Treatment gap for mental health problems

A psychotherapist provides counseling to a patient near the stairs of a hospital for lack of space
(Contributor/IRIN)

Facilities and resources needed to treat the nearly 14.5 million adults with mental disorders in Bangladesh, as well as nearly 20 percent of children aged 12-17, are inadequate, health workers say.



“If you look at the total amount of expenditure for the mental health system, you understand that successive governments showed their negligence towards mental health,” Golam Rabbani, chief researcher on a recent survey by the National Institute of Mental Health, published in June 2011, and one of just 134 psychiatrists in the country, told IRIN.



The survey focused on the growing issue of mental health in children and found mental illness is more common among children in rural areas than in cities. As many as 17.5 percent of rural children have a mental illness, compared to 14.3 of city children, it said.



According to a World Health Organization (WHO) report, in 2005 the health department spent US$1.4 million (less than 0.5 percent of the healthcare budget) on mental health. No mental disorder is covered in social insurance schemes and no human rights review body exists to inspect mental health facilities, the report added.



Moreover, the Indian Lunacy Act of 1912, which allows discrimination against the mentally ill, remains in effect in Bangladesh.



Not much has changed since 2005, noted Mostafa Zaman, a WHO officer for non-communicable diseases in Bangladesh and co-author of the WHO report. It seems the number of people with mental disorders is on the rise, as is the number of people seeking professional help, he said.



The predominant affliction is depression and the main obstacle is stigma, explained Omar Rahman, a psychiatrist in Bangladesh and also an associate professor of epidemiology and demography at Harvard University.



“People do not consider mental health as a disease like other diseases. Moreover, people with mental disorders do not go to hospitals as they think it will hamper their social dignity,” Rahman said.



“The number of human resources is completely insufficient for the huge population in Bangladesh. The human resources have to be increased to reduce the treatment gap,” Rahman said. Currently there is less than one psychiatrist for every one million Bangladeshis.



In 2006 mental health policy, strategy and planning came under the surveillance and prevention of non-communicable diseases. At the time a draft version of the Mental Health Act was elaborated, but it has yet to be approved and enacted, Rabbani said.



mw/nb/cb


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