Bridging the Mental Health Treatment Gap Must Be a Global Priority

 

 equal_treatment_closing_the_gap

Every year, the World Health Organization (WHO) organizes the mhGAP Forum as part of its annual partnership event on mental health. The mhGAP Forum is an informal group of Member States, intergovernmental and nongovernmental organizations, including UN agencies, international development agencies, philanthropic foundations, research institutes, universities and WHO collaborating centres, for coordinated action on the implementation of mhGAP. The mhGap is WHO’s flagship publication aimed at scaling up care for mental, neurological and substance use disorders.

 

WHO’s first global report on suicide prevention will be launched at this year’s annual event. This report will be the first of its kind with in-depth information about the global scenario of suicide, groups at risk of suicide and the ways in which the number of deaths from suicide can be prevented by action from the individual and collective levels. Along with the report, this year’s event is examining the ways to communicate mental health issues effectively and global strategies to advocate the implementation of WHO’s Comprehensive Mental Health Action Plan 2013 to 2020 through partnership.

 

Suicide is a leading global public health issue. Around the world, in every 40 seconds, there is one death because of suicide. In the last 45 years suicide rates have increased by 60% worldwide. According to WHO, “Suicide is now among the three leading causes of death among those aged 15 to 44 (male and female). Suicide attempts are up to 20 times more frequent than completed suicides”. Globally each year approximately one million people die from suicide. Although suicide rates have traditionally been highest amongst elderly males, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of all countries.

 

Mental health disorders (particularly depression and substance abuse) are associated with more than 90% of all cases of suicide. Kathryn Goetzke, the founder of the International Foundation for Research and Education on Depression (iFred) says, “over 350 million people around the world have depression, a treatable disease, yet less than 50% of those with depression are currently receiving treatment”. Ms. Goetzke stresses the importance of this year’s WHO mhGAP forum as being critical to draw global attention to the urgency in bridging the mental health treatment gap. Her organization iFred works to #endstigma, to ensure all those needing treatment feel comfortable getting help. She says, “iFred also believes that by rebranding with a focus on hope, business and individuals are going to be more inspired to donate and fund solutions for this debilitating disease”. With the goal of rebranding depression, iFred has started global campaigning using hashtags like #sharehope #rebranddepression #endstigma.

 

 

According to WHO research, the mental health treatment gap is unacceptably high across the world ranging from 50% to 98%. In rich countries as well, 50% to 60% of people who are believed to be in need of support do not seek any kind of help for their problem. This is a global shame that world governments must give attention. Right to quality mental health services is a fundamental human right. In this context, much work lies ahead for us towards creating #innovative mental health services which will attract and build the trust of users.

 

I believe this mhGAP Forum will build some #hope in this direction. As a participant at the Forum, Ms. Goetzke says that “iFred is thrilled to be participating in this year’s event at the World Health Organization, as this year’s focus directly fits to our new Schools for Hope program. We are inspired by the amount of work occurring globally in mental health, and admire Dr. Shekhar Saxena and his team in creation of the Global Mental Health Action Plan and its implementation advocacy around the world”. She further adds, “we are looking forward to hearing more from the WHO Director General Dr. Margaret Chan who plans to speak at the event this year.”

 

Mental health services are highly stigmatized—regardless of whether the country or society is rich or poor. As a result, people are demonized, and alienated from the entire social process. This is a major factor that discourages people from seeking help. We must aim to overcome this barrier, through shared learning, and move toward bridging the shocking mental health treatment gap.

 

A new article written by Jagannath Lamichhane

 

 

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

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.

Support During Suicide, Feeling Passionate Grief, and Finding Hope

A friend of mine told me today she lost her friend’s father to suicide.  It was completely unexpected.  Why, she asks?  How did we not know?  How does this happen?

Suicide is such a mystery.  Sometimes there are signs, other times there aren’t.  No matter how hard we try, we can not save another person.  The bottom line is they must want and know how to save themselves.

The unfortunate thing is that most people don’t know how to ask for that help – don’t feel comfortable asking for it.  Instead they act out, running from the pain, in the end making it only worse because usually that acting out has negative consequences.

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