Mental health care’s double negative
Two negatively stimulating streams are causing mental health care to be under supported in East African Countries. Firstly, the public stigma on mental health related issues is enormous in almost the entire African continent and with that the East African countries. The ignorance in the perception of actual psychological conditions is raising a big concern. Secondly, mental health issues in East Africa are often viewed as a “silent crisis” since they are usually given the lowest priority in a region of Africa where international aid is focused on communicable diseases and malnutrition. A staggeringly shy 20 percent of people in East Africa have access to mental health care in East Africa. Prioritizing mental health is as important to improving patient care as adequate spending and infrastructure. Without practical mental health policies, gaps in treatment provision are likely to persist.
Despite mental health being mentioned in the general health policy of most African countries (80%), almost half (44%) of African countries do not have an approved or updated mental health policy. It is not unusual to either not have a policy specific to mental health care or to have a policy that is not practical or has not been implemented at all levels of care or throughout the entire country – particularly in remote rural areas. This means that structures and strategies for implementing services and developing health worker training are lacking at multiple levels.
The first concern has been highlighted more since local mental health counselors have been speaking out about the status of the refugees in some of the camps in countries such as Sudan, Tanzania, Uganda and Ethiopia. Furthemore, the political unrest in the forms of civil wars, rebellions and inter-national wars add oxygen to the fire of insufficient mental health care.
As media attention is a big part of getting the eyes of ‘foreign’ parties involved these messages play a key role in the developmental shift that is necessary to support the population of East Africa. Also each country in Southeast Africa is consistently confronted with barriers that make mental health policies a challenge to implement, including the lack of policy, social and cultural barriers, the role of traditional medicine, HIV/AIDS, and the stigma surrounding mental health issues.
Regional effects
The number of displaced people is on the rise. It has been speculated that there exists a correlation between displacement and mental health. If this is taken seriously, the exceptional levels of displacement in the East of Africa in 2018 would suggest an inevitable rise of mental health problems among the uprooted populations. The UN reported an unprecedented total number of people were displaced in 2017, with nearly 70 million people either internally or externally displaced. Out of these, roughly a fifth of these stemmed from the East African region, according to the 2018 Global Report on Internal Displacement.
In countries like Ethiopia, host to the second largest refugee population in Africa, these numbers are bound to continue. The UN warns that, despite a peace agreement between Ethiopia and Eritrea, conditions within Eritrea remain unchanged while the border between the formerly restive countries has opened up. This new porous border has allowed a fourfold increase in Eritrean refugees entering Ethiopia, with most going to Hitsats Refugee Camp in the northern Tigray region of the country. A call for action! Change itself is inevitable and we are in control of making that a positive change.
Sources used:
– https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1489826/ (1)
– https://www.msf.org/displaced-and-distressed-people’s-mental-health-east-africa (2)
– https://www.researchgate.net/publication/283091942_Addressing_mental_illness_in_Africa_Global_health_challenges_and_local_opportunities (3)
East Africa 
Hi,
Very interesting blog post. Stigma is a difficult problem as you described, which could worsen the health status of many people. It is hard to read that due to stigma many people with mental health issues do not seek help because they are afraid of the reactions of others. Also, the government does not see mental health as an important issue, given the fact that there are no specific mental health policies.
I think the stigma about mental health is partly created due to a lack of awareness among individuals. So I was wondering if you have any suggestion on how to possibly raise more awareness around mental health in your area. Secondly, I was curious if you have any ideas on how the stigma around mental health can be reduced because you need to tackle two forms of stigma the social stigma and the self/perceived stigma? Lastly, According to you, which parties plays a significant role in reducing the stigma around mental health?
I am looking forward to your reactions!
Julia Schellekens
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Hi Julia,
Thank you for you specific and clear questions.
To answer your questions, I must answer your questions on the parties and actors first. Since the mental health support is so limited at the moment, the most prominent parties addressing mental health issues are NGO’s, usually as a form of developmental aid.
In this case specifically, the NGO ‘Medecins sans frontieres’ is zooming in on this issue and they – among other NGO’s – and forms such as refugee camps (organised mostly by western staff) are forming the backbone around mental aid. Secondly, their aid is required to and significant to future awareness programs. I think their role and potential advices in the local ministries of health would have the biggest impact. So that the infrastructure of the countries themselves can be developed. Placing collaboration between these two parties as the cornerstone for future improvement.
