Mental health is a worthwhile goal for United Nations Sustainable Development Agenda

 

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The post-2015 development goals will, as we know, set out the world’s development agenda for the foreseeable future—in the same way that the Millennium Development Goals provided a framework for global development over the past couple of decades. The United Nations is now preparing to choose its new set of sustainable development goals and the Global Mental Health community must work hard to ensure these goals include mental health.

Professors Vikram Patel and Graham Thornicroft have recently published an article in the British Medical Journal, which outlines why the case for including mental health in the UN’s new development agenda is a compelling one.

Indeed their case is compelling. When we think about it logically, it makes sense: poor mental health is a precursor to reduced resilience to conflict, they argue. In the midst of conflict, hope is a scarce resource and instead of teaching hope, “in the aftermath of war people with mental illness are often accorded the lowest priority”. If we think about the seemingly intractable global conflicts of today, from Syria and Iraq to the massacre in Gaza, the call to address mental health concerns as a priority development agenda, and as a result, rebrand mental illness and teach hope to thousands, is most pertinent.

Including mental health in the new global development agenda will also go a long way towards ending the paralyzing stigma associated with all kinds of mental illness. Not least, the most common mental disorders like depression and anxiety would be well on their way to receiving a more hopeful image globally, recognized as issues which affect us all personally and as communities, cities and countries.

Thornicroft and Patel in fact argue that if mental health is included in the new development agenda and mental health systems are globally improved, that would also “have a decisive role in making cities and human settlements inclusive, safe, resilient, and sustainable”. For addressing mental health concerns of an individual is not only beneficial to the person suffering, but when the problems associated with mental illness are given importance by society and a collective effort to address them is taken, it will inevitably create a sense of common belonging, hope, equality and indeed resilience among communities.

This would then also require addressing the income and economic inequalities faced by people who suffer from mental health problems. They have far lower rates of employment, but also, in times of economic recession, a population’s mental health is worse, argue the two professors. If we can thus promote a principle of ‘sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all,” again this too would benefit wider society as a whole.

The narrative which is understood by these arguments is that mental health problems are a global issue that impacts not only those who suffer, but wider society and large populations of human settlements. It is thus, for our collective benefit that we make treatment available to people who are suffering and in turn spread the message of hope globally.

The reasons that we need to push for the inclusion of mental health in the global development agenda are of course many, and only a few have been mentioned here.  But what is important to remember is that the proliferation of mental health problems is the result of collective ignorance of these issues over a long period of time. When we can talk freely about depression, anxiety and other mental illnesses, we can find and develop ways to tackle these issues whether it’s through modern medicine, community-building or teaching hope to young people. What we do know is that the conversation can become truly global if we can secure mental health in the Post-2015 development agenda. The BMG editorial rightly highlights that mental health is a worthwhile goal for sustainable development.

A new article written by Bidushi Dhungel

Young and Vulnerable: The biggest tragedy regarding youth mental illness is collective inaction

This year, United Nations International Youth Day (IYD), on August 12, has been designated to celebrate the importance of youth mental health with the slogan ‘Mental Health Matters’. This is an opportunity, particularly for low and middle-income countries, to highlight a vitally important—but utterly neglected—aspect of youth life. The neglect has occurred on many levels by both state and society. In a statement, UN Secretary-General Ban Ki-moon rightly highlighted the global urgency to address the stigma and discrimination of youth with mental health conditions.

For the majority of youth who suffer from mental illness, they are forced to live a life of rejection from friends, society and relatives. They are denied the status of ‘citizen’, social membership and basic human needs, robbing them of a dignified life. Around the world, mental illnesses play a significantly negative role in the development of hundreds of millions of youth and their social and economic inclusion and empowerment. In poor countries like Nepal, the young population with mental illness is in a particularly vulnerable position because of the lack of a public health approach in dealing with mental illness, the absence of basic support for their recovery from the state and the deeply entrenched stigma of their illness.

More at risk

Coinciding with the IYD 2014, the United Nations Division for Social Policy and Development, the Department of Economic and Social Affairs has published an insightful report, ‘Social Inclusion of Youth with Mental Health Conditions,’ targeting global actors involved in the field of youth empowerment. I would recommend that youth activists and development workers in Nepal and abroad read this report seriously.

While the young years of life are usually considered to be the most physically active, healthy and energetic of one’s life, this phase is also one when people are most susceptible to mental health problems. However, in many low and middle-income settings, the latter risk is entirely ignored. I do hope that the exposure the issue is getting this year will be instrumental in changing the outlook of mental health, particularly of youth mental health, across the globe.

