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.

Youngboylookingup

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

Global Mental Health: Medical versus Social Approaches to Treatment and Social Change

It has been just six years since the Movement for Global Mental Health took off on October 8, 2008. In that time, the Movement has sought to create a platform that connects the global network of the stakeholders in the field of mental health. While the movement has made much progress in the past few years, it has not been without controversy and criticism.

The most common allegation being that the Movement represents a bio-medical approach to mental health, where psychiatrists rule the roost and the discipline is defined in terms of medical, as opposed to social, parameters. Naturally, such allegations have come from the stakeholders within the field who work within the human rights framework and define mental health within socio-economic parameters. A recent book written by China Mills at Oxford University entitled Decolonising global mental health: The psychiatrization of the majority world (Concepts for Critical Psychology), examines this critique of global mental health well. Mills argues that there is a continued colonial mindset in the field of mental health global mental health.

However, there seems to be a misunderstanding among social-model advocates of mental health regarding the aims and methods of global mental health and in particular the Movement for Global Mental Health.

In this context, iFred wants to draw your attention to a recent interview taken of Professor Vikram Patel, a leading intellectual in vikram patelthe field of Global Mental Health, with Bio Medical Central.

Here, Patel talks about the impact of global mental health on traditional concepts of psychiatry and discusses the initiatives and platforms being developed to promote capacity building, research, policy, advocacy and human rights within the established Centre for Global Mental Health at the London School of Hygiene and Tropical Medicine in London. The anticipated challenges, controversies, and future directions of the global mental health are also highlighted as well. You can also listen to the audio version of this interview here.

 

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Interview with Vikram Patel, reproduced via Bio-Medical Central

What is global mental health and how will it impact the field of medicine?

Global mental health is a discipline of global health and, as with the mission of global health, its primary goal is to improve the health of people worldwide, with a strong focus on equity and access. There is no health without mental health. I think we know, through a large body of evidence, that mental health and physical health interact with each other in very diverse and intimate ways. Therefore, any attempt that we make to improve the mental health of individuals and populations will inevitably have a positive impact on the physical health of those individuals and populations. Therefore, investing in global mental health is, ultimately, an investment in global health.

How was the Centre for Global Mental Health established?

The Centre for Global Mental Health is a partnership between the London School of Hygiene and Tropical Medicine, which is Europe’s leading school of public health, and the Institute of Psychiatry at Kings Health Partners, which is Britain’s leading school of psychiatry and neurosciences. It’s a perfect marriage between academics who have strengths in the various disciplines of global health, and academics who have strengths in the various disciplines of clinical sciences related to mental health. The centre was founded in 2008 to bring these two complementary sets of disciplines on to the same platform to further the science of global mental health. The goal was to promote research, capacity building, and advocacy for policy to improve access to care for people living with mental disorders around the world, with a particular focus on those countries where the treatment gaps were the largest; that is, the low- and middle-income countries of the world.

Can you describe the initiatives and platforms that are involved with this collaboration?

Let me give you examples from each of the three broad themes of work that the Centre for Global Mental health pursues. Firstly, with capacity building, we are delighted that, after many years of plotting and planning, we were able to launch our full-time Masters in Global Mental Health last year. This year, we have had more than 20 applicants successfully admitted and beginning the MSc program. The MSc is, to my knowledge, the only face-to-face residential MSc in this discipline in the world today.

In the area of research, we are currently involved with dozens of research projects in more than 20 countries within sub-Saharan Africa, Latin America and Asia. Some of this research focuses on randomized controlled trials of innovative new interventions to improve access to evidence-based treatments, but we are also engaged in some exciting health systems work that examines how these evidence-based packages of care can be integrated into routine healthcare systems. Our portfolio also includes social science and epidemiological research on mental health problems.

Finally, in the realm of policy and advocacy, we have recently embarked on a number of exciting developments. The first is that we led the Mental Health Forum for the World Innovation Summit for Health, which was held in Qatar in December 2013. Along with Shekhar Saxena of the World Health Organization, I co-chaired this forum, which produced a report specifically directed at ministers of health and other policymakers, to recommend policy actions based on the research evidence in global mental health. Another exciting development is the Mental Health Innovations Network, supported by Grand Challenges Canada, whose goal is to synthesize the rapidly growing evidence base in the field into products that can be useful to a variety of different audiences, from researchers and practitioners to civil society and policymakers.

This is very exciting in terms of all the initiatives and platforms. What do you think are the current anticipated challenges?

