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Mental Illness in the Developing World

Posted Aug 18 2010 8:37am

Two years after launching the Mental Health Gap Action program to highlight the treatment needs of people suffering from psychiatric, neurological and substance abuse disorders, the World Health Organization (WHO) reports that, worldwide, over 80 per cent of people in need have no access to psychological or psychiatric treatment.  In many developing societies, people with disorders such as epilepsy, depression, and psychosis face tremendous stigma and are often deprived of the family and community support necessary for successful integration into society. The resulting neglect and abuse that mental patients face often leads to a worsening of their condition and tremendous human rights violations.  Due to their marginal status, many countries forbid mental patients from marrying, holding jobs, or even voting. 

In Africa alone, nine out of ten epileptics do not receive anti-convulsant medication to control seizures despite the relatively low cost per dose.  Similar findings are noted for people suffering from schizophrenia and depression.  In the majority of Third World countries, only 2 per cent of health care dollars are allocated to mental health treatment with charities often being forced to raise funds to cover the shortfall.  The lack of proper support  is linked to negative attitudes towards mental illness which is often not regarded as a "real disease" (and often viewed as being due to lack of character or a punishment for immoral behaviour).  Factors such as poverty and social unrest can worsen existing psychiatric conditions

In humanitarian crises, including natural disasters or pandemics, survivors often deal with long-term trauma that is rarely addressed by proper treatment.  Refugees are also particularly vulnerable to mental illness due to the lack of a stable support network and uncertain living conditions.  Combating emotional and psychiatric problems in the developing world is exacerbated by a critical shortage of mental health professionals.  According to WHO statistics, the global psychiatrist rate varies from 0.4 psychiatrists per 100,000 people in parts of Africa to 9.8 per 100,000 in Europe.  Some countries have no psychiatrists, psychologists, or social workers at all and psychiatric care is usually left to primary care physicians and workers with limited treatment experience.  As a result, relatives of mental patients often resort to traditional medicine or religious practitioners ( including exorcists ) for treatment.  

In her speech launching the Mental Health Gap Program , WHO Director-General Dr. Margaret Chan said that "The Mental Health Gap Action Programme gives WHO and its partners an opportunity to speak out against the neglect of these disorders with a unified and convincing voice. As I said, there is work to be done, and the voice of outcry may need to be rather shrill. But there are no excuses left. Together, we must make the case".   Despite intense efforts by the WHO and aid organizations, progress remains slow.

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