41% of countries do not have a mental
health policy.
25% of countries have no legislation on
mental health.
28% have no separate budget for mental
health.
37% of countries do not have mental
health community care facilities.
These statistics present the current
situation of global mental disease burden. However, behind the statistics, the
reality shows more cruel pictures: discrimination and stigmatized images around
people with mental disorders and shortage of mental health professionals lead
the marginalized population to live in the shadow.
Like the person who has been locked in
the wood house for ten years in the video we showed in the class, many people
with mental disorders are victimized for their illness, and become the target
of discrimination. Some stigma are from general population, as Dr. Maselko
mentioned in her lecture, because the definition of mental illness is so vague
and incomplete in developing countries, people may hesitate to search for help
because they do not even have the knowledge of the symptoms. Therefore, due to
inaccurate information of mental disorders, many people believe that the disease
is untreatable, and the person with the disease needs to be excluded from
population. On the other hand, abundant evidence from Western countries
indicates that people with mental disorders are stigmatized and discriminated
against by health professionals. Specifically in developing countries,
treatment suggestions from health professionals to those with mental
disorders include a wide range of proposals, some of them are punitive and
discriminatory, and far from official guideline recommendations. These negative social attitudes towards people with mental disorders have an
adverse effect on prevention and early treatment. And these attitudes are pervasive even though the United
Nations has provided a basic standard for people with mental disorders:
All person with a mental illness, or
who are being treated as such person, shall be treated with humanity and
respect for the inherent dignity of the human person. All person with mental
illness, or who are being treated as such person, have the right to protection
from economic, sexual and other forms of exploitation, physical or other abuse
and degrading treatment.
United
Nations Principles for the Protection of Persons with Mental Illness
However, most countries of the world are far from complying with this principle.
As Dr. Maselko and Dr. Shirey mentioned
in their lecture, there is a global disparity of receiving mental health care
between high-income and low or middle-income counties. For over 30 years,
international organizations such as World Health Organization have been
encouraging developing countries to increase their mental health facilities,
however, the progress in achieving well-equipped facilities for the care of
mental disorders has been slow. Almost one-fourth of developing
countries have no system for providing basic mental health treatment for
citizens. Even among countries that have such a system, the health facilities lack trained professionals who can provide good mental health
services. Most of the facilities contain few doctors and many non-professional
health workers. The doctors are usually too busy for managing patients who need
specialized care, and have no time to supervise other health workers.
“
Where is the mental health hospital I can go for help? ” asked by the father in the
video. He is still searching for a mental hospital that can provide accurate
information and appropriate treatments for her daughter. As well as the father, we still have a long
way to go to bring people with mental disorders fully out of the shadows.
Discrepancy between developed and under developing countries is well known aspect in global health challenges. Mental illness treatment, of course like many other diseases, has a huge gap between the rich and the poor.
ReplyDeleteAccording to the lecture, mental illness is much more neglected compare to other diseases. I think this is because of the nature of this disease. It is easy to report if we spend money on certain disease and it will save a concrete number of lives. However, it doesn’t seem very effective to say, this will make people more happliy live their life.
Also, it is hard to detect. People sometimes can not even notice the symptoms and how much it is worse. In many asian countries, cultural norms are huge obstruct to access on mental clinic or hospitals. I think these are the reasons why we should develop better index that can show gravity of mental illness.
Thank you Phoebe for highlighting these issues surrounding mental health.
ReplyDeleteAs you have pointed out it is clear that stigma and discrimination play a crucial role in the health seeking behavior of the individuals suffering from mental health disorders. One thing that strikes me is that the discrimination and stigma is not only by general public population but also by the health care professionals who are educated and considered knowledgeable in regards to mental health disorders. This inclines me to underscore the idea that in order to eliminate and fight these negative perceptions multifaceted approaches that entail more than just education interventions are necessary. For example it is important that we first understand then challenge the myths, practices and wide spread beliefs that particular communities hold that tend to perpetuate the stigmatization and discrimination attitudes.
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ReplyDeleteThanks for such a comprehensive summary of the poor situation of mental health treatment, Phoebe. Coming from India, I definitely empathize with the lack of priority given to mental health and treatment in many parts of the world. However, I think that the issue is deeper than we think it is. For instance, the issue of mental health is completely ignored in school education, and neither is it advertised as something to be aware of. This leads to lack of understanding of their own mental condition by the patient, who thinks that it is something normal like mood swings.Family members also refuse to acknowledge this as a medical abnormality with the fear that their child may be labelled as mad by society. To come back to the point, this cycle of ignorance, social stigma and lack of proper medical treatment, has led to overall deterioration of mental health in developing countries. All of these aspects must be looked into to ensure a healthy and safe environment for those who are suffering from mental illnesses.
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ReplyDeleteI agree with Loise. As with many diseases in the world, mental issue also needs (perhaps even more so) multifaceted approaches that involve public education, awareness, treatment, research, crisis response, counseling, etc. In Korea, people have only recently begun to discuss mental health disorders, much owed to the news media covering stories of celebrities as well as students committing suicides. There seems to be a big mismatch between people becoming more aware of the existence and prevalence of mental health illnesses and the rate at which these illnesses are prevented and treated. I would suggest that this is because the symptoms of mental illnesses are not as visible, fairly newly conceptualized compared to other diseases and highly stigmatized, further hindering individuals to seek help. It would be interesting to read about how successful mental health hotlines are in preventing further development of mental health disorders especially because no one is physically going to a clinic or seen at a clinic.
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