There are a number of different challenges. The key is limited resources. There has actually been a fantastic increase in the amount of resources available for research, and of course the Centre for Global Mental Health has been a great beneficiary of that largesse. However, there has not been a similar increase in resources for mental health for ministries of health, particularly in the poorest countries of the world, which rely, to a large extent, on development assistance for their health programs. Thus there has not been the needed increase in resources to scale up mental health services in these countries. So the first important challenge is to mobilize development agencies to finance mental health services in the poorest countries of the world.

The second important challenge is a continuing concern among some communities about the validity of some of the mental health problems that the field is grappling with, in particular the common mental health problems like depression and anxiety. The concern is really whether these conditions are biomedical categories that have universal validity in all cultures, and whether the biomedical approaches that are being utilized in medicine and psychiatry in particular, are relevant and appropriate to all cultures of the world.

Can you indicate also the controversies such as the debate against global mental health?

In fact, my second point is at the heart of the critique that certain mental illness categories, such as depression in particular, do not travel well across cultures. The critique is that the use of such labels represents a medicalization of a social condition where the solutions lie not within a medical approach but more likely within the social or political sphere. And related to this is the concern of exporting psychiatric paradigms of treatment and care which have been at the heart of the mental healthcare systems of the developed world to developing countries where there is very little formal psychiatric care.

Do you also think that global mental health will be influenced by DSM-5 with its recent launch, and ICD-11, which will be launched in the future?

The honest truth is that global mental health is a completely different animal from its predecessor, which comprised cultural psychiatry and international psychiatry. First of all, global mental health is not simply psychiatry. Like global health, it is an interdisciplinary endeavor, and is firmly grounded in the South (that is, in the developing world). Most of the leading practitioners of global mental health live and work in developing countries, not in the developed world. Global mental health is completely contextualized to the cultural and social circumstances of the country in which this work is being carried out, and is action-oriented, seeking to improve the lives of people affected by mental health problems.

An important implication of this reality, in relation to your question, is the replacement of rigid diagnostic systems, which are much more suited to psychiatry and the specialized mental healthcare systems you might encounter in developed countries, with broader, more public health-oriented and contextually appropriate labels and diagnostic systems that communicate better to local policymakers, primary care workers and most importantly, to local communities. Global mental health barely uses DSM-4 or ICD-10 in any concrete way, and I think it is unlikely that DSM-5 or ICD-11 will have much traction either.

What do you think are the future directions for global mental health?

The future directions of global mental health lie in three big areas. The first is to mobilize resources by advocating to policymakers, especially in middle-income countries which have more resources, to finance scaling up of mental health care. This is particularly important in the context of universal health care to advocate for mental health to be given at least parity with physical health in resource allocation and service provision in middle income countries. For low income countries that continue to be dependent on development assistance, we need to be similarly advocating with donors to increase their resources specifically for mental health.

The second is to build capacity. It has to be admitted that there is a great shortage of every kind of mental healthcare provider in the developing world, from specialists like psychiatrists and psychologists all the way through to community-based workers who can provide frontline mental healthcare. There is a great need for investing both in programs that can build capacity that is scalable, and in curricula and other kinds of tools that can be utilized in these sorts of settings for these diverse professional groups.

The third, of course, is research. We clearly need to continue to build evidence which focuses on addressing questions about how we can integrate evidence-based packages for care within routine healthcare systems, so that we can inform governments on how they can make their mental health programs more effective and efficient.

What are you most excited about in relation to the recent developments in global mental health?

What I am really most excited about is that mental health has come out of the closet. I remember 15 years ago when I began working in this field, it was usually embarrassing in India to say that you were a psychiatrist because, if they did not walk away from you, they would look at you perplexed and ask, “Is this really relevant in our country?” I think there has been a dramatic change in the attitudes towards mental health in every sector of society in India, which is the country I know best, whether it is in the community, in the media in terms of the amount and the quality of the reporting on mental health issues, and of course at the level of policymakers. Today, it is so straightforward for me to sit with a Secretary of Health and talk about mental health issues; they are much more receptive, and indeed, more importantly, are much more willing to back their interest with resources.

 

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)

 

Hidden Pictures and the World Health Organization: A Journey to Uncover Global Stories of Mental Health

Hidden Pictures Film

Here is a video we are all about right now at iFred. It’s a summary of the film Hidden Pictures by filmmaker and physician Delaney Ruston. Ruston’s work highlights both the serious need for global mental health resources and the power our personal stories can have

iFred joined global leaders to support the World Health Organization in crafting the Mental Health Global Action Plan by in 2012, that was then adopted by the United Nations in 2013.  Countries around the world convened to discuss implementation of the action plan for Global Mental Health Day in October, 2013, and, with policy highlighted in Ruston’s film. Have you browsed the document yet? You can read an mhGAP summery here or the entire document here. on creating social change.

