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Mental Health in ArmeniaHundreds of thousands of civilians fled in search of safety when violence broke out in Nagorno-Karabakh on Sept. 27, 2020. Following these first violent clashes, organizations stepped up to provide humanitarian assistance for displaced civilians arriving in the capital Yerevan. The extensive damage to infrastructure and disruption of daily life, coupled with a harsh winter climate and COVID-19, will require help from the international aid community for many months to come. One area that this incoming aid will go to is mental health education and support. In 2019, the World Health Organization reported that one in five people in conflict-affected areas lives with a mental health issue. The longer a person lives with acute stress, anxiety or other mental health challenges, the more difficult it is for them to successfully secure basic needs. Aid groups are addressing the issue of mental health in Armenia with various programs.

Mental Health Support for Armenia

The Armenian Red Cross Society is providing humanitarian assistance to help people with basic necessities. This includes psychosocial support for returning soldiers and civilians. As of late December 2020, it had provided around 1,000 psychological services to wounded soldiers and their families.

The International Medical Corps, another emergency aid response group, is working with the Armenian Ministry of Health to assess current needs. In October 2020, the organization expressed its plans to provide training in psychological first aid for frontline healthcare workers. The organization will also provide mental health and psychosocial assistance to people who need it.

UNICEF Addresses Child Trauma

The UNICEF Armenia team and a local arts and music school called the Nexus Center for the Arts offer art and music-based support groups. These support groups give children and teenagers a chance to express themselves without having to talk. UNICEF reported testimonials of students who upon arriving were too afraid to open up but after participating in the support groups felt ready to talk about the trauma they had experienced. The groups also give students a chance to hang out, decompress and enjoy music in a comfortable and safe environment.

To help school teachers, UNICEF partnered with several civil society organizations to teach them how to address trauma in the classroom. UNICEF offered virtual lessons on trauma-informed teaching. The lessons gave 150 school psychologists and 900 public school teachers the skills to work in high-pressure situations and strategies to provide better psychological support to their students.

UNICEF Armenia also put together a psychological first aid guide. This guide has clear and concise information on how to respond to children in a mental health crisis. It emphasizes the importance of responding to children in an age-appropriate and individualized way.

The Increased Need for Mental Health Support in Armenia

Mental health in Armenia, especially following the conflict, is an issue that requires prioritization. The conflict and displacements have left 39,000 children out of school. The trauma caused by displacement has affected children in multiple ways. Ensuring the well-being of these children is a top priority for UNICEF and other organizations addressing mental health in Armenia. The hope is that these initiatives will combat the negative impacts of traumatic experiences in conflict-ridden areas like Nagorno-Karabakh.

Caitlin Harjes
Photo: Flickr

 Mental Health in Rwanda Rwanda is a small country in sub-Saharan Africa. Rwanda has struggled to become a stable country economically and politically since it became independent in 1962. As a developing country, Rwanda is still trying to develop its healthcare system. With years of conflict and instability, people especially struggle with mental health in Rwanda.

5 Facts About Mental Health in Rwanda

  1. The Rwandan Genocide plays a significant role. Roughly 25% of Rwandan citizens struggle with PTSD and one in six people suffer from depression. The reason why so many Rwandans have mental health conditions can be explained by one key event in Rwandan history. During the Rwandan genocide of 1994, members of the Hutu ethnic majority murdered as many as 800,000 people, mostly of the Tutsi minority. The mass genocide caused severe trauma to survivors who still suffer from mental health issues 26 years after the event.
  2. Rwanda has very few resources. According to the World Health Organization, Rwanda has only two mental health hospitals, zero child psychiatrists, and only 0.06 psychiatrists per 100,000 people. With a large amount of the population plagued by mental health issues, Rwanda needs more resources to help the mentally ill.
  3. Suicide rates have greatly decreased in Rwanda. In 2016, the suicide rate in Rwanda was 11 deaths per 100,000 people. This is a great improvement compared to the 24.6 suicides per 100,000 people in 2000. An increase in mental health resources contributes to the lowering of the suicide rate in Rwanda.
  4. Increased mental health funding is essential. The average mental health expenditure per person in Rwanda is 84.08 Rwandan francs. Most citizens of Rwanda do not have the financial resources to afford mental healthcare. The government currently uses 10% of its healthcare budget on mental health services. Considering how large the mental health crisis is, the government should increase its expenditure to address the crisis. Since citizens cannot afford to pay for mental health resources, the government will need to help provide more free or affordable resources.
  5. The Rwandan Government is updating policies to address mental health. In 2018, Rwanda’s updated strategic plan for its health sector set new targets for expanding mental health care services. Its purpose is to help increase access to mental health resources by decentralizing mental health and integrating it into primary care. Also, this plan calls for a decrease in the cost of mental healthcare and an increase in the quality of care. The plan hopes to accomplish strategic goals by 2024. If successful, this plan may be used as a method to help other countries establish a quality mental health plan.

