treatments included locking patients in asylums, away from society. However, a broader, more comprehensive approach to reframing mental health diagnosis and care can help overcome stigma.

The Mental Health Centre 

Saint Vincent and the Grenadines has one psychiatric hospital called the Mental Health Centre. The colonial British Government was built it in 1938 to keep psychiatric patients away from society. It was designed to house 90 patients.

The center serves a different purpose today. It provides inpatient, outpatient and drug rehabilitation services. It can now house more than 160 inpatients. As of 2020, the total number of hospital admissions was 401, with 387 being involuntary. About 29.4% of inpatients stayed in the center for less than a year. 

Schizophrenia, substance abuse and related disorders, such as psychosis, are the main mental health conditions that receive treatment in SVG. As of 2020, out of 1,125 treated cases of psychosis, 954 were men and 171 were women.

Suicidal behavior among Vincentian adolescents is disproportionately high at 26%. Economic class disparities, substance use, being bullied, access to mental health services and loneliness are all risk factors.

Legislation

SVG passed the Mental Health Act in 1981 and amended in 1991. It includes sections for admission to the psychiatric hospital, mental review board, approved homes, and protection of property of persons suffering from mental disorders.

Psychiatrist Shortage in SVG

The shortage of psychiatrists in Saint Vincent and the Grenadines is alarming. The Saint Vincent Times explained in an April 7, 2025 article, “The recruitment of mental health professionals is hindered by various factors, including limited resources, inadequate incentives and the growing global competition for qualified psychiatrists.” The government of SVG is aware of this issue and is working to recruit qualified mental health professionals.

Government Efforts To Improve Mental Health in SVG

The government, led by Prime Minister Ralph Gonsalves, recognizes that mental health services in Saint Vincent and the Grenadines are still weak. Gonsalves has expressed the importance of providing mental health support to marginalized groups such as prisoners and disaster survivors. 

About 6% of the government’s health expenditure goes to mental health care. Mental health services and medication in SVG are free of cost to patients and national health insurance covers them. However, it is a cost to the state. The state’s limited resources continue to be a challenge to improving mental health services for Vincentians. Additionally, the stress of poverty and lack of employment leads to increased depression, anxiety, and other mental health struggles.

Examples of mental health programs implemented by the government include Mental Health Awareness, Mental Health and Suicide Awareness and Psychological First Aid and counseling.

Conclusion

Although SVG has made progress, mental health in Saint Vincent and the Grenadines still has a long way to go. Ongoing efforts to address poverty, increase mental health awareness, fund mental health programs and recruit mental health professionals will help close the gaps in SVG mental health care needs. 

– Vijji Michael

Vijji is based in New York, NY, USA and focuses on Good News and Global Health for The Borgen Project.

Photo: Wikipedia Commons

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Making Mental Health in Global Aid a Priority

Making Mental Health a Priority in Global AidMental health remains underrepresented in global humanitarian response. According to the World Health Organization (WHO), common mental health conditions account for 10% of the global disease burden, yet mental health programs receive less than 2% of international health funding. In humanitarian settings, mental health challenges are widespread: data from the United Nations High Commissioner for Refugees (UNHCR) indicates that up to one in three displaced individuals may experience depression, anxiety or post-traumatic stress. In conflict zones, refugee camps and low-income communities, unaddressed trauma and psychological distress hinder recovery, education and development. These conditions often go untreated, limiting the effectiveness of education, health and livelihood interventions.

Mental Health in Crisis Settings

Access to mental health care remains limited in many low-income countries. In Syria, more than half of displaced children report symptoms of depression and anxiety, but only a small portion receive psychological support, as reported by Médecins Sans Frontières. Children with untreated mental health conditions often struggle in school. Adults experiencing psychological trauma may find it difficult to participate in the workforce, while entire communities suffer from weakened social cohesion. These ongoing challenges perpetuate the cycle of poverty.

A Shift Toward Integrated Solutions

Several organizations now recognize the value of integrating mental health into humanitarian aid. The International Rescue Committee (IRC) equips local health workers in Lebanon and South Sudan with training in psychological first aid and ongoing mental health care. This approach ensures sustainability and culturally appropriate care while reducing stigma.

In Nepal, Transcultural Psychosocial Organization (TPO) runs community-based mental health programs that are both cost-effective and scalable. By training teachers, social workers and community leaders to identify and refer individuals with mental health needs, TPO Nepal ensures that services reach even the most remote areas. These community-based models improve sustainability and reduce stigma.

Mental Health Crisis Among Marginalized Groups

Even in high-income nations, marginalized communities face significant mental health challenges. Indigenous groups in Canada and Australia report high rates of suicide and depression linked to intergenerational trauma and systemic neglect. A 2023 report by the United Nations Permanent Forum on Indigenous Issues called for culturally grounded mental health services as part of international development partnerships.

In British Columbia, Canada’s First Nations Health Authority has launched community-led healing programs rooted in Indigenous traditions. These initiatives, supported in part by development funding, serve as a model for mental health in global aid that respects cultural identity while addressing clinical needs.

Likewise, refugee communities in Europe face significant barriers to mental health care. Programs like the Mental Health and Psychosocial Support Network bridge the gap by providing trauma-informed therapy to displaced people from Syria, Afghanistan and other war-torn countries. 