Nearly one fifth of the global population is comprised of youth aged 14 to 24 years. Almost 90 percent of these live in low and middle-income countries. In a study carried out by Professor Vikram Patel and his team, it is estimated that approximately 20 percent of youth experience a mental health condition each year around the world. Because the youth years are a phase of emotional transition and a time to nurture and pursue childhood dreams, the pressure to study well, find jobs and opportunities is also high.

Drug use, emotional and learning difficulties and disappointment are common. In countries like Nepal, socio-economic disparities and practices of early marriage and strenuous labour can make the situation worse, leaving young people more at risk of experiencing mental health problems than anyone else. Many studies suggest that over 70 percent of mental disorders start before the age of 16. One in nine children attempt suicide before high school graduation and 40 percent of those are in grade school.This is clear evidence that mental health services must be developed to target young age groups.

Educating and collective action

OPRF School Planting, 2013

The prevention and promotion of mental health issues is the way to deal with the growth in mental health problems amongst the youth. Integrating mental health issues into school education is the most effective approach to prevent and promote mental well-being. With an ambition to institutionalise mental health education at the school level and teach hope from an early age, US-based entrepreneur Kathryn Goetzke and her team have just started a pioneering programme, Schools for Hope. This team strongly believes that we can teach our kids how to find pathways to hope, no matter what they experience and that ultimately, we can prevent suicide in youth and adulthood. If this programme is successful, it will be a revolutionary step forward in promoting and institutionalising emotional health and mental well-being.

The biggest tragedy regarding mental illness is collective inaction, which has perpetuated tremendous fear, uncertainty, helplessness, segregation, and hopelessness in the lives of those who suffer. Rather than the illness itself, a fear of social rejection and segregation leads almost a million people to commit suicide every year, with the majority of them young people. By promoting greater social inclusion and empowerment of youth living with mental illness in society, we can change this reality.

It is also vitally important to spread the message that effective services (both social and clinical) exist to manage all kinds of mental health problems. We need to build capacity and a knowledge base to address them. Now, we have to start demanding equitable investment for the mental well-being of the population by asking that the state make holistic mental health services available and accessible for all.

 A new article written by Jagannath Lamichhane

Lamichhane is global coordinator of the Movement for Global Mental Health

Depression and anxiety are linked to happiness and there’s plenty that can be done from a young age

In the last blog, I talked about the World Happiness Report 2013 and began to explore the links between mental health and happiness. I want to explore this in further detail here, to examine the issues which effect happiness in an individual’s life and the implications of positive mental health on these indicators. As I mentioned in the earlier post, and as the Happiness Report 2013 clarifies, mental illness is the “single biggest determinant of misery.” While the prevalence of the problems varies between countries, at any given time, around 10 percent of the world’s population suffers from some kind of mental illness. Among all the mental illnesses, depression and anxiety are most common—accounting for about a fifth of all disability globally. Naturally, this has an incredible effect on the output of individuals, societies, countries and globally! And as we’ve heard so many times before, people are not receiving treatment for these illnesses for which cost-effective treatments exist—not even in the richest of countries!

 

For depression and anxiety disorders, evidence-based treatments can have low or zero net cost, according to not only the latest Happiness Report, but a host of professionals working in the field. They can and should be made far more universally available. However, these are all post-illness measures and the majority of interventions have focused too heavily on tackling the issues surrounding mental ill health at a later stage in life, when illnesses have been brewing and developing for years.

 

But in order to successfully make the case for childhood intervention, a paradigm shift is required which would look to establish mental health as intrinsically linked to personal happiness and not just a medical illness. That is what the World Happiness Report seeks to do precisely, by pointing out that “schools and workplaces need to be much more mental health-conscious” and “directed to the improvement of happiness” in order to prevent mental illness and promote mental health.

Ifred blog photo

 

The importance of good mental health to individual well-being can be demonstrated, in fact, by reference to values, according to the World Happiness Report 2013, which sit “at the very heart of the human condition.” Here, the Report, for example, says that if the ultimate goal in life and the truest measure of well-being is happiness, it’s “hard if not impossible” to flourish and feel fulfilled in life when individuals are beset by health problems such as depression and anxiety. This couldn’t be truer. Further, an individual’s self-identity and ability to flourish are often influenced by their social surrounding, relationships and engagement with those around them, but with mental illness, these become increasing difficult to maintain and manage. Importantly, the other issue identified by the report is that once an individual loses the ability to manage thoughts, feelings and behavior, then happiness becomes a distant dream to them.