Watch the WHO and Ruston’s video here and tell us what you think:

Hidden Pictures

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.

Kathryn’s Story: Tackling Depression with a Smart Treatment Plan

Kathryn Goetzke, Field for HopeAs we hold onto our own islands of Hope in the face of depression, we are sure that the same treatment doesn’t work for everyone. Along with therapy and medication, various lifestyle choices and changes may add to our well being. In an article from Everyday Health, iFred founder Kathryn Goetzke discusses how she copes with depression.

‘Over the years, Goetzke has tried numerous medications, therapies, and healing modalities and has settled on “a pretty long list of things I do to keep myself mentally healthy.” Still, she notes, “even then I am not completely free from depression.” On the flip side, she says, “I have learned coping mechanisms that seem to keep my life running along very well.””

Read the story and tell us what a smart treatment plan looks like for you. Join our social networks for mental health,  including our community on Insipre, if you want to talk and learn more from others who find hope through their depression.

Everyday Health: “Tackling Depression with a Smart Treatment Plan”

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.

The Past, Present, and Future for Depression; A Perspective of Hope from Geneva

 

As I sit here at a crowded Starbucks in sunny Geneva Switzerland, preparing for the meeting tomorrow at the headquarters of the World Health Organization, I marvel at how far we have come in the field of mental health since my father’s suicide over 20 years ago.  In those days, we looked upon suicide as a poor choice a person made and simply did not talk about it.  Today, while we still have a long way to go, we are starting to understand that it is more than a choice; it is a complicated combination of life circumstances, chemical processes of the brain, genetics, and childhood trauma.

Last year I had the privilege of attending the discussion of the ground breaking resolution for the UN to make global mental health a priority throughout the world with a proposed Global Mental Health Action Plan.  On May 27th, 2013 the World Health Assembly adopted the “Comprehensive Mental Health Action Plan 2013-2020“, putting the world on notice that mental health must be a priority.   I have the honor of attending the WHO follow-up conference tomorrow October 7th, during Global Mental Health week, to hear across the globe how member states and affiliated organizations are going to put the plan into action.

In 2004 when I began my work to end the stigma of depression through rebranding, less than 25% were receiving treatment leaving a full 75% of the world population untreated.  Last year, the World Health Organization statistics reported that the number untreated is now 50%, so while progress might not be evident it is improving.  These statistics bring me joy and gratitude that the tireless work of the people in the field of mental health, creating awareness and bringing services to the 350 million with depression, is not happening in vain.

That being said, there is much left to do.  Depression is now the leading cause of disability worldwide, yet it is treatable.  It is significantly underfunded and still highly stigmatized and there is much more to do to bring treatment numbers to 100%.

I encourage you to join us October 10th, Global Mental Health Day, to learn more about depression.  Join us in watching the free, live Global Web Screening of Hidden Pictures, the first feature documentary on global mental health.  Read and share information on mental health from organizations like Psyhcentral and Webmd with perspectives from both the medical profession and patients.  Or take the pledge to plant a virtual sunflower, showing your solidarity in our movement to bring dignity and respect to those living with depression.

Follow us on Twitter and join our Facebook community for posts throughout Global Mental Health week.  There is Hope.  Depression is treatable.  Share the word and help save a life today.

 

 

“Four simple words…I suffer from depression”

I recently came across this video of Kevin Breel speaking to a group of people at a recent TED-X conference and was blown away by his poignant account of what it’s been like living with depression and his hopes for a future without stigma.

As you may remember from my earlier posts, I lost my father when I was Kevin’s age to suicide and I consider myself a depression survivor. It is through the sharing of these stories and personal accounts that I believe we will be able to shine a light of HOPE for the 350 million worldwide living with depression.

I hope you’ll take 11 minutes to watch this video of Kevin. If you live with depression, someone in your life lives with depression, or you don’t think you know anyone living with depression – you need to watch this video. It will be well worth your time.

Watch Kevin’s video here: http://www.causes.com/causes/101854/updates/793004

 

 

Stories from the Field

Americans across the country are getting ready to celebrate the 4th of July holiday tomorrow, a holiday all about the human spirit and a renewal of #HOPE. So it seemed like a fitting time to bring you our first Story from the Field, stories about the people we have had the honor and privilege to meet through the Field for Hope campaign. These narratives, pictures and videos are our way of helping spark positive conversations around depression and mental health in order to help chip away at the negative stigma surrounding the disease.

Earlier this year we met Tim Kahlor at the PRISM Awards in Los Angeles, an annual awards show that honors TV, movie, music, DVD and comic book entertainment that accurately depict mental health issues. Tim’s son Ryan is a military veteran who lives with Post-traumatic Stress Disorder (PTSD). We asked Tim to share his incredible story with us to help kick off our Stories from the Field series.

