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Mental Health in Namibia 

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

Poverty and Mental Health in Namibia

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

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

HIV and Psychological Issues

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

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

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

Cultural Influences

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

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

Solace in Drugs and Alcohol

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

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

Alleviating These Issues

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

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

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

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

– Mustafa Tareen

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

Photo: Flickr

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IDIL: Mental Health Access for Indigenous People in Oaxaca

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

The International Decade of Indigenous Languages

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

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

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

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

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

Implementation of ENHP

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

Importance of Reconceptualization

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

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

Impacts of the IDIL

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

– Tanisha Groeneveld

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

Photo: Flickr

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Initiatives Supporting Mental Health in Zimbabwe

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

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

The WHO’s Special Initiative for Mental Health

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

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

The Zimbabwe Life Project

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

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

Conclusion

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

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

– Alysha Miller

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

Photo: Flickr

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Causes of Mental Health in Estonia

Mental Health in EstoniaThe people of Estonia have been grappling with mental illness for years. With a population of 1.3 million, approximately 20% are affected by anxiety and depressive disorders. Several factors contribute to the high rate of mental illness in the country, including gender, economic status and the impact of COVID-19. However, a significant factor is the existing policies regarding mental health.

Gender Differences

Worldwide, women are at a higher risk for certain mental illnesses than men. Women are more likely to have mental distress like anxiety, depression, eating disorders and more. At the same time, men are more likely to have Attention-deficit/hyperactivity disorder (ADHD) and autism.

A 2021 post-COVID-19 survey in Estonia revealed that 31% of women in the study had developed depression, 25% had anxiety and 44% experienced sleep disorders. While women showed higher rates of certain mental disorders, men had a significantly higher rate of alcohol addiction at 34%, compared to 17% among women.

The Effects of Socioeconomic Status

The economic status of certain demographic groups in Estonia also correlates with higher levels of mental distress. According to the National Library of Medicine, “lower personal income was associated with higher rates of all mental health complaints (stress, depressiveness, overtiredness and suicidal thoughts) among employed adults in Estonia.” Economic status is not the only socioeconomic factor contributing to the rise in mental distress in Estonia.

Education has also been identified as a high-risk factor for mental health disorders. “The mental health of Estonian students has never been as critical as today.” Compared to other European countries, Estonia’s student population has twice as many reported mental health 0issues. In 2021, 5% of students across Europe were admitted to university with mental health problems, while Estonia’s rate was 9%.

COVID-19

COVID-19 significantly contributed to a global increase in mental distress and Estonia is no exception. The country continues to feel the effects of the mental strain left by the pandemic. According to the Health Systems and Policy Monitor, a 2022 study revealed that one in four adults in Estonia is at risk of developing depression in the aftermath of COVID-19.

Furthermore, a survey conducted by the National Library of Medicine found that elite athletes in Estonia experienced high levels of mental distress when COVID-19 hit. Female athletes showed higher distress levels than their male counterparts. With competitions canceled, training facilities closed and face-to-face coaching suspended, stress levels among athletes soared.

Policies

Estonia’s mental health services have improved in recent years due to continuous policy changes. Initially, the country had only drafts of policy documents for mental health services. However, as mental distress increased among its citizens, Estonia updated and strengthened its policies to address the growing need.

The Health Systems and Policy Monitor (HSPM) Network has provided an update on future policy changes aimed at improving mental health in Estonia. Due to the impact of COVID-19 and the rise in mental illness among low-income groups, policymakers have made mental health initiatives a top priority. A new “Mental Health Action Plan” is set to take effect from 2023 to 2026.

The Mental Health Action Plan details anticipated changes in the field of mental health. The plan emphasizes the Ministry of Social Affairs’ (MoSA) role in implementing these changes. It recognizes that addressing issues in mental health will require additional actions beyond what is currently outlined and achievable within the plan’s timeframe.

Conclusion

Mental distress can affect individuals regardless of gender or socioeconomic status, highlighting a widespread issue. However, positive strides have been shown, as evidenced by the significant improvements in Estonia’s mental health services in the past 10-15 years.