 

The focus then should be at promoting happiness in all spheres of life, at home, school, work, and, in effect, promote mental health too. This would mean fostering an environment, for example, where young people and young professionals would not be personally, professionally or socially pushed to be isolated, over-stressed, keep feelings bottled up and be accepted and nurtured to grow and develop on their strengths and manage their weaknesses.

 

Further, there is plenty of scientific evidence that links happiness (thus equating to the absence of mental illness) to healthy lifestyles, including getting plenty of exercise which releases endorphins – aka happy hormones – and eating right. Personally, meditation and yoga I believe are also great techniques which can be developed as a lifestyle to promote well-being overall. Teaching these kinds of lifestyle choices from a young age can also prove to be extremely fruitful in the long run to fight unhappiness and mental illness simultaneously. After all, while it’s necessary to further develop medical and social interventions – as is most popular today – to address mental illness, nipping the bud at the root would undoubtedly be the most effective approach!

 

Having said all of this, I am thrilled to say that iFred is already well on its way to adopting this model of intervention, through all of its work. From developing a positive image of depression globally, to educating children about the value of hope in schools, iFred’s work deserves not only praise on this account, but some serious up-scaling through global partnerships!.

 

A new article written by:

Jagannath Lamichhane

 

The Path to Happiness is Sound Mental Health

In July 2011 the UN General Assembly passed a historic resolution:  It invited member countries to measure the happiness of their people and to use this to help guide their public policies. Bhutan topped the first report published in 2012 as the ‘happiest’ country, in a shocking revelation. According to the report, “the word ‘happiness’ is not used lightly. Happiness is an aspiration of every human being, and can also be a measure of social progress.” It further goes on to take the example of the US to explain: “America’s founding fathers declared the inalienable right to pursue happiness. Yet are Americans, or citizens of other countries, happy? If they are not, what if anything can be done about it?”

Undoubtedly, this “happiness” discourse is intrinsically linked to the mental health of individuals, communities and countries. One has to wonder: Why are Mexico and Costa Rica “happier” than the US, even in the event of massive income, development and freedom deficits in the former countries? This then leads us to the idea that perhaps — just perhaps — happiness cannot be measured by wealth or external development, but rather by other factors like peace of mind, social cohesion, satisfaction, inclusion in the community and personal integrity: all factors associated with good mental health. Unsurprisingly, the 2013 World Happiness Report reveals in chapter three that mental illness is, in fact, the “single most important cause of unhappiness, but it is largely ignored by policy makers”.

The 2013 report shows that mental health is the “single most important determinant of individual happiness” (in every case where this has been studied). About 10 percent of the world’s population suffers from clinical depression or crippling anxiety disorders going by UN data.  And accordingly, that makes depression and anxiety the biggest causes of disability and absenteeism, with huge costs in terms of misery and economic waste. Most cases of depression and anxiety are easily treatable—medically and socially.

Cost-effective treatments exist as I have discussed in previous blogs, but even in advancedcountries, only a third of those who need it are in treatment according to the report. The incredibly frustrating part is that the available treatments ranging from psychotherapy (CBT, Mindfulness) to medication produce recovery rates of 50% or more, which means that effectively, fifty percent of the world’s ‘unhappy’ people could be happier and be living far more fulfilling lives!

That means that there are indeed objective benefits of subjective well-being. The Happiness Report 2013 shows a broad range of evidence showing that people who are emotionally happier, who have more satisfying lives, and who live in happier communities, are more likely both now and later to be healthy, productive, and socially connected. These benefits in turn flow more broadly to their families, workplaces, and communities, to the advantage of all.

But it seems not enough that human rights require that treatment should be as available for mental illness as it is for physical illness. The policy priority in much of the world for mental health, especially in developing countries, is incredibly low. Even politicians are marked by the terror of the stigma associated with mental illness such that mental illness is rarely expressed or internalized as a leading cause for the misery of any state’s population.

What I found particularly useful in the 2013 World Happiness Report are the solutions suggested to overcome these barriers to sound mental health and thus a happier global population. It suggests two main strategies: to provide better healthcare and social support for adults who are mentally ill. But a second is to intervene earlier — since half of adults who are mentally ill experienced the onset of their mental health problems by the age of 15, say the writers of the report. This, I suppose, would mean starting to talk about mental health as a real and substantial issue from a young age within schools and local communities. The research done on the mental health variable with regards to happiness shows the contribution of a child’s development to his/her resulting life satisfaction as a child. Basically, the emotional development of children is crucial to determining their mental health later in life. According to the research, “if you are interested in well-being, intellectual development needs to be balanced by much more interest in emotional and social development”.

