August 21, 2013, by Yvonne Teoh

Mental Healthcare; Still a Long Way to Go

In the 21st century most of the major projects that are being conducted to improve the living conditions of people, as well as smaller projects, mostly focus on what’s believed to be basic needs. This is perfectly justified considering that basic needs logically earn their place as a priority that should at once be met, in contrast to those that can wait. One example for such projects is the UN Millennium Development Goals, the 8 goals that the UN is aiming to reach by the year 2015 revolve around hunger, healthcare, poverty and such more typically important issues. In today’s world where these issues are what is believed should be addressed first, mental healthcare seems like a privilege that ought to wait while “the important matters” are resolved first.

This notion is in great contradiction to the statistics we have about the burden of mental illnesses and the current situation of mental healthcare facilities, as discussed by Vikram Patel in his TED talk on training members of communities to give mental healthcare  , the WHO estimates that one in four families has at least one member suffering from a mental or behavioural disorder, and mental health disorders are among the 20 leading causes of disability worldwide, what is mentioned here are but very few examples, not even touching on the indirect burden of mental illness. Marginalizing mental healthcare does not only contradict the facts available but it also hinders the progress of eradication of other issues that are seen as a priority, as they are all interlinked.

The short period in which I worked in Al-Tijani Al-Mahi, Sudan’s largest-yet not so large-, best-yet not so good- Psychiatric hospital, in only such short period it was all too clear that even the psychiatrists and clinical psychologists on whom the whole of the mental healthcare system of the country depends, believe that this industry is a luxury that stands far in a long waiting line of issues that should be addressed first in this troubled third world country. As I thought about it, I made peace with this belief, after all when you have political instability, extreme poverty, civil war and relentless corruption eating out on your country then maybe mental healthcare really can wait.

On the left, The emergency entrance of Al-Tijani Almahi Psychiatric hospital. On the right, an in-patients ward.  Photo Credit: Marine Alneel

On the left, The emergency entrance of Al-Tijani Almahi Psychiatric hospital. On the right, an in-patients ward.
Photo Credit: Marine Alneel

This belief I adopted faced much confusion when I saw the situation of this industry and the attitude of the people working in it in a country where all those issues previously mentioned are not present, this showed me that there’s more to the matter. Mental healthcare was still not a priority, better education, more comprehensive healthcare, and economic progress were more important. So even when the basic needs are met, improving them still comes before providing basic mental healthcare. This made me wonder, then when will mental healthcare finally be considered a priority. In Malaysia it is still viewed as a luxury; this I have noticed during my internship in the Malaysian Mental Health Association (MMHA), where this NGO struggles to find funding and competes with other NGO’s for the attention of the public. Those other NGO’s always seem to win, because they, unlike MMHA, provide something the people view as more important (e.g. food, education or shelter).

Some of the staff and clients in MMHA selling some handmade crafts by the clients as a mean for raising funds. Photo Credit: Marine Alneel

Some of the staff and clients in MMHA selling some handmade crafts by the clients as a mean for raising funds. Photo Credit: Marine Alneel

Seeing that mental healthcare is viewed as a luxury by the society regardless of the state of the country helped me reach the conclusion that putting mental healthcare second is not a necessity imposed by circumstances, it is an attitude, an attitude that is the result of several decades of associating it to “western societies with too much money to spare”, “whiney people who can’t manage their own lives” and several other stereotypes, stigmas and labels stuck to those who choose to resort to clinical psychologists, psychiatrists or other mental healthcare providers.

Mental healthcare needs to be reintroduced to the public with the right facts. To a fair percentage of any population, those who have mental illnesses that prevent them from leading a productive life such as schizophrenia, PTSD and depression, It is crucial to have a well-functioning mental healthcare system. It is also important to relief hospitals from patients occupying much needed space while they are actually in need of mental healthcare attention. This industry is also essential for providing the needed facilities to people with mental disabilities offering them ways to make fruitful and satisfying lives for themselves. To all these people, and this is just to name a few examples, mental healthcare is a need not a luxury, therefore the whole of the society not just these categories should demand better mental healthcare facilities.

The world should educate itself about mental healthcare to realize the importance of tending to it, because currently it suffers from an array of problems that are not realized to be the result of neglecting mental health. No problem stands independent and completely unlinked to other issues, all issues are interlinked, and mental healthcare is as much a basic need as education, physical healthcare and shelter, because basic needs are not only about providing a life and a living, rather the quality of the life lived is what’s of the most importance. The first steps in establishing a good mental healthcare system throughout the world is not building the appropriate infrastructure nor is it qualifying more mental healthcare workers, it is changing the attitude of thinking about this industry as a luxury and affirming its place as a basic need instead, not for the convenience of the workers of the industry but rather for ensuring that those who are in need of this care have their needs met as a right not a privilege.

Marine Alneel
(Year 2 Student in BSc (Hons) Psychology and Cognitive Neuroscience)

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