– Ashley Diaz

Ashley is based in Homestead, FL, USA and focuses on Global Health for The Borgen Project.

Photo: Flickr

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Migration to Bosnia and Herzegovina

Migration to Bosnia and HerzegovinaThe Balkan country of Bosnia and Herzegovina experienced the displacement of more than 2.2 million of its citizens during the 1992-1995 Bosnian war. However, now Bosnia and Herzegovina is at the forefront of a new migration crisis due to increased rates of global poverty and conflict. Since 2018, more than 110,000 migrants have entered the Balkan country. The numbers first increased in 2018 after 24,067 migrants and refugees arrived in the country compared to 755 in 2017. Despite migration challenging the infrastructure of Bosnia and Herzegovina, obstacles are often overcome thanks to the cooperation of various international institutions and charities

Western Balkan Migration Route

Bosnia and Herzegovina falls within the Western Balkan route, popular among migrants who look to enter EU countries. From January to September 2023, the International Organization for Migration (IOM) recorded 128,871 migrant, refugee and asylum seeker arrivals through the corridor. The large number and potential for an unexpected increase of migrants strain Bosnia and Herzegovina’s resources.

However, the IOM, UNHCR and EU provide financial support for the country to ease the pressure of this corridor on countries like Bosnia and Herzegovina and to protect migrants. The “Individual Measure to Strengthen the Response Capacity to Manage Migration Flows in Bosnia and Herzegovina” project aims to transfer the migration response to Bosnian authorities.

This project continues to receive considerable funding. In August 2024, The IOM confirmed 100% of the financing for protection management for the arrival of migrants into Bosnia and Herzegovina.

Accommodation for Migrants

The increased number of migrants in 2018 strained infrastructure in Bosnia and Herzegovina. Collaboration between the country’s Ministry of Security (MoS) and the IOM facilitated the creation of seven temporary reception centers (TRCs) to house more than 8,000 migrants.

In 2018, the IOM revealed that the national infrastructure was not adequate to house the sudden influx of migrants in Bosnia and Herzegovina. The closure of TRC Lipa and Bira in 2020 reduced overall accommodation capacity from 8,282 to 3,540 beds.

Despite the challenges of accommodating migrants, international cooperation has helped resolve these problems. In 2021, a newly built TRC Lipa increased its accommodation capacity to 1,500 migrants compared to its prior 1,400 migrant capacity. Johann Sattler, Head of the EU Delegation, commented on the opening of TRC Lipa: “This is a good reminder for all of us that those crises can be solved, and the only way to resolve crises is through dialogue and a willingness to compromise.”

War and Poverty

In July 2024, the UNHCR reported that the top three countries of origin of migrants in Bosnia and Herzegovina were the Syrian Arab Republic (35%), Afghanistan (29%) and Morocco (8%). The high number of Syrians and Afghans in Bosnia and Herzegovina correlates to the high levels of poverty in these countries due to war. In 2022, poverty affected 69% of Syrians and 90% of Afghans.

Mental Health

Migrants often face traumatic journeys that have psychological impacts. Adil, a Moroccan migrant who resides in TRC Lipa expressed how migration impacted his mental wellbeing to the IOM: “This journey is hard and dangerous. I have seen and experienced things that I do not want to remember.”

There are ongoing efforts by the IOM and Bosnian authorities to provide mental health support for migrants. The IOM continues to provide mental health screening for migrants inside and outside TRCs and aims to increase mental health support access for migrants in Bosnia and Herzegovina.

Between April 2024 and July 2024, the UNHCR assisted 585 migrants with psychosocial support.

Cultural Programs for Migrants

Alongside the efforts of international organizations and the Bosnian government to integrate migrants into the workplace and provide psychological aid for migrants, cultural programs also help improve their well-being.

In 2024, IOM ran creative programs in multiple TRCs. TRC Blažuj held a canvas painting workshop which allowed migrants to express their creativity. TRC Lipa has a creative zone where handcrafting workshops were held for migrants and refugees from Afghanistan, Gambia, Iran and Syria.