Having read this report, I am even more enthused about the work that iFred is doing through the Schools for Hope program! While the notion of providing better mental health services at the adult stage will forever be crucial to the well-being of society, measures to incorporate the ideas of hope into school curriculums could well go a long way in preventing common mental disorders like depression and anxiety in the first place by nipping the bud at the root. And that is exactly what the World Happiness Report 2013 has clarified – that preventative care is possible, through education and services for young people!

A new article written by:

Jagannath Lamichhane

(with support from Bidushi Dhungel)

#happiness #teachhope #mentalhealth #shinelight

Artwork Inspires a Message of Hope Among Students

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April 4th, 2014 was a day of true celebration.  Students gathered in the heart of campus at the University of North Carolina in Charlotte to witness the dedication of a beautiful piece of artwork.  But it is the powerful and inspiring message that the sunflower sculpture displays that will continue to touch the lives of all who view it.

The sunflowers stand to honor the 350 million who suffer worldwide from depression and other forms of mental illness.  With that honor, it serves as a reminder that no one student or person should ever have to stand alone.  Help and Hope are always available in our greatest time of need.  A plaque reads:

This sunflower sculpture is donated to the University in recognition for those suffering from depression and other mental illnesses.  The sunflower is yellow, the color of joy; it naturally grows toward the sunlight and likewise, this sunflower sculpture symbolizes turning away from the darkness and embracing the light.  Embrace the light that surrounds us, as no amount of darkness can overpower the light that is available to all.

The Graduate Team and the Inspiring Story Behind Their Project

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 Pictured from left to right:  Bhargavi Golluru, Chris Yoder, Paul Franklin, Samantha Howie, and Tim Seckler

Their passion came from the heart with each student having known someone or been impacted in their life in some way by mental illness.  When learning about iFred’s Field for Hope project, the team initially wanted to do a sunflower planting on campus to help raise awareness and reduce the stigma of depression.

Early into their project, they were met with their first obstacle.  A viable location did not exist for the planting or care of sunflowers.  The team did not give up hope!  Instead, they decided to engineer and construct a sculpture in the form of a sunflower.  This course of action opened up the opportunity for creating awareness and sharing the message with campus inhabitants, faculty and visitors year round.

They put in an incredible amount of time and effort to see the sculpture come to life in a matter of weeks.  The team posted fliers announcing the unveiling, as well as creating an event on social media to invite the student body, faculty, and visitors.  Please visit Artwork for Hope for a visual display of their creative process.

The Dedication

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 The entire team was present to welcome attendees and share the story of their project.  Sunflower pins and brochures were distributed near a bright colored sign displaying the message “Help Bring Sunshine Into The Lives of Others”.  Samantha Howie stated, “Our ultimate goal is to let those with depression know that they are not alone.  There is help available.”

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Melissa Marshburn from Cardinal Innovations and Penny Tate from iFred were proud to attend, speak, and personally thank the students.
Cindy Ballaro was so inspired by the event, she has plans to carry on the message with her own sunflower sculpture displayCindy-Ballaro at The Respite: A Centre for Grief and Hope.  What a beautiful way to deliver hope through the creative process of art.

iFred extends a heartfelt thank you to the following students on the “To Give Them A Choice” Team.  These individuals deserve the highest recognition for all of their hard work in shining their light.  Their vision was brought to a reality and will impact the lives of students, faculty, and visitors to come.

A new article written by Penny Tate

#sharehope #endstigma #shinelight

Shining a Light for Depression: An Invitation to Plant Hope

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Many of us recognize the unfortunate stigma that remains in society when it comes to openly discussing our own or our loved ones depression and/or mental health.  Yet, as Paolo del Vecchio, M.S.W and Director of Mental Health at SAMHSA shares on his recent blog, less than 1/3 of those with mental health challenges receive treatment.  This must change.

Many of the images we are bombarded with in the media depict colorless and isolating scenes of those with depression, full of silent expressions of shame, hopelessness, and grief.  While this may be a key symptom of someone in the middle of a major depressive episode, the fact remains that depression is treatable and many find this experience their greatest gift.  All that is needed is for them to make it through the pain and find their way to light.

iFredBlogLogoToday on this Mental Health Blog Day, I would like to share my journey out of isolation.  It all started with planting a sunflower.

