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

 

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

Penny_Tate_Pinning_Rick_Springfield

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.

 

 

 

There is a strong need to transform the Movement for Global Mental Health into an inclusive movement

-Jagannath Lamichhane

Although some claim that The Movement for Global Mental Health (MGMH) is, essentially, the brainchild of the Western medical framework, a closer look at the work being done under the MGMH banner would prove contrary. I know that less powerful and low income countries and their citizenry are making important strides to define the problems and solutions related to mental health because of the work of the Movement.

against mental violence The MGMH is the first cross-continental effort to bring diverse expertise, resources and perspectives on to one platform with a common goal of addressing mental health both at the global and local level. Their representation of a global movement, rather than western brainchild, is particularly evident in the recent shift of the global secretariat of the movement from the West (Sydney, Australia) to New Delhi, India, as well as the transfer of the movement’s leadership from medical professionals to those with expertise in social and community based fields. These changes are working to accommodate the diverse concerns of civil society groups regarding the rights of the persons with psychosocial disability and mental health problems.

Contrary to traditional approaches of addressing mental health, in which ‘professionals’ thrust ‘treatment’ onto ‘patients’, the MGMH promotes the role of people with psychosocial disabilities and mental health problems as equal partners in every endeavor from the health care setting, to the community and in efforts to promote human rights, fighting stigma and discriminations. Also, the MGMH advocates greater human rights along with affordable and accessible mental health care for all by putting greater emphasis on the UN Convention on the Rights of Persons with Disabilities (CRPD).

The MGMH believes in building an international civil society that can speak out and stand for the cause, and mobilise direct actions in order to overcome mental health challenges ranging from stigma, inequitable health services, social discrimination and others. This international community looks like a consolidated effort among the various stakeholder and creative partnerships among stakeholders around the world.

There are already some effective examples of partnership in promoting human rights and mental health. For example, the EMPOWER project brought together civil society groups representing all kinds of professionals working in the fields of medicine, research and human rights and together they worked not only to generate a new knowledge, but have set an example to advocate mental health in low and middle-income countries.

Towards creating a leadership community across the globe, the movement offers training and short courses like the Leadership in Mental Health, which is an annual two-week leadership course in mental health for all kinds of people interested and affected by mental health issues. The tutors in the course range from activists to researchers and psychosocial disabilities.

However, the future of MGMH is not straightforward. The divide among the stakeholders in the mental health community — some of whom prioritize the human rights elements over the medical elements and vice versa — is the greatest obstacle to fulfilling the goals of the movement.

The tussle over where the emphasis needs to be within the mental health domain has been at the centre of this divide. In fact, there is a misconstrued understanding among some stakeholders– largely non-professional groups– that the MGMH is a banner through which the medical model of psychiatry and mental health is being promoted. On the other hand, many professional groups believe that the non-professional activists and their associated movements in the realm of mental health reject the very idea of the possibilities of modern medicine in addressing mental health concerns. Some individuals and opinion makers have even labeled the MGMH as a neo-colonial project.

But these polarized views are untrue to the genuine efforts and initiatives being made across the board — by professionals and activists, and civil society groups in the field. That’s why although the major barrier for the Movement is this divide among stakeholders, I believe that these initial days of the Movement’s efforts can in fact be used to create a sense of belonging among all of those concerned. We can also hammer out the differences –among professionals, activists, researchers and psychosocial disability community – in order to come to a consensus which would benefit the hundreds of thousands of people living with mental health problems and psychosocial disability globally today.

There is no doubt in my mind that all groups are working tirelessly to find sustainable ways through which the needs of one of the most vulnerable groups in the world can be met –medically, socially, politically and economically. While making an effort to find solution, it is urgent among stakeholders to understand each other’s work and promote respect for each other.

(With support from Bidushi Dhungel)

 

INTERNATONAL COMMUNITY MUST SHOW MORAL SOLIDARITY TO ADDRESS MENTAL HEALTH SUFFERING IN DEVELOPING COUNTRIES

Jagannath Lamichhane

In my last blog post, I had briefly mentioned the need for international moral solidarity as a first step in addressing mental health related suffering in developing countries. Here, I will elaborate why international moral solidarity is important in the field of mental health and psychosocial disability.

Let me begin with a short description of a video aired on Channel4 (UK) a few months ago called life in chains: the plight of Somalia’s mentally ill. This film features Abdullahi, who was chained up by his kin for the past 17 years. The story of Abdullahi imbibes the viewer in his pain, his suffering. According to a BBC news report, Somalia has the highest rate of mental illness in the world. In a country where social order and the health care system have been devastated by decades of war, people with mental health problems are the forgotten people.