The Economic and Social Payoff

According to the World Bank, each dollar invested in mental health generates a $4 return through better health outcomes and increased productivity. According to the WHO, untreated depression and anxiety in low-income countries cost  $1 trillion annually. Moreover, mental health support enhances the effectiveness of other aid sectors. For instance, in education, children receiving psychosocial support are more likely to stay in school. In post-conflict reconstruction, communities with mental health services are better equipped to rebuild trust and social infrastructure.

Moving Forward

Expanding the role of mental health in humanitarian aid involves increasing financial investment, integrating psychological support into broader health initiatives and supporting community-based, culturally informed services. Training local health workers can potentially improve the accessibility and continuity of care while helping reduce stigma. As humanitarian needs become more complex, aligning mental health with long-term development efforts could enhance the overall effectiveness and sustainability of global aid.

– Rhasna Albuquerque

Rhasna is based in Fortaleza, Brazil and focuses on Good News and Celebs for The Borgen Project.

Photo: Flickr

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Mental Health and Homeless Youth in East Asia

Mental Health and Homeless YouthHomelessness and mental health are problems that exist around the world, developed and undeveloped countries alike. Among homeless youth in East Asia and Southeast Asia, mental health is a massive issue. These youth typically become homeless due to past abuse, and usually experience more while on the streets; past research has shown that homeless youth are highly susceptible to sexual exploitation and prostitution. 

This demographic of homeless youth reports high rates of mental health issues, such as depression, PTSD, bipolar disorder and suicidal ideation, with suicide being their leading cause of death, and 80% of the population having reported attempting suicide at some point. To cope with these issues, many turn to substance abuse and other maladaptive coping mechanisms. 66.7% report drinking problems, and 77.8% report smoking problems. 

Causes of Homelessness

There are various reasons why youth become homeless in the first place. It is worth mentioning that one primary cause of poverty in the East Asian Pacific region is natural disasters. Natural disasters like earthquakes and tsunamis affect East and Southeast Asia more than most other regions in the world, making them a significant and notable contributor to homelessness that might not necessarily apply or apply as much to other regions around the globe, according to a 2024 article.

Poverty can cause stress and subsequent dysfunction in the home, driving children and young people away. A 2024 article found that parental abuse was the most common reason (40.7%) for leaving home, especially from fathers. General family conflict follows at 29.6%. 

Cultural Differences

Treating these problems requires understanding and accommodating the differences in cultural attitudes between Eastern and Western societies. Due to the way Eastern cultures raise kids to view themselves, their obligation to and role within family and the way they view mental health itself, means that Western mental health techniques do not always transfer or have the same result.

For example, Western programs tend to emphasize working with direct service providers and place a lot of value on individual autonomy. Conversely, services and government interventions in the East Asian Pacific regions might put more emphasis on family and community support.

Few components of culture influence mental health and responses to mental health treatment. The first is emotional expression: depending on what level of emotional outburst or emotional behavior is considered acceptable in a given culture, it will be easier or harder to identify when a person needs help. The second and likely most influential element is shame: many cultures, especially Asian cultures, see mental illness as something shameful or born out of weakness.

Individuals may be hesitant to seek treatment because it means admitting to themselves and to a mental health professional that they are struggling. Individuals may also be reluctant to interact with a mental health professional because of the third element, “power distance,” according to the Frontiers in Public Health. Regulations on mental health treatment and the power given to mental health professionals vary from country to country, having varied implications about autonomy and the power dynamic within a therapeutic relationship. 

Results 

A 2024 article revealed the results of eight studies conducted throughout Malaysia, South Korea and the Philippines. These studies researched the impacts of various mental health interventions on homeless youth, including art therapies, cognitive behavioral therapy (CBT), life skills education (LSE) and government services.

A Philippines-based study found visual art and poetry psychotherapies to be effective for abused adolescents in reducing symptoms of PTSD and depression, measured via Child Report on Posttraumatic Symptoms (CROPS) and Self-Rating Depression Scale (SDS). It was noted that art therapies seemed to also help empower homeless youth to engage actively in their own treatment.

A study on CBT implemented in South Korea measured impacts on depression, self-efficacy, and self-esteem. While the treatment resulted in increased self-efficacy and a significant decrease in depression, there appeared to be no significant difference in self-esteem pre- and post-test. LSE treatment, however, was successful in increasing self-esteem, as well as decreasing anxiety, depression and stress, according to a study out of Malaysia.

Closing Thoughts

While these mental health interventions have appeared to be successful, one of the key takeaways is that it is difficult to treat this demographic when there is no universally accepted definition of homelessness. Every study and every country uses different definitions, which leaves large gaps in understanding both the nuance and variation within the “homeless” experience and the actual overall figures of the demographic. Whether or not an individual fits within a jurisdiction’s given definition of homelessness may determine whether or not mental health and homeless services are provided to them; this makes the varying definitions of homelessness a possible barrier to mental health services. 

– Sandhya Mathew

Sandhya is based in Los Angeles, CA, USA and focuses on Global Health for The Borgen Project.

Photo: Pixabay