Wednesday / 5 / Rajab / 1445 AH – 22:01 – Wednesday, January 17, 2024 22:01
Today the world is experiencing a mental health crisis. From growing climate concern in wealthy countries like the United States to severe trauma in conflict zones like Ukraine and Gaza (particularly among children), psychological suffering has become so widespread that traditional health care services can no longer keep up. This would put tens of millions of people at risk of serious illness and suicide.
Currently, more than 25% of the world’s population reports feelings of social isolation and loneliness, and more than 150,000 people between the ages of 15 and 29 die by suicide annually. Climate changes threaten to increase this alarming rate. As the American Psychiatric Association reports, climate change can lead to “job losses, people being forced to move, the disintegration of social cohesion and a lack of community resources, with mental health consequences.”
Furthermore, thinking about climate change and its consequences for “national security and individual well-being” can cause feelings of “distress and anxiety.” No age group is excluded from this. Young people fear for their future; The elderly feel sad after the destruction of their childhood world. Activists and climate scientists suffer from emotional exhaustion and despair. Not to mention the post-crisis stress and depression experienced by those already affected by climate-related disasters, especially in vulnerable developing economies. A psychiatric patient usually attends individual therapy sessions with a trained clinician. However, even health systems in rich countries lack the capacity to provide such services on a large scale as needed and to the extent required: in the United States, more than 150 million people live in areas that lack mental health clinicians.
Within a few years, the country may be short of about 31,100 psychiatrists. The situation is even worse in poor and conflict-affected countries, where traditional psychological interventions are often difficult to access, if available at all.
Consider my home country, Zimbabwe: despite being a country of 16 million people, it has only 13 psychiatrists and 20 clinical psychologists. The consequences of this shortage became starkly evident in 2019, when Cyclone Idai struck parts of Zimbabwe. The strong winds and heavy rains resulting from the storm – and the severe floods and landslides it caused – killed hundreds, displaced about 60,000 people, and demolished 50,000 homes. It also damaged unharvested crops, destroyed seed stocks, and killed livestock, leaving people without food or livelihoods. All of this has contributed to mental health problems, including post-traumatic stress disorder.
Almost a year later, things have gotten very bad: the Covid-19 pandemic has forced nationwide lockdowns, increasingly undermining people’s social and economic well-being. The health care system has been unable to cope with the mental health problems resulting from the pandemic.
But this does not mean that Zimbabwe did not have any other options. The Friendship Bench project, which I founded, trains community volunteers with no prior medical or mental health training to provide talk therapy to patients on wooden benches in all ten provinces of the country. So far, we have trained more than 2,000 of these female health workers, known as “grandmothers,” to provide advice to their communities. The program has proven effective in treating many mental health disorders. In 2016, a randomized clinical trial found that patients with common mental disorders and indicators of depression who received counseling through “Friendship Bench” sessions had a significant reduction in symptoms. Communities that accessed Friendship Bench services also saw improvements in other areas, from HIV outcomes to maternal and child health. Even the grandmothers who provided the treatment benefited from a stronger sense of belonging and resilience, they said. Other organizations in low-resource countries have pioneered new, scalable models for delivering high-quality, low-cost mental health care to communities where it was not previously available. Among the leading institutions we find “Sangat”, a non-governmental organization headquartered in the Indian state of Goa, which works to train ordinary people to provide psychological and social treatments, especially in areas that lack mental health services.
Clinical trials have consistently shown the effectiveness of these “lay counselors” in treating a wide range of mental health conditions, from depression and anxiety to alcohol use disorders.
Similarly, Strong Minds is training “mental health providers” to provide free group therapy to low-income women and adolescent girls with depression in Uganda and Zambia. The organization has proven its effectiveness and impact, especially in supporting communities affected by climate-related environmental disasters. And that impact is expected to grow: Sean May Perry, founder and CEO of Strong Minds, expects the program to reach 335,000 people this year.
Western models of psychiatric care require so many resources that they are difficult to roll out across the world, especially in Africa and South Asia, where rapid population growth and accelerating climate risks pose enormous challenges. Well-designed community initiatives are also cost-effective and highly scalable.
Beyond improving individual mental health and resilience, such programs strengthen community cohesion and encourage collective problem solving, both of which will become increasingly important as the climate crisis worsens.
Effectively addressing the global mental health crisis will require greater engagement by the international community. The WHO Special Mental Health Initiative, which sought to provide greater access to mental health services across its six regions between 2019 and 2023, was a step in the right direction. But work must be done to continue and expand it. On the other hand, local and national governments and philanthropies must embrace new, local approaches and approaches that have proven their ability to help communities deal with increasing risks to their lives, livelihoods and well-being.
2024-01-17 18:18:08
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