In 2009, I lost my mom to suicide.  She fell into a clinical depression in 2008 after undergoing some medication changes.  She suffered silently and lived in great fear of anyone finding out.  My dad and I knew of her struggle and did our best with the information we had at the time to help her.  But we also lived in isolation.

She begged for us not to ever share her suffering.  She saw herself as damaged goods and less than others.  As family members, we honored her request for privacy.  We only spoke to her doctors.  No one else in our family knew of her struggle.  She hid it from her siblings, extended family, and dear friends; the people who truly loved and cared for her happiness and well-being.  The stigma of depression had robbed our family of much needed guidance and support.

In my time of healing, I came across iFred’s message to “Shine a Light on Depression”.  When researching the topic, this was something I had never seen.  Seeing the beautiful sunflowers accompanied by the inspirational message that there is hope was very welcoming.  All around the world, sunflowers were being planted to honor the World Health Organization’s most recent statistic of the 350 million who experience depression.  I read about their Field for Hope project and knew I wanted to be a part of it.  I initially donated one dollar to have a sunflower planted in my mom’s honor, and it spiraled from there.

Next, I decided to plant my own garden which inspired Gardens for Hope. The sight of the sunflowers outside my window I knew would help cheer me.  I printed a sign from the website and posted it in my yard that I was “Shining a Light of Hope on Depression.”  What happened next came as a wonderful surprise.  Conversations were started in regards to my sunflower planting with my family and friends…and then neighbors.  People wanted to know about the project and its message.  Having the opportunity to open up the subject in such a positive way connected me to others in a way I never thought possible.  I was amazed at the response I received.  It truly opened the door for sharing experiences.

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From my backyard, I saw my own pathway to continue the conversation.  A farm located behind my home grows sunflowers in their field each season.  So I decided to approach the farmer and ask if they would be interested in donating their sunflowers to the cause by displaying a Field for Hope sign.  She immediately agreed and had her own stories to share.  With every visitor to her local farm stand, another community member was reached.

Once the conversations got started, I found it easier to share.  After posting on Facebook and Twitter, I received hundreds of messages.  People thanked me for talking about it.  Many then shared their stories with me.  I began to see that by shining my light on depression, it encouraged others to shine theirs.  I believe as we continue to have the conversation, we will indeed reduce the stigma by creating awareness and knowledge…and that all of us are most definitely not alone.

iFred saw the work I was doing, and asked me to come on their team to help #teachhope to kids dealing with depression and talk to celebrities like Rick Springfield to help end stigma with #famousfaces.  When I learned that research suggests HOPE is teachable, I got on board.  So we are now creating a curriculum that is being tested in schools across the country called Schools for Hope.

For me, it started with planting a sunflower and sharing my story.  Now I am no longer isolated.  My fear has dissipated.  I talk about depression.  I talk about available treatment.  I am the voice for my mom.  I am proud to talk about the wonderful human being she was and I do not define her life by her death.  She was an amazing mother, wife, sister, friend, and the list goes on.  And she had depression.  She lost her life to an illness that we are afraid to talk about.  This needs to change.

Never underestimate the power of your own voice and your own story.  Someone will be listening.  Just begin the conversation and plant your seed.  Shine Your Light for Hope.

A new article written by Penny Tate

#mhblogday #planthope #shinelight #endstigma #teachhope

 

 

The Concept of “Mental (In)capacity” can never be a basis to deprive people with psychosocial disabilities and mental health problems of “legal capacity”

by Jagannath Lamichhane

Last week, I came across a Facebook post of a dear friend, which moved me to tears. Gabor Gombos, a former United Nations member of the Committee on the Rights of Persons with Disabilities (CRPD) — and a man whom I always looked at with high esteem as a source of knowledge and inspiration for the millions of people in the mental health and psychosocial disability rights movement across the world — was in a state of utter despair.

Gabor had written on his wall page: “Doctors say there is no hope for Kati, my only wife in my life, my co-worker, the mother of our child, who survived three days. We jointly did what I became famous of. We had hard times recently as well. Now she is slowly dying. I am dying too. Life is meaningless and impossible”.

His message affected me deeply and I felt depressed the entire day. I never thought I’d have to read such words of despair coming from a man of such strength and accomplishment in the field. Gabor had even gone as far as to indicate he was most inclined to hang himself. In response, there were hundreds of comments on his Facebook page praying for the good health of his wife and his own strength. I also wrote a few words: “My prayers Gabor, stay strong’.

