We need to strengthen our response
Von Carine Weiss
Mental health disorders affect one in four of us over a lifetime. They represent a huge cost to our healthcare systems and affect some of the world’s most vulnerable people through stigma and lack of understanding. Nine out of ten people with mental health problems experience stigma. All around the world – and more so in middle and low-income countries – services for treating mental health disorders are scarce. The amount of money governments are spending on mental health is very small. The shortfall of services means that millions of people are being left behind in terms of treatment and prevention.
Carnival in Jacmel, Haiti, 2011 (Photo: Carine Weiss)
I studied psychology as my first degree. After graduation I feared I did not have the strength to face people with mental health disorders and I therefore specialised in public health. During three years living in developing countries I encountered many people with mental health disorders. In Haiti a naked woman ran around in the market and a man got drunk on a regular basis in front of our compound. In Myanmar we employed a doctor not realising that he was suffering from severe alcoholism. He failed to make it to the duty station because he got totally drunk on the way and did not stop drinking for four entire days. From one day to the next a young women had to take care of her entire family because her mother was arrested for having drugs in her house – drugs someone else had left there. Working with these communities, I looked into many sad and depressed eyes.
I have always been amazed by the amount of daily problems people in such countries face. Every day something tragic happens. Either they lose a close relative, they fall ill, have a car accident or get into trouble with the police or the government.
Mental Health in your own words: 13 people, aged 18-25 talk about what it’s like to live with a mental health problem, and what helps them cope.
These examples are just a fraction of everyday challenges many people face. I could not have imagined living under such conditions if I had not seen them for myself. What I admired most about these people was their strength to cope with such situations on a daily basis.
People develop assumptions and expectations about the world they live in throughout their lives. They are often influenced by their upbringing, personal life experiences, personality, cultural norms and individual belief systems. The way in which people cope with stress factors depends on the culture and their personality and external circumstances such as the availability of community and family support.
Psychosocial Support Programmes should be enhanced
The provision of psychosocial support has been acknowledged to have a significant and positive impact on people’s health and health-seeking behaviour. Psychosocial support can prevent distress and suffering which may develop into something more severe; it helps people to cope better and become reconciled to everyday life.
Medicus Mundi Switzerland recently conducted a round table discussion entitled Mental Health – How to support staff affected by a trauma? The effect of traumas on the workforce in developing countries is far more serious than many people realize and may jeopardise the successful outcome of a project. During this discussion we heard about a fascinating approach to psychosocial support: the Solution Focused Approach (SFA) implemented by our member organisation terre des hommes switzerland. SFA was developed by Steve de Shazer (1940-2005), Insoo Kim Berg (1934-2007) and their colleagues in the late 1970s in Milwaukee, Wisconsin (USA). As the name suggests, SFA is future-facing, goal-orientated and focuses on solutions rather than problems. It is based on the firm principles that every person is unique, that they possess strengths, gifts and talents, and that the main focus of any ‘helpful conversation’ is to assist people to develop and achieve their own vision of a preferred future and thus improve their wellbeing. It is a great tool to empower a person to find their own solution to their problem. (read the article by Irene Bush: Nachhaltige Entwicklung braucht psychosoziale Komponenten und Selbstfürsorge)
Port-au-Prince after the earthquake, 2011 (Photo: Carine Weiss)
Civil Society needs to “step up”
In most parts of the world mental health and disorders are unfortunately not regarded with anything like the same importance as physical health. We must not neglect mental health if we want to ensure healthy lives and promote wellbeing for everyone at all ages. The scarcity of mental health workers is worrying! Even more so is the lack of political will and allocation of resources towards improving mental health. We cannot emphasise enough the milestone we reached by having mental health included in Sustainable Development Goal 3. Now we need to use the momentum created to take mental health out of the shadows and into the spotlight.
There are many opportunities for developing awareness and understanding in improving mental healthcare.
Addressing mental health in the era of sustainable development demands both a scaling up and a transformation of advocacy efforts.
Civil society organisations need to continue to raise awareness and pursue advocacy on the national and international level. Key steps for supporting policy-makers and planners are to compile technical evidence, determine the magnitude of mental health disorders, highlight their cost and identify effective mental health interventions.
Advocacy ranges from raising awareness, sharing information, providing education and undertaking trainings to promote mutual help and counselling. Advocacy actions should aim to combat stigma and negative attitudes about mental health.
Never underestimate the influence of media and social media. It can reach many people and help to reduce the stigma and discrimination related to mental health and enhance help-seeking behaviour.
There are a lot of tools available – connect and share them!
And sometimes it can just be enough to listen and give your time to a person who needs an ear and a helping hand…
Mental health funding and the SDGs: What now and who pays? Jessica Mackenzie and Christie Kesner. Report 2016
Carine Weiss is project leader at Medicus Mundi Switzerland