Mental Health resources in developing countries

I noticed something while browsing and learning about the World Health Organization’s (WHO) website. There are homepage tabs such as health topics, countries, newsrooms, and so on. When I clicked on the countries tab, regions essentially dropped down, and I tapped into each one; all regions, with the exception of Africa and Southeast Asia, had a slot for mental health. WHY? You might as well have already come up with an answer (Leave a comment below). Clearly, there are few or no studies on mental health in these areas. Because there is a scarcity of existing data and facts about mental health in these areas, they are predisposed to mental disorders. The lack of awareness makes it impossible to move forward with sensitization and resource allocation.

Mental illnesses account for 7.4 percent of the global disease burden. Despite this, only 2% of the country’s health budget is spent on prevention. Low-income countries spend less than 25 cents per person per year on mental health, whereas high-income countries spend $44.8 per capita. [1] In terms of physical resources, there are 0.61 mental health outpatient facilities per 100,000 people globally, but there are huge disparities. In low-income countries, there are 0.04 outpatient facilities per 100,000 people, while in high-income countries, there are 2.32 outpatient facilities per 100,000 people. [3] Similar disparities exist in the availability of mental hospitals. The global median rate of mental hospitals is 0.03 per 100,000 people, ranging from 0.002 in the World Health Organization’s (WHO) Western Pacific region to 0.16 in the WHO European region. There are also significant differences in the number of psychiatric hospital beds available. The rate per 100 000 people in the WHO African zone is 1.7, compared to 39.4 in the WHO European zone. In some parts of the world, mostly developing countries, there is less than one psychiatrist for every 100,000 people, compared to 8.6 psychiatrists for every 100,000 people in developed countries. [1]

According to research, many developing countries lack adequately trained medical and nursing professionals to treat brain disorders. “For example, in India, there are approximately 3,000 psychiatrists and 565 neurologists to serve a billion people, whereas, in Zimbabwe, there are 10 psychiatrists and 29 neurologists to serve 11 million people. [4] In Indonesia, the ratio is one for every ten million people. In Uganda, the total number of human resources working in mental health facilities or private practice per 100,000 population was 1.13, with 0.08 psychiatrists, 0.04 other medical doctors, 0.78 nurses, 0.01 psychologists, 0.01 social workers, 0.01 occupational therapists, and 0.2 psychiatric clinical officers, not including auxiliary staff, non-doctor PHC workers, and health assistants. [5] The World Health Organization reported in 2005 that a number of countries, including Afghanistan, Rwanda, Chad, Eritrea, and Liberia, had only one or two psychiatrists.

The Uganda Ministry of Health (MoH) requires at least one encoded psychiatric nurse with a two-year certificate to work in outpatient communities, and clinical and medical officials to work in health centers, despite the fact that both levels have many vacancies. Regional referral hospitals have psychiatric units supervised by psychiatric Clinical Officers (Diploma-prepared professionals), and two National referral mental health facilities with psychiatrists and psychologists provide mental health treatment. Private international non-governmental organizations (INGOs) and health facilities that provide mental health care are expensive, concentrated in urban areas, and tend to focus on HIV/AIDS, limiting access for the vast majority of people who require assistance. [6]

I attended a boarding school where HIV/AIDS was noted on every sign on campus. When you arrived at the school’s gate, there was a large blue sign with the words “abstain from sex” written in white on it. As one walked from the staff building to each class, the dining hall, and the kitchen facility, one could see every HIV/AIDS signpost. All the way to the dormitory’s gates. Every day, there was either a play or a declaration about HIV/AIDS at assembly, or the matrons would make a point of telling a scary story about a boy or girl who died as a result of the disease. It was engraved on our unconscious minds because that is what our thoughts were focused on when we closed our eyes at night. Each year, the majority of the music, dance, and drama performed focused on HIV/AIDS. I remember reciting a poem about the disease, and our team did indeed win. According to the argument, HIV/AIDS is a topic of discussion and activism from the time a child is born until they reach adulthood. The government made every effort in this regard, and I believe we were all aware on a daily basis, which was greatly appreciated. How about we devote the same amount of effort to raising mental health awareness as we do to HIV/AIDS?

“It is time for governments to make mental health a priority and to allocate the resources, develop the policies and implement the reforms needed to address this urgent problem. One in four people will suffer from mental illness at some time in life,” added United Nations Secretary General Kofi Annan.

“Mental Health Care in the Developing World.” Psychiatric Times, http://www.psychiatrictimes.com/view/mental-health-care-developing-world.

References

[1]World Health Organization. Mental Health Atlas 2011. Geneva:
WHO, 2011

[2] World Health Organization. Global burden of mental disorders and
the need for a comprehensive, coordinated response from health and social sectors at the country level [monography in internet]. Geneva: WHO,
2012 [cited 2017 Dec 6]. Available from: http://apps.who.int/gb/ebwha/
pdf_files/EB130/B130_R8-en.pdf

[3] Octavio Gómez-Dantés, and Julio Frenk. “Neither Myth nor Stigma: Mainstreaming Mental Health in Developing Countries.” Salud Pública de México, vol. 60, no. 2,mar-abr, Mar. 2018, pp. 212–217. EBSCOhost, doi:10.21149/9244.

[4]“Mental Health Care in the Developing World.” Psychiatric Times, http://www.psychiatrictimes.com/view/mental-health-care-developing-world.

[5] Kigozi, Fred, et al. “An Overview Of Uganda’s Mental Health Care SYSTEM: Results from an Assessment Using the World Health ORGANIZATION’S Assessment Instrument for Mental Health Systems (Who-Aims).” International Journal of Mental Health Systems, BioMed Central, 20 Jan. 2010, ijmhs.biomedcentral.com/articles/10.1186/1752-4458-4-1.

[6]Kopinak, Janice Katherine. “Mental Health in Developing Countries: Challenges and Opportunities in INTRODUCING Western Mental Health System in Uganda.” International Journal of MCH and AIDS, Global Health and Education Projects, Inc, 2015, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4948168/.

5 thoughts on “Mental Health resources in developing countries”

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s