Cultural programs extend beyond reception centers in Bosnia and Herzegovina into mainstream society. Migrants from reception centers contributed to a fashion collection for The No Nation Fashion brand showcased at the 30th Sarajevo Film Festival.

Cooperation for Solutions

The impact of global poverty meant the influx of migrants to Bosnia and Herzegovina from 2018 onwards presented challenges to the country’s infrastructure and the safety of migrants. However, cooperation between the former Yugoslav country, international governments and organizations shows the capacity to overcome the potential challenges of migration to improve the quality of life of migrants.

– Sofia Brooke

Sofia is based in Oxfordshire, UK and focuses on Good News and Politics for The Borgen Project.

Photo: Flickr

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The Chomuzangari Cooperative: Food Security in Masvingo

The Chomuzangari Cooperative: Food Security in MasvingoIn many rural, impoverished parts of Zimbabwe, women are the primary producers of staple food within households. However, many face discrimination that detracts from their access to resources and decision-making capabilities. The Chomuzangari Cooperative bolsters female participation, empowerment and mental health in these areas. Furthermore, the Cooperative directly enhances food security, water access and education. Individuals who have directly experienced the challenges of rural life in Zimbabwe drive the success of the Cooperative. The Welsh Government, through Hub Cymru Africa, largely funds and supports this initiative.

Women in Masvingo

In the Chivi District of Masvingo Province, where women form the majority of the population at 787,098, they traditionally play a diminished role in community decision-making. The Chomuzangari Cooperative aims to empower these women by boosting their confidence and self-esteem, ensuring their voices are heard and their participation increases. The theory is simple: with more resources and confidence, women can enhance food production in the area. A significant method for bolstering self-esteem is through education. To make education more accessible to everyone in the community, the Cooperative has introduced e-learning resources, including Raspberry Pi technology.

Mental Health

In addition to enhancing learning, water access, sanitation and hygiene, the Cooperative also focuses on destigmatizing mental health in Zimbabwe. Typically, mental health services are concentrated in hospitals in major urban centers, leaving rural areas poorly served. Rural mental health care suffers from stigma, resource constraints and staff shortages. Moreover, care for the mentally ill often falls on women, which can be traumatic and detrimental to their mental health. By boosting female self-esteem, the Cooperative hopes to not only support women through these challenges but also empower them to advocate for improvements in the mental health system.

3 Success Stories of Women in Masvingo

  1. Nutritious Veg Gardens. By encouraging women in Masvingo to gather and share nutrient-rich recipes and foods, the community saw a significant boost in local nutrition. Women in the area started a one-hectare nutrition garden where they planted nutritious crops such as rodade tomatoes, Texas Grano onions, cabbage, kale and much more. This initiative dramatically improved the quality of life for women and enhanced food security in the region, as it eliminated the need for women to travel 90 kilometers to Chivi Growth Point or 140 kilometers to Masvingo town to buy fresh vegetables.
  2. Access to Clean Water. Following a collaborative initiative with Hope Foundation, funded by the Welsh Government, thousands of Chomuzangari residents now have access to clean drinking water. The program financed the installation of a borehole, a solar pump and a 5,000-liter storage tank. Local volunteers contributed by making bricks and installing parts of the system. This development ended the previous burden of walking 3-8 kilometers to collect water. Now, nearly all women in the district live within 500 meters of a water point. This significantly reduces food insecurity and prevents children from missing school to fetch water.
  3. Protection of Crops. Due to a new fence constructed with the help of 67 volunteers, 600 women can now grow more food for their families. This fence, which encloses a hectare of garden space for growing vegetables, was funded by a grant from the Welsh Government. The initiative recognizes that protecting crops from animals is essential for fostering food security in the region.

Looking Ahead

The Chomuzangari Cooperative has significantly enhanced the perception of women and the quality of life in entire communities throughout the Masvingo region. Before the project began, the changing climate, discrimination and limited resources severely hindered women’s ability to provide food for their families. Although these challenges persist, the Cooperative’s ongoing efforts and funding have greatly mitigated their impact.