A few days passed through which time and again I would think of Gabor and the loss to the movement and myself were he to really take his own life. I was quite worried actually.

A couple of days later, I heard about the United Nations Committee on the CRPD General Comment on article 12 ie legal equality (legal capacity) of people with disabilities, including psychosocial and mental health problems.  Although article 12 of the disability convention was already a revolutionary article giving equal legal recognition of people with disabilities — including mental health problems and psychosocial disabilities — in absence of the United Nations CRPD Committee’s authoritative interpretation of the article, its interpretation remained controversial since the adoption of the CRPD in 2006.

However, this general comment brought an end to the ongoing controversy, endorsing equal rights and equal recognition of people with disabilities before the law. The general comment has explicitly interpreted that legal discrimination on the basis of disability or in the name of mental (in)capacity is clearly a violation of human rights and against international human rights principles. The general comment has highlighted that there has been a general failure to understand that the human rights-based model of disability implies a shift from the substitute decision-making paradigm to one that is based on supported decision-making.

The general comment discards the concept of “mental capacity” as a social and political construct lacking an objective, scientific and naturally occurring phenomenon. The CRPD Committee explicitly recommends the state parties to guarantee civil and political rights for people with disabilities, even if they might require support in decision-making. While developing a policy framework in the country level, the Committee clearly recommends that support in decision-making must not be used as a justification for limiting other fundamental rights of persons with disabilities, especially the right to vote, the right to marry (or establish a civil partnership) and found a family, reproductive rights, parental rights, medical treatment and the right to liberty.

Most importantly, the interpretation heralds an end to the era of forced psychiatry, a long and much-awaited battle in the fields of psychiatry and human rights. Following this committee report, involuntary detention in psychiatric or mental health facilities without consent is now considered a violation of human rights and punishment can be sought.

It was great news. I had not expected such a bold and clear interpretation of the article 12 of the CRPD so early. And it is because of people like Gabor and so many others, who fought their whole lives to establish equal rights and stop the practice of involuntary detention, that the interpretation has been possible. This general comment is the greatest victory yet for the thousands of millions of people living with psychosocial disabilities and mental health problems across the world.

But while the community was celebrating this this historical moment, I couldn’t help but think of Gabor’s tragic situation. All of the sudden, I saw a thank you message from Gabor on his Facebook page–full of emotion, hope and victory. He wrote: “thank you all for your empathy, love and support. That means a lot. Kati’s health is slightly improved. No immediate danger. This morning, she was much more attentive than before. I spoke to her about the General Comment on the CRPD article 12. I can’t know how much she understood. Once I heard about the general comment I felt some peace. Pain is very much there and sorrow, but also peace”.

It was upon reading this that my eyes filled with tears. I reminded myself how indispensable liberty and freedom is in an individual’s life.  We do not have control over our future and destiny and at any time, we might suffer from disease, disability, mental illness, tragedy and the like. However, no misery can be a cause to take away an individual’s right to live as he/she pleases. Now a new era has begun where mental illness cannot be the reason or justification to deprive people of equal legal and human rights. I salute Gabor and the countless others who made it possible.

 

 

 

Why the Global Movement for Mental Health? Time to Join.

Countries in crisis are a breeding ground for ill health. The social, political and economic conditions harbored by crises – from Tsunamis and earthquakes to conflicts – make countries ripe for disease. That’s why we see figures related to infant and maternal mortality, life expectancy and most communicable and non-communicable diseases posing a real threat to the livelihoods of a good chunk of the population in countries like the Sudan, Afghanistan or Iraq.

These factors of instability, destruction and violence have a huge impact on the mental health of a population as well. In fact, it has been proven that in countries where conflict is present the rate of mental health problems are higher. Take Afghanistan for example: it is estimated that 73% of Afghan women show symptoms of depression, 84% suffer from anxiety, and 48% from post-traumatic stress disorder. Of course, the figures are not much better for men either, but, women being the most vulnerable group, suffer most.

In many African countries, the situation concerning mental health is simply diabolical. Decades of conflict and violence matched by extreme poverty and destitution have left huge populations in a mental crisis. However, as dire as the situation is, these populations are the “forgotten,” “condemned” to a life of “misery and abuse,” according to photographer and journalist Robin Hammond, who recently published a collection of revealing photographs depicting the suffering of those with mental health problems in African countries which are most in crisis.