The Road Ahead for Rwanda

Considering Rwanda’s violent history, it is no surprise that the population struggles with mental health. Over the years, progress has been made with regard to mental health in Rwanda. However, many more resources are needed to help address the mental health crisis in Rwanda. With Rwanda’s updated strategic plan to address the issue and an increase in expenditure, the well-being of Rwandan’s will be positively impacted.

Hannah Drzewiecki
Photo: Flickr

Mental Health in Northern NigeriaNorthern parts of Nigeria have become the epicenter of brutal and violent attacks carried about by the notorious militant ISIS group, Boko Haram. Many victims are left with painfully traumatic memories that develop into post-traumatic stress disorder (PTSD). Functioning normally is impossible for those affected by PTSD and northeast Nigeria only has a single mental health institute. Nonprofits advocating for mental health in northern Nigeria have taken to Twitter and other forms of social media to provide guidance and healing to help bridge the gap.

Mental Health in Northern Nigeria

The treatment of mental illness and the ability to treat different disorders varies from country to country. In Nigeria, three of every 10 people suffer from mental illness. Constant disruptive violence weighs heavily on the psyche and with northern Nigeria becoming known as “Boko Haram’s Den” it is not surprising that a single facility cannot handle the number of people in need. Out of every 100,000 people, 17 of them commit suicide in Nigeria, ranking the country seventh in Africa for suicide.

The NEEM Foundation

Founded in 2017, the NEEM Foundation’s primary focus is to pave the road for mental health in Nigeria to improve, with free treatments primarily centering on victims of Boko Haram.

NEEM’s plan of action has been to send counselors and psychiatrists out on small motorized bikes to aid families affected by the terrorist group. These volunteers are also sent to families and individuals who escaped the group after being forced to join. The people that are lucky enough to escape from forced involvement submerge back into society without mental health check-ins or assessments, making them a possible danger to themselves or others. Mental health in Nigeria as a whole is not given enough funding to offer these services, despite the severity.

Last year alone, NEEM and its team of experts were able to provide care for 7,000 patients. Its work is primarily focused on children suffering from trauma due to the terrorist group, by setting up group therapy sessions for children and youth to attend. To boost available counselors, NEEM founded a nine-month training program in Maiduguri where college graduates of science or lay counselors are trained to become child psychologists. Adding more trained counselors and psychologists furthers NEEM’s reach and ability to give the mental healthcare needed by victims in Nigeria.

Moving Help Online

In total, the country of Nigeria only has eight mental health facilities, leaving a lot of ground to be covered by nonprofits like NEEM. The organization Mentally Aware Nigeria Initiative (MANI) is using WhatsApp and Twitter in order to reach as many Nigerians in crises as possible and provide free mental health first aid.

Mental health in northern Nigeria is a problem that grows with its population of victims and refugees. By using free social media platforms in lieu of physical counseling, organizations are able to extend their reach to those in need.

– Amanda Rogers
Photo: Flickr

Poverty and PTSDCommonly associated with combat veterans, Post-traumatic stress disorder (PTSD) impacts more of the global population than maybe expected. Recent studies have found a link between poverty and PTSD that reveals that socioeconomic status contributes to the majority of anxiety disorders.

How Poverty Contributes to PTSD

Mental disorders manifest in distinct ways for many people. However, the common underlying origin of Post-traumatic stress syndrome (PTSD) remains a terrifying or traumatic life event. Living in poverty often means surviving daily in vulnerable conditions, and with financial instability that limits access to necessities such as food, shelter and water. The inability to pay for expenses starts to become emotionally and mentally taxing. Poverty acts as a traumatic experience in many people’s lives and even after graduating in class status, difficulty persists to enjoy day to day life.

Symptoms of PTSD can appear within months of the traumatic event and include:

  • Avoiding: Detaching from the traumatic event by avoiding triggers such as places, situations or people.
  • Reliving: Flashbacks and nightmares due to memories that force reliving the traumatic experience.
  • Increased Arousal: An increased blood pressure or heart rate accompanied by outbursts of anger and difficulties sleeping

Some people with PTSD may exhibit all these symptoms, while others exhibit just a few. The severity of PTSD also varies from person to person. PTSD can be broken down into subtypes such as:

  • Delayed on-set PTSD: This variation refers to when symptoms of the disorder develop many years after the traumatic event.
  • Complex PTSD: This type of PTSD usually surfaces after ongoing childhood physical or sexual abuse.
  • Birth Trauma: This type occurs after traumatic childbirth.