" It is on this humanitarian and human rights ground that I argue the international community must show moral solidarity in addressing mental health-related suffering of people with mental health problems in developing countries. That means we start to value people with mental health problems as equals to care about; as worthy as others to pay attention to, and their suffering as real as others’ to address. "

” It is on this humanitarian and human rights ground that I argue the international community must show moral solidarity in addressing mental health-related suffering of people with mental health problems in developing countries. That means we start to value people with mental health problems as equals to care about; as worthy as others to pay attention to, and their suffering as real as others’ to address. “

They cannot enjoy human status. They cannot enjoy the freedoms that even animals can. They are unseen everywhere in society and its social order, all the while physically and mentally in chains in front of our eyes in public spaces. Just like Abdullahi. In Somalia alone, over one hundred thousand people with mental health problems are living their lives in chains.

Somalia is not a stand-alone case. Take Indonesia for another example where over 30,000 people with mental health problems are still inhumanly chained across the country today. No matter — rich or poor — people with mental health problems are the worst victims of abuse, discrimination and social exclusion globally. The nature and degree of the problems are different in different countries but very much there and of their own local nature. While over-medicalization, forced treatment, torture and institutionalization are the major mental health-related problems of developed countries, lack of access to basic social services, medical treatment, chaining, abuse and discrimination are the widespread mental health related problems of low and middle income countries.

Despite the above mentioned evidence of abuse, neglect, discrimination, torture, cruelty, inhuman and degrading treatment of people with mental health problems, the international community, actively involved in the low and middle income countries, is completely overlooking these issues. It is both a shame and surprise to me.  Why is the international community failing to show moral solidarity (at the very least) on mental health and psychosocial disability issues in developing countries?

Its answer is not simple. In my observation, it seems ignoring mental health problems in developing countries is a kind of hypocrisy being practiced by the international community. Their failure to notice such widespread mental health related human rights violations in poor countries is a challenge to the moral foundation of their work where they stand and what they preach.

The inhuman and degrading treatment of people with mental health problems are among the most disgraceful acts of our time. On the basis of superstitious beliefs; traditional, social and cultural practice; ignorance about the nature of  problems; lack of adequate social and family support; that those suffering are dangerous to self and other, people with mental health problems are being chained, locked up years in jails, and denied basic social and medical care.

After being labeled mentally ill, people loose their social status, community network, and kinship, which is equal to a social death, as explained in this article from The Lancet, ‘Global Mental Health: a failure of humanity’. This label creates permanent inequality in the society.  People with mental health problems cannot imagine enjoying their civil and political rights. They are shamed and demoralized. They turn into unequal and forgotten citizen. The suffering of these people however do not get any space at the global or local levels of discourse on human rights, development, social security, health, and others.

In the absence of moral solidarity, moral exclusion takes place. As described by Susan Opotow in her essay, Moral Exclusion and Injustice: An Introduction, “Moral exclusion occurs when individuals or groups are perceived as outside the boundary in which moral values, rules, and considerations of fairness apply. Those who are morally excluded are perceived as nonentities, expendable, or underserving. Consequently, harming or exploiting them appears to be appropriate, acceptable, or just”.

In this context, my point is that the silence of the international community on mental health related problems endorses all kinds of atrocities against people with mental health problems, like Abdullahi. In a battle to challenge and stop such inhuman actions, first, it is important for everyone, including the international community, to acknowledge the prevalent tragedies faced by people with mental health problems in developing countries as unacceptable on humanitarian and human rights grounds.

It is on this humanitarian and human rights ground that I argue the international community must show moral solidarity in addressing mental health-related suffering of people with mental health problems in developing countries. That means we start to value people with mental health problems as equals to care about; as worthy as others to pay attention to, and their suffering as real as others’ to address.

(With support from Bidushi Dhungel)

Press Release: iFred Launches Depression News Blog to Shine Light, Advocate Hope and End the Stigma of Depression

For Immediate Release:

February 5, 2014

iFred to launch global blog to shine  light, advocate hope, and end stigma of depression

Chicago IL:  The International Foundation for Research and Education on Depression (iFred) today launches its new blog series “Seeds for Hope” at (www.ifred.org). The aim is to shine light on the leading cause of disability around the world and give hope to the 350 million depression survivors worldwide with the disease. Jagannath Lamichhane, pioneer in mental health media from Nepal, is authoring the biweekly blog in the wake of the United Nations-adopted World Health Organization’s ‘Global Mental Health Action Plan’.