I hope this helps.
If you have any other questions, please feel free to contact again!
Thom van der Meer
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Hi!
I’ll start with saying that your blog is beautiful!
I really like that you have some general information about the topic of the blog and the people behind it on your homepage. However it is unclear to me which double burden you are focussing on? Or will you continue discussing the whole double burden in Eastern Africa? Another point that you could maybe clarify is which countries you see as Eastern African? Especially because, at some point, you also say something about Southeast Africa.
I think it is really good that you name both the issues neglecting mental health care. Also the quotations you use really emphasise the problem and make it more personal. However I think you could maybe point out the problem of stigmatisation a little bit more?
Overall I really like your blog, keep going!
Simone
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Dear Simone,
Thank you for your response.
To answer a few of your questions I would like to direct you to our general and background information posts. Most of the answers you’re looking for can be found there.
As to the double burden, that is a good point. We are focussing here on a single burden at first. To see the impact is has on its own.
Then later we have more posts coming up on the double burden of diseases and connections between diseases.
I hope this clarifies your addressed points.
If not, feel free to contact us again!
Thom van der Meer
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Good comments from fellow students. One of the nice things about a blog is that if you want to, you can respond to comments and edit the text to reflect new information.
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Dear group,
My greatest compliments for your blog lay-out. I really like the subtopics at the of the pages. The topic of this post is really interesting. As you already mentioned, the mental health issues are much underprioritized in many developing countries. One of the biggest underlying cause of mental health problems is probably the stigma around these problems. Facing that stigma is really difficult because it takes a lot of time. Are there already some implements that worked out to a decrease of the mental health issues? Is it the government that should come with such changes, or is it up to the NGO’s?
I really look forward to your anwers,
Bye,
Tharsini
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Dear Tharsini,
Thank you for your questions, they hit the mark precisely in the areas most needing our attention.
I would like to direct you to the answer we provided Julia with, since the answers we gave there are addressing the same points you are raising.
I hope that helps,
Please let us know if you have any other questions.
Warm regards,
Thom van der Meer
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Hi,
The quotes that you used and design method gives a nice overview of your blog. Very attractive! I have a short question for you. Why do have only 20% of all people in East Africa have access to mental health care in East Africa? I couldn’t really read this in your blog post. Is this only due to the stigma or are there other underlying factors that play a role, such as the lack of mental health care? I also have a tip for you. Perhaps it is an option to include measures in your blog that are about fighting against stigma. Have you thought about this?
Good luck with writing your next blog posts!
Kübra
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Dear Kübra,
Thank you for another good question! And your tip is much appreciated, we will take that into account in our revision and the future blogs!
The reason behind the lacking mental healthcare is twofold.
On the one hand, you are right. There is stigma around these issues which is causing the very small allocation to tackling mental health issues.
Secondly and on the other hand, there are signs of still a huge ignorance around the topic. Empirical data suggest mental health not being recognised in the way we are doing.
This combined with a stigma makes it incredibly hard to change the current culture around mental health.
I hope this helps,
Please feel free to share any responses or other questions!
Kind regards,
Thom van der Meer
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Hi,
The quotes that you used and design method gives a nice overview of your blog. Very attractive! I have a short question for you. Why do have only 20% of all people in East Africa have access to mental health care in East Africa? I couldn’t really read this in your blog post. Is this only due to the stigma or are there other underlying factors that play a role, such as the lack of mental health care? I also have a tip for you. Perhaps it is an option to include measures in your blog that are about fighting against stigma. Have you thought about this?
Good luck with writing your next blog posts!
Kübra
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Hi,
The quotes that you used and design method gives a nice overview of your blog. Very attractive! I have a short question for you. Why do have only 20% of all people in East Africa have access to mental health care in East Africa? I couldn’t really read this in your blog post. Is this only due to the stigma or are there other underlying factors that play a role, such as the lack of mental health care? I also have a tip for you. Perhaps it is an option to include measures in your blog that are about fighting against stigma. Have you thought about this?
Good luck with writing your next blog posts!
Kübra
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