Global Mental Health proposes an approach to mental health in all corners of the planet. That, for example, any person with mental illness would receive a service, whether in France or Namibia. This approach is relatively new, and represents a firm commitment to the accessibility of psychological treatments to those developing countries, which precisely have less impact and service given their low socioeconomic resources.
there is no health without mental health
Being a recent approach, both its research and psychosocial intervention aspects are still in their infancy, taking into account the spectrum of humanitarian intervention. However, the World Health Organization already strongly emphasizes a slogan that is often remembered in the humanitarian field: “there is no health without mental health,” which is gaining weight within the International cooperation.
Regarding mental illnesses, there is a cultural component that delimits and considerably influences what is a mental illness and what is not. However, there are common patterns, which make us human, whether you are from Germany or Kenya. As Vikram Pattel quotes in his TED talk, there is the so-called Black Dog, which is a metaphor for the symptoms of depression, one of the most common diseases globally. Many people may think it does not exist in Africa simply because their concerns might be different. What the epidemiological studies shown in the video indicate is that, out of 20 people in the world, one would have depression. This leads us to the fact that there are 300 million people with depression on the planet.
Accessibility: Mental health for everyone
As indicated, accessibility to mental health is strongly determined by the socioeconomic level of the country where you reside, together with your own purchasing power. This would make the diagnosis and treatment of our depression very different if you are from England or Liberia. Easy to understand. So much so that 90% of people with mental illnesses living in developing countries will not receive any type of treatment. Out of 10 people, only 1 would receive treatment for their mental illness in Myanmar, for example.
As if that were not enough, the problem lies not only in the lack of accessibility, but also in the poverty trap, and its vicious cycle towards mental illness. This circle is evident: the contextual variables of poverty (low economy, low education, homelessness, etc.) have a negative impact on mental health. Emotional discomfort or mental illness means that the individual and/or the community in general have fewer skills and tools to improve their situation, which generates social exclusion, negatively impacting their psychological well-being…. and so on.
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Accessibility to mental health is strongly determined by the socioeconomic level of the country where you reside
What can we do? Psychosocial intervention in developing contexts
Although humanitarian aid took a great leap in the 1990s, the psychosocial component began to become professional relatively recently. It marked a before and after, in which the ineffectiveness of some psychosocial interventions and even counterproductive interventions was seen.
Our work, in a very summary way, consists of training and empowering the country’s local workers so that they themselves can carry out such psychosocial interventions in a self-sufficient way, always adapting our knowledge to a particular context and culture. An example is how in psychoeducation programs In the West, the provision of condoms is permitted as a preventive measure, while in a Muslim culture it can be seen as an incitement to sex.
One of the problems we often encounter is the lack of psychosocial workers in developing countries. There are no psychiatrists, psychologists or mental health nurses or if there are, they exist in a very small number.
A simple way to solve this problem is simply to train those people who are interested in the psychosocial component, even if they do not have any experience. Those who show interest and have social skills, listening skills and empathy can do much better than any qualified but unmotivated person. In such a way that our work is usually with unqualified personnel, but who have the necessary qualities to perform the job. We therefore have the feat of adapting very technical concepts in psychology in a simple language adapted to their culture.
Why isn’t global mental health interested?
Possibly because we are afraid to talk about mental illness. It is something that we dislike, it wants to sound distant, very far from our problems.
Global Mental Health continues to be uninteresting due to the strong discriminatory component that mental illnesses have. If there is discrimination in our countries, the stigma and rejection in countries like Zambia or Sierra Leone are incredibly greater. Nobody wants to position themselves in a reality in which anyone could fall.
On the one hand, sometimes mental illnesses are not considered a clinical condition, mental problems are associated with the misery of life itself, or worse still, that poverty itself justifies the fact of having depression, in such a way that it is unconsciously legitimizes. This means that in forgotten countries, the mentally ill are forgotten.
Accessibility to psychological treatments is strongly determined by the human condition itself.
On the other hand, the person could be dehumanized, that is, classified in a less human category for having mental illness. In fact, phrases like “they are human too” or “they also deserve treatment” are microracisms, since such statements are understood and taken for granted. In short, accessibility to psychological treatments is strongly determined by the human condition itself.
Solutions?
Vikram proposes taking the example of HIV as a model. A few decades ago it was a devastating disease, however, not only medical treatment but also social perception and acceptance have improved significantly. The parallel is clear, Mental Health should have that capacity for mobilization, denunciation and social movement of both the carriers and families affected by this chronic disease, in order to take the leap that Global Mental Health deserves.
When we are truly free of stigma, discrimination, or people with mental illnesses stop being labeled as crazy or aggressive, we will be able to stop being ashamed. We will not see ourselves as distant from the rest of our peers. A work both from the media and from psychology professionals themselves that humanizes mental illnesses and that the rest is willing to humanize themselves.
Perhaps at that time we could provide service to those people with mental disorders in those countries that no one remembers, or worse still, that is not even known to exist. To, at least, stop forgetting the forgotten.