Women with PTSD

Research estimates that 284 million people globally suffer from anxiety disorders such as PTSD. About 63 percent of people that suffer from anxiety disorders are women. In addition, women living in poverty tend to face PTSD at higher levels than any other group within the general population. The relationship between poverty and PTSD embodies that of the domino effect. Poor women’s PTSD symptoms often worsen due to the fact that living in impoverished neighborhoods risk ongoing exposure to triggers of the traumatic incident. A study undertaken by the Social Cognitive Theory also reveals that most of the women living in poverty with PTSD share a history of domestic violence and lack social support.

Treatments

It can feel nearly impossible to live a normal life with PTSD. Luckily, effective treatments exist that minimize the symptoms of the disorder. One of the best treatments for PTSD is Psychotherapy. Psychotherapy allows PTSD victims to talk about their cognitive behavioral process to a mental health professional to reduce and change reactions to triggers. Another important tool for managing PTSD is having a strong support system. The help of friends and family means everything during a mental health crisis. A support system of others that have suffered from PTSD also helps signify that a person is not alone in the experiences of the mental disorder. There are also organizations such as the PTSD Alliance, who work to educate and empower people with PTSD psychologically, economically and emotionally to thrive beyond environmental barriers. The organization currently has five international partners that provide programs to help improve the lives of those living in poverty with PTSD.

Overall, poverty and PTSD remain two prominent issues impacting people on a global scale. The connection between poverty and PTSD only further emphasizes that the more work that is done to reduce global poverty also diminishes the mental health crisis.

Nia Coleman
Photo: Wikimedia

art alleviates poverty
Researchers at the Pontifical Catholic University of Chile have found a way to combat some of the negative psychological effects of poverty by using art.

Marianne Daher and Ana María Haz’s study, published in 2011, looked at the impact of artistic activities on the minds of 10 impoverished women living in Chile’s capital, Santiago. The study used art to help these women better understand the impact of poverty on their lives.

The researchers defined poverty as a deprivation both of physical needs and psychosocial needs, the latter of which includes self-knowledge, education and confidence.

Deprivation of both has been shown to arouse anxiety and affective disorders in women who live in poverty.

The study’s participants worked with a variety of materials and in a variety of mediums, including drawing, collage and painting. They worked alone and collaborated with other participants as well. At the end of the study, they invited friends and family to an exhibition of their work.

Researchers collected qualitative data through interviews with the participants. The women answered questions that asked them about their psychological state before, during and after the creation of their art.

Through their work, the scope of the burden of poverty became clear both to researchers and to the women themselves, who noted they rarely had chances to express themselves before. The women felt overwhelmed by their lack of education, their large families, their dangerous neighborhoods, their inadequate access to health services, their unfulfilling and unappreciated role as housewives and their inability to hire others to look after their children.

Art alleviates poverty by combating the stress that threatened to overwhelm these women. Women described the process of painting as relaxing, and they appreciated having time for self-development. Many women also learned about themselves during their artistic experiment.

“I find something absolutely different,” one participant said. She continued, “I find myself and my feelings. More than the painting itself, I find something I have always had, but now I got it: I find myself.”

Researchers discovered that the feeling of well-being nurtured by the artistic process carried over into the women’s daily lives. One participant described the metaphor between the correction of her mistakes while painting and the correction of her mistakes in her daily life:

“Many times I have complained because it [the painting] went wrong, but finally I could fix it! So, why shouldn’t I believe this is possible if I was also capable to correct my mistakes [at home].”

In the study’s conclusion, the researchers noted art’s potential to serve as a defense against the stresses of poverty. However, the study also shows how effective the artistic process can be at digging up the frustrations that impoverished women bury within themselves as a coping mechanism.

Bringing those frustrations into the open is a challenge that has perplexed many who have sought to find a way to measure poverty’s impact on the mental well-being of the poor.

During the past decade, traditional measures of poverty have seemed more and more inadequate—Chile’s CASEN survey, for example. The CASEN survey focuses on economic factors, comparing “homes’ per capita income with a minimum expected income,” but these factors say nothing about the psychological traumas that poverty can inflict on the impoverished.

To uncover those traumas, art may be the answer.

Ryan Yanke

Sources: Oxford Poverty and Human Development Initiative 1, Oxford Poverty and Human Development Initiative 2, Psychology Today, American Journal of Community Psychology

Photo: Photography Blogger