The images are telling in themselves and speak volumes about the unthinkable extent to which men, women and children are being treated as sub-human – caged, locked-up, chained, abused, beaten and bruised – within their own communities. In many instances, as the photos describe, there seems to be no alternative available in the context of abject poverty, lack of awareness and access.

One photograph which stands out is of a 13 year- old Ahmed Adan Ahmed, who “spends his days walking in circles, or sitting running his hands through the sand at his feet,” as “for 10 years, he has been tied to a stick under the tarpaulin of a tent in a camp for Internally Displaced People in Galkayo, Somalia.” What is painstakingly hard to digest is that his mother Fawzia “sees no other option – if she doesn’t tie him he will run away,” she told the photographer.

Ahmed Adan Ahmed

In another photograph from Nigeria, the image is perhaps even more distressing: a “patient” is tied to a tree with his hands joined as if begging. The caption for the image reads: “Native Doctor Lekwe Deezia claims to heal mental illness through the power of prayer and traditional herbal medicines. While receiving treatment, which can sometimes take months, his patients are chained to trees in his courtyard. They begged the photographer for food – they say they are only fed once a day, sometimes only once every 3 days. The Niger Delta, Nigeria.”

Nigerian Man Chained to Tree

These photos and the collection by Robin Hammond is perhaps one of the most comprehensive collections of images which portray the devastating reality of the negligence of mental health issues and of those who suffer on the ground in some of the world’s most marginalized countries in communities. In the midst of upheaval, they are left to suffer in silence.

In countries like Somalia, ravaged by over two decades of civil conflict, the World Health organization says that at least one in three people have some kind of mental health problem. And yet, the way in which such a major problem is being dealt with is by not dealing with it at all. The victims of disaster are being made to bear the brunt of their countries’ crisis — well demonstrated in the way in which those who suffer from mental illness are living across Africa.

But I have to admit that when I saw these photographs, I couldn’t help but think about the situation in my own country, Nepal. Centuries of exploitation and poverty, followed by a brutal civil conflict and social, political and economic instability has left the country ravaged. In many ways, those who suffer from mental health problems in Nepal share a similar fate to those as shown in Robin’s photographs. One image, in particular, of a 12-year old boy, Prabin, whom I came across years ago, keeps coming to mind. He was chained and locked up for seven years because he “lost his mind”. His father had to leave his job as a policeman during the Maoist insurgency because of the fear of violence. And when Prabin was two and half years old, his father went to Malaysia for work and returned home only after four years. Since then, no one had been employed in the family and one family member needed always to be around to look after Prabin.

There were many cross-cutting issues I saw in Prabin’s family which are symptomatic of all countries in crisis— poverty, disability, mental illness, trauma from the conflict, lack of healthcare, migration and unemployment — all of which collectively pushed the whole family into a predicament, with Prabin at the centre of the suffering. Prabin is no longer in chains thanks to a few well-wishers, but thousands like him, young boys and girls across Asia and Africa, are still being chained, locked up and abused. Prabin’s photo is pasted below.

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If the simple fact that massive human rights abuses and violations don’t inspire you to act, consider this.

If the simple fact that massive human rights abuses and violations don’t inspire you to act, consider this:  Some of the most famous people in the world, contributing the most to our global prosperity, had mental health issues they faced.  The only difference is they were treated with respect, had access to quality social and health care services, and used their mental anguish to fuel their trade .  Some of the greats include Thomas Jefferson, Winston Churchill, Oprah Winfrey, and others mentioned on our Famous Faces page.  Imagine a world where all those with mental health issues received timely support and treatment, and used their emotional depth as a force for good?

Today’s blog post is just a reminder, to myself and others who are working towards achieving the goals of the Movement for Global Mental Health, of why we need to pool our efforts to address this immediate crisis. Sometimes, it’s easy to forget why we do what we do. I hope this serves as a reminder to us all.

by Jagannath Lamichhane

With support from Bidushi Dhungel

A Touching Message from a South African Sacred Activist; Her Thoughts on Mandela, Healing, and Hope