Contributed by Tim Kahlor

Ryan joined the military in 2002 when he was 18-years-old on a delayed entry program so he could get his braces off his teeth before basic training. He was promised a $12,000 sign-on bonus and told he would be stationed in Germany. We’d sent him to Europe when he was in high school and he loved it. Ryan was always an adventurous kid and loved playing sports; the thought of being paid to keep in shape was his dream job. The military offered him adventure, the ability to work out and stay in shape, all while seeing the world.

Photo of Ryan Kahlor and his rescued shelter cat taken by Hannah Kahlor.

Photo of Ryan Kahlor and his rescued shelter cat taken by Hannah Kahlor.

He left for basic training on March 18, 2003, the day before the war in Iraq started. Ryan was a member of the 1st Armored Division based out of Baumholder, Germany, and was being sent to Holenfeld, Germany, to a non-deployable unit. However when they offered him rank quicker and no tax on his combat pay if he went to Iraq, he accepted the offer. In 2003 Ryan served as an Infantryman in Bagdad, guarding the green zone and then was later sent out on missions in other areas. There was a lot of action, but it was the next deployment that caused the most damage to Ryan. When we saw him next in 2004 he was friendly, but guarded.   

Ryan was married in December of 2005 and deployed to Iraq again in January 2006. That November Ryan endured many struggles, as he was involved in several horrible firefights leaving him to handle many of the dead and wounded. During his two deployments Ryan received repeated injuries to his head and body, including a Traumatic Brain Injury. When he returned to the U.S. they finally sent him to Balboa Naval Hospital in San Diego to be part of the Wounded Warrior Project for Army members who are injured in combat. There, Ryan’s PTSD really began to erupt, resulting in fighting and explosive yelling. One day I found him rolled up in a ball in the middle of the living room. Ryan was sent to Palo Alto’s in-patient program for PTSD at the VA hospital there. Which I believe, to this day, is still the best program I’ve seen Ryan come out of since 2007 for dealing with PTSD.  

When your child is killed in combat the pain of war is over for the soldier or marine, but continues on for their family. When your child lives through combat and comes home with PTSD the mental war of combat is brought from the battlefield into the living room, kitchen, bedroom and to the surrounding community. Ryan was the poster child in 2007 and 2008 for getting and responding to PTSD treatment, but there are always going to be relapses no matter how well treatment has served in addressing the problem. That is the hardest part to get through; the rough times that disillude the thought that the struggle is over after everything seems to be going so well. My family has found that being willing to listen to him when he wants to talk about it and always letting him know I am there for him is one of the most helpful things we can do. I don’t ask questions unless he opens a door that will allow me to ask a questions. There are people that think you can “shake it out of them” or “tell them some story about a cousin, uncle or buddy they knew that was in combat” or the guy that says “you got to pull yourself up by the bootstraps and get on with your life” (my response to that one is ‘what if the boot straps are already broken?’)  Then you have the people who want you to explain why there is more PTSD now than in past wars. I ignore things like the above and celebrate Ryan’s success; I often text him about how proud I am of what he is doing.  

Ryan just finished a semester of college with great grades and we celebrated it as a family going out to dinner. This is major because in the past he couldn’t sit in a classroom long enough to finish a semester. We set goals and plans for future outings together that I know Ryan enjoys. Last summer, Ryan and his wife Hannah took me to Yosemite camping and it was like heaven for us all. I saw the joy in my son’s face taking me someplace that I loved and he loved it too. This year we already have a trip planned at the Kern River and Yosemite hiking the whole time and playing in the river. Ryan teaches surfing and kayaking to wounded warriors during the summer, so we encourage him to keep doing that when he can as well as cycling.  

It is so important that families don’t forget to find time to get help for themselves and the knowledge to help a loved one suffering from PTSD. They should always be aware of signs of isolation and frustration to be readily to supportive. Families dealing with a loved one with PTSD should remember that there will be good days and bad days, and you have to hope that the good days get longer and the bad days get shorter.

Tim’s story exhibits one main and powerful fact: being open and honest about the reality of PTSD can enable our sons, daughters, fathers, brothers, sisters, mothers, and friends to hold their heads up high, walk around unashamed and seek treatment in spite of the stigma. This example further promotes the belief that above all we must love, care, support and advocate on behalf of our loved ones living with conditions like PTSD and depression. Liberate yourself and your loved ones by taking a stand and joining us in the cause to end the negative stigma associated with the disease. Speak out, volunteer, contribute and help us build a community. Take the Pledge to Plant, spread the word and join iFred in honoring the 350 million around the world living with depression.