Jagannath Lamichhane was chosen to author this important endeavor as he is a human rights activist and has pioneered mental health advocacy in Nepal and globally.  When Jagannath was asked about authoring, he stated, “I am thrilled to be a part of iFred’s international effort to combat the stigma against depression,” adding that he would, through the blog, try to “address the range and depth of concerns facing those who suffer from depression and other health and human rights issues surrounding the disease and disability.  I also plan to highlight the incredible work countries and individuals around the world are doing globally in helping those with depression.”

Depression and other mental health problems have recently been recognized as a serious global health burden.  According to a new report entitled Transforming Lives, Enhancing Communities – Innovations in Global Mental Health – edited by Professor Dr. Vikram Patel and Dr Shekhar Saxena, two renowned authorities in the field of global mental health – at least 10 percent of the world’s population is affected by one of a wide range of mental disorders. The report also reveals that depression will be the leading cause of disability worldwide by 2030.

Currently, The WHO estimates that more than 350 million people from around the world already suffer from depression and that depression is behind a large portion of the one million yearly deaths caused by suicide globally. In fact, the burden of mental illness (among which depression is the leading cause) is more than 1.5 times that of all cancers.  These past two years the World Health Organization hosted a groundbreaking effort, of which IFred participated, to develop and implement A Global Mental Health Action Plan adopted by the United Nations for which member states around the world agreed to make mental health a priority.

Kathryn Goetzke’, iFred Founder, thinks this blog is critical to efforts for hope as she states “Depression is treatable, yet according to the World Health Organization less than 50% of those needing treatment receive treatment primarily due to stigma.  This blog is going to help us communicate the issues around depression, educate mental health consumers around the world on treatment, and continue to shine a positive light of hope to help end stigma.  I first met Jagannath in Athens, Greece at an event I spoke for on rebranding depression on the Global Mental Health Movement as we worked with the BBC to raise public awareness of our work.  We met then again at the United Nations while advocating Human Rights for those with depression, so I know we are in great hands and so very fortunate to have him on board”.

iFred hopes this endeavor will yield impactful results in awareness raising and engaging communities in finding solutions to tackle the greatest challenge of our time – depression.

About iFred:

The mission of International Foundation for Research and Education on Depression (iFred) is to shine a positive light on depression and eliminate the stigma associated with the disease through prevention, research and education. Its goal is to ensure 100% of the 350 million people affected by depression seek and receive treatment.  iFred is creating a shift in society’s negative perception of depression through positive imagery and branding—establishing the sunflower and color yellow as the international symbols of hope for depression. iFred also engages with individuals and organizations to execute high-impact and effective campaigns that educate the public about support and treatment for depression.

 

About Jagannath Lamichhanejagannath 3 (190x143)

Jagannath Lamichhane: Jagannath is a psychosocial disability and human rights activist from Nepal. He is the founding chairman of the Nepal Mental Health Foundation, the only advocacy and policy focused mental health service user-run organization. He has contributed greatly to the mental health discourse, including in The Guardian and the Lancet medical journal, among others. His main areas of interest are human rights violations, legal inequality, dehumanization, and social exclusion of people with psychosocial disabilities and mental health problems. Currently, he is doing MSC in Global Mental Health at the London School of Hygiene and Tropical Medicine and Kings College London.  In his free time, he likes to meditate, watch films and hopes to see more of this beautiful world.

Seeds for Hope

Lamichhane and Goetzke at the first Global Mental Health Summit

I still remember the first day I met Kathryn Goetze, founder of the International Foundation for Research and Education on Depression (iFred). It was in Greece on the 2nd of September, 2009, during the first ever global mental health summit; the early days of my entry into the then-newly emerging field of global mental health. I guess you could say that until then, when it came to issues of mental health, my understanding was traditional and shaped by negative public perceptions.

However, it was upon hearing Kathryn speak at the summit about the need to rebrand depression and her endeavor to give depression a positive brand with the help of the image of sunflowers, that I began to understand how we can work to re-construct social understandings of mental illness and depression. I began too slowly realize that societal perceptions of mental health are constructed with negative images and that with effective campaigning, could well be re-constructed with the use of positive imagery like that of the sunflower.