– Bea Newington-Bridges

Bea is based in Edinburgh, Scotland and focuses on Good News and Global Health for The Borgen Project.

Photo: Flickr

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How Inequality and Mental Health Fuel Global Poverty

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

Understanding Global Inequality

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

Psychological Dimensions of Inequality

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

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

Mechanisms Perpetuating Poverty

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

Global Efforts to Tackle Inequality

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

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

Conclusion

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

– Sandeep Kaur

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

Photo: Pexels

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Improving the State of Mental Health in Suriname

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

The Mental Health of Indigenous Peoples

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

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

Youth and Women

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

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

Supporting Mental Health Services

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

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

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

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

Conclusion

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

– Tanisha Groeneveld

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

Photo: Flickr

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Ethiopian Mental Health: Challenges and Progress

Ethiopian Mental HealthThe world is becoming much more aware of mental health issues. Countries all over the world are looking for solutions to mental health issues. However, poorer countries are working at a disadvantage. Ethiopia has been able to overcome this disadvantage and improve its mental health care.

Ethiopian Mental Health Issues

Ethiopia has been looking for ways to improve mental health for years. As recently as 2021, it had included mental health services in the health extension package but had not implemented any changes. The lack of any action was due to many factors. Some include “low political commitment, lack of resources, non-functional referral system, lack of interest from private health care organizations,” stigma within the culture and poor reporting, according to Dove Medical Press.

One of the biggest factors is the stigma and discrimination of mental health issues in Ethiopia. A majority of the people in Ethiopia follow Ethiopian Orthodox Christianity. Some followers of this form of Christianity believe demonic possession is the cause of mental health issues, which could prevent people from speaking up on these issues. This presents a huge hurdle into addressing Ethiopian mental health.

The Ethiopian government is currently using the media for advocacy of mental health issues. Its strategy is to reach the Federal Ministry of Health, general and mental health physicians, mental health service users and providers and the general population.

The battle against the stigma is just half the battle. Even if the stigma issue was removed, Ethiopia does not have enough physicians to sustain an increased volume of patients. In 2022, Ethiopia had 1.08 physicians per 10,000 people.

Solutions

The Federal Ministry of Health in Ethiopia along with the World Health Organization (WHO), European Union and Foundation d’Harcourt have worked together to implement the Mental Health Gap Action Programme (mhGAP). This program aims to help low and middle-income countries scale up their mental health services.

Dr Tedla Wolde-Giorgis, Mental Health Advisor in the Office of the Minister of the Ethiopian Federal Ministry of Health explains that the program’s goal is “to integrate mental health in the existing primary health-care system by leveraging the existing health delivery platforms. The strategy that we developed emphasizes the training of health staff on mental health issues using the mhGAP programme and making sure that they are provided with close supervision and oversight at the different health centres. To this end, the mhGAP training materials and approach was very helpful to us.”

The program has made some huge progress quickly. As of March 2023, a total of 1,230 general health care workers received training from mhGAP.

The Future

The progress in the Ethiopian mental health landscape illustrates the challenges and opportunities that many low- and middle-income countries face. While there are many obstacles like stigma, resource constraints, and limited healthcare infrastructure, the collaboration between the Ethiopian government, international organizations and local communities shows that meaningful change is possible. By continuing to build on these efforts and fostering a more inclusive and understanding society, Ethiopia can pave the way for a healthier future. Furthermore, this is an example for other nations facing similar struggles. The journey is long, but with sustained commitment and international support, the vision of comprehensive mental health care in Ethiopia can become a reality.

– Matthew Mendives

Matthew is based in Colonia, NJ, USA and focuses on Global Health and Celebs for The Borgen Project.

Photo: Unsplash

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Mental Health in India: Community-Based Care

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

Mental Health in India

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

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

Community-Based Care

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

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

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

Final Words

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

– Carlee Unger

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

Photo: Flickr