Dear fellow Sacred Activists:
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I have a heavy heart and many tears I am shedding this morning.  I am crying for my beloved country.  My heart is aching for all those who sacrificed so much in service to a just and civil society, and continue to do so. I pray that those who are currently in power in South Africa will pause as they mourn our beloved Madiba, and remember that he transformed from freedom fighter and enemy to a revered leader who sought reconciliation. Mandela was arrested after being found by a CIA agent.  My great-uncle (by marriage) Bram Fischer, was Mandela’s attorney during his trial. I remember as a child seeing Robben Island and learning of the prison that held many who are now famous and a number who have died.  During my political activism I came to know people who had served at “the university” as it was called. Colleagues and friends would just disappear without explanation. When they ended up on Robben Island they would be part of conversations orchestrated by the leaders incarcerated there.  And then, on being released, would teach those of us working in townships and squatter camps, trade unions and community organizations, giving us word of what the leadership’s plans were.  Each and every one of their legacies lives on. In South Africa during that time we were not allowed to have images of Nelson Mandela.  Possession of the Freedom Charter that became the most progressive constitution on the planet was grounds for being imprisoned without trial.  We were all imprisoned by the draconian system, even the most privileged, even those who never saw the inside of a cell. When I left South Africa in 1986 during a State of Emergency, and into political exile, I never imagined that in my lifetime Mandela would be released. I never imagined I would ever be able to return to South Africa.  I never imagined that my mixed race daughter would have children who could be friends with children of different colors and cultures.  I never imagined that South Africa would ever be embraced by the rest of Africa because it had always been such a pariah in the eyes of the rest of the continent.  I never imagined that the world would support the change we all fought for and made huge sacrifices for – my imagination was limited by the oppression I grew up in. One never knows how the tides of change will shift the sands.  One never knows how orchestrated insignificant acts can create a crescendo of change such as was experienced in my homeland.   There have been rare moments in my life, as a 5th generation white South African, that I have felt proud to have that legacy.  Today, my pride is mixed with a depth of grief because I am not there on South African soil, to be caught up in the crowds of mourners honoring and remembering. As South Africa moves towards a presidential election, may we all pray that the current  leaders remember that power is to be shared, not hoarded and used to corrupt. In solidarity with all around the globe who mourn with me. Lyndall Hare

Schools for Hope; New Campaign to Prevent Suicide in Youth

High School Teens at Oak Park River Forest High School Planting Hope, 2013

Did you know 1 in 9 kids attempt suicide prior to graduating high school, and that 40% of those kids are in grade school?  (Journal of Adolescent Health via Family Matters, 2011).  And that the number one autofill on google is ‘Hope makes me…  depressed’?  We don’t know exactly why, but what we do know is that the primary predictors of suicide include hopelessness and depression.  (Association of Physicians, 2004).

The Good news?  HOPE is teachable and depression is treatable? (Rand and Cheavens, 2008),  It is true.  Research suggests that Hope can be taught  and that the greater the hope, the greater the level of well-being (Scioli, 2009).  Hope is defined as the perceived ability to create pathways to a desired result, and the motivation to follow those pathways through to the desired result (Rand and Cheavens, 2008).  Higher Hope corresponds to greater emotional and psychological well-being, greater academic performance, and enhanced personal relationships (Snyder, 2005).

With your help, we can bring a lesson plan of HOPE with activities to the classroom.  Our goal is to raise $85,000 throughout December for this project through our Indiegogo campaign, and then to spend January and February creating the research-based curriculum to launch in ten test schools in April of 2014.  Our goal is then to take the finalized curriculum global in 2015.

Our Overall Vision for Schools for Hope:

Our aim is to expand on our Field for Hope project that cultivates Hope through seeing through a planting of sunflowers; from seed to flower and back to seed.  With your help we aim to take this project further and share messages and symbols of hope with others; creating curriculum around the planting specifically to teach Hope to children.  And then to nurture Hope and through peer to peer support to teach this to the next classroom.

  • Engaging children through a 360° support and wisdom sharing system—peer-to-peer, teachers, counselors/psychologists and parents.
  • Partnering with mental health education experts, curriculum will be targeted, self-paced and ready to implement into school systems.
  • Leverage online and new social mobile application technology to implement the program. Content will be engaging and inspirational and delivered on a relevant youth-oriented platform.
  • Integrate a yearly sunflower planting symbolic of HOPE in the Spring, writing messages of Hope to those that then harvest the seeds in the fall, starting the infinite spiral for Hope.
  • Garner research through metrics analysis, evaluation and optimization.
  • Pilot in Chicago schools; adapt to deploy tailored program focused in PTSD and tragedy to those areas as needed. (i.e. Sandy Hook, Columbine, Oklahoma, etc.)

Please help us make this campaign a success!  With your generous donation of time, brain power, and/or contacts we can get this moving.  Hope is teachable, depression is treatable. Let’s help make ALL kids feel value and like there is always a way to resolve problems in a positive, productive way.

Please visit www.schoolsforhope.org and help us make this project a reality.