Since 2009, I have remained in constant communication with Kathryn, keenly observing her work. It was in 2011 that I finally got a chance to actually work with her on her global initiative — the Field for Hope campaign, where fields of sunflowers are planted to shed light on depression and simultaneously work to give the mental health related problems a more positive image. It was, however, only recently that I thought about exactly what the motivations for Kathryn’s involvement in the sector were. I knew that she was doing wonderful and innovative work to tackle stigma against depression but didn’t know why she was doing it. I caught up with her and what I learned was telling.

Kathryn had lost her father to suicide at the tender age of 19. “It was very devastating to me. He was a brilliant businessman, very close to me, and I knew there was something ‘wrong’ with him from an early age, but had no idea what it was,” she recalled. It was only after several years of study in her 20’s that she realized it was untreated depression.

By the time she was in her 30’s Kathryn began to apprehend that she too was struggling with depression, “a chemical imbalance of the brain that manifests itself in different ways through different people,” in her words. She had developed addictions – to food, alcohol and could not understand why for a long time.

That’s why when Kathryn launched her company she wanted to donate her time and resources to help educate people about depression. However, in order to do so, she would have to start a new movement herself.

The sad reality of the global context of depression is that even the non-profits and organizations working on depression are by and large straggled themselves by the negative stigmas and imageries surrounding depression. Kathryn found that “the nonprofits doing work in this area were often, ironically, depressing.” According to her, these non-profits focused more “on symptoms rather than the impact of treatment,” and fail to recognize the fact that depression is the “most hopeful disease there is — depression is treatable.” That fact is one that many societies across the world, even the most developed, are yet to come to terms with.

The majority of images of depression are depressing people–sad men and women, head bowing down, arms wrapped around the knees and almost crying, in dreadful black and white gloom. As an expert in marketing and branding, Kathryn set out to challenge and, thus, change the stigma surrounding depression. by creating an organization to help rebrand the disease through “educating other NGOs about branding and stigma, engaging celebrities and role models to talk about the disease, and teach the public about the biology of the brain.”

 

For Kathryn, it is this biology of the brain that is central to being mentally fit. “We must learn about creating and maintaining a healthy brain. Everything they think, eat, feel, and do affects the health of their brain.” According to her, the world is going to be based more and more on human intelligence, so creativity, brain health, and ability to solve problems is increasing ever more in importance. That is why Kathryn has begun this new movement to “Learn about and feed the brain in positive ways.”

 

This is not the first time such a rebranding of a disease is taking place. A major rebranding success was seen in fighting the stigma surrounding breast cancer some decades ago. Iconic symbols like the pink ribbon and the ownership of the cause by celebrities helped to quickly bring the disease to the mainstream and strip it of its negative stigma. Kathryn hopes to help enable the same for depression.

When asked what she would like to see accomplished in her life, she replied that she’d like to see an “event similar to ‘Stand Up to Cancer’, engaging celebrities from all walks of life to raise money and awareness for depression by speaking out on how to find hope when all else is going wrong.”  Further, Kathryn wants to be able to “live in a world where there are no suicides and people feel fine about getting treatment for their depression.” Her advocacy is undoubtedly on the right track to make this a reality.

In addition, Kathryn is working with companies to implement depression awareness and prevention programs in the workplace. She is also working on her Schools for Hope, “a curriculum we are developing to teach kids about how they can create Hope,” she said. Towards this end, she is also seeking support from consumer products companies.

Having been a part of the Field for Hope campaign, I can see its positive effects in encouraging communities to gather and talk about healthy brains and as a way to “honour those with depression,” as Kathryn told me. Overtime, the image of the sunflower will drown out the negative images of depression we see all-too-prevalent today. What Kathryn hopes for the future is to “have people think of a sunflower when they hear the word depression.”

Her work has been exemplary and encouraging in every way for the millions who are suffering. She vows to continue encouraging others to find the beauty in their darkness, and use the powerful force to create something full of light and inspiration for others.

I am proud to continue to be a part of her noble endeavor through my weekly blog beginning as of January 2014. I urge all to join hands to combat the greatest tragedy of the 21st century–depression.

-Jagannath Lamichhane

(With support from Bidushi Dhungel)

Jagannath Lamichhane is a mental health and human rights activist from Nepal. Currently, he is doing an MSC in global mental health, a program jointly run by Kings College London and the London School of Hygiene and Tropical Medicine, UK. 

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

Dear fellow Sacred Activists:
Nelson-Mandela-Quotes-Wallpaper2
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