Reimagining Healthcare; Addressing Mental Illnesses
Mental illnesses are a reality that has to be dealt with. One in four people suffer from mental disorders. Four of the six leading causes of ‘years lived with disability’ are mental illnesses. Depression is the second highest global disease burden.[ii]
What causes mental disorders? Society has progressed from the days when we believed that mental illnesses are the result of our own wrong doing, witchcraft or evil spirits. Medicine is now able to pinpoint various factors that result in mental illnesses; genetics can cause people to be susceptible to diseases such as schizophrenia and alzheimer’s while environmental and psychological factors can decide if these irregular genes evolve into an illness or not. Infections and toxins can cause diseases like dementia and Obsessive Compulsive Disorder (OCD), while prenatal damage and chemical imbalances can result in disorders like autism and depression respectively. As in the case of physical illnesses, a greater understanding of mental illnesses can only be achieved if medical professionals and states commit their time and resources to research.
It is in the state’s mandate to uphold a citizen’s right to life by means of quality healthcare. The state also benefits from doing so as healthy citizens can actively contribute to society whereas sick and dying citizens are a burden to the state. Therefore, healthcare is already considered a vital component of development and every year countries pour resources into combating any illness that is a threat to public welfare.
Mental illnesses are as big a threat to the public’s welfare as any physical sickness. Suicide is one of the leading causes of death in most countries. In the last 40 years, suicide rates have increased by 40% worldwide, with one person killing himself or herself every 40 seconds. 90% of suicides are the results of a mental illness such as depression, schizophrenia, bi-polar disorder and anorexia.[iii] The mentally sick are not only a threat to themselves but - as seen in incidents such as the Navy Yard tragedy in the United States[iv]- they can also be a threat to others. Considering that mental disordershave the same consequences as physical illnesses, should they not be given the same weightage?
Eventhe world’s most developed and well-resourced countries have yet to combat mental illnesses adequately. In Canada, 1.2 million children are affected by mental illnesses, yet only 25% of them get the appropriate treatment.[v] In Europe 50% of the mentally ill do not get treated for their sickness and inmany developing countries this statisticcan be as high as 90%.[vi]
Culture exacerbates the problemin countries like China where there have been reports of psychiatric wards being used as political prisons andpatientsabused in the form of beatings and electric shocks.[vii]Resources area serious problem in many countries; at the end of 2013, Laos had only two psychiatrists for a population of approximately six million people and there were no psychiatric nurses, clinical psychologists, social workers or occupational therapists working in the country at all[viii]. However, even in the poorest of countries,steps such as equipping communities to deal with common mental illnessescan be taken to abate their impact. This particular method has proved successful in countries such as Uganda, Pakistan and India.[ix]
Sri Lanka has one of the highest suicide rates in the world. The 2004 tsunami and the civil war are two major contributors to the mental illnesses prevalent in Sri Lanka. Over thirty years of brutality and violence has cost our country countless lives and left many people wounded and disabled. However the war has left more than just physical scars. According to the Daily News, September 10th 2013, 106,000 Sri Lankans committed suicide between 1985 and 2000; this is double the amount that was killed by the war in the same period.[x] In the after-math of the war, our focus on physical casualties and on rapid ‘development’ has evidently overshadowed the great need for psychological care. Despite the widespread mental trauma, Basic Needs, a humanitarian organisation that works in developing countries, stated that Sri Lanka has only one psychiatrist for every 500 000 people, most of whom are in urban areas. Furthermore, while psychiatric help is vital in extreme cases, counselling is a solution for those who suffer from mild mental illnesses. In fact, counselling may help to deter the deterioration of mental illnesses to a state where it is disabling. Unfortunately this solution is not given enough credit by our healthcare system and there is a lack of counsellors available to the public.
It is important to keep in mind that development is more than simply increasing the economic capacity of a country. Increasingly-in addition to a country’s GDP - other indicators, such as the Human Development Index and Gross Happiness Index are also given prominence when measuring a countries development. Why? Because the world has recognised that social development, mortality rates and general satisfaction of citizens are as important indicators of development as the economic status of a country.
Therefore, development must take place in many spheres; the acceptance of those with mental disorders is social development. Aesthetic development can take place if society creates room for the mentally sick to thrive in the fields that they are adept in. After all, Beethoven suffered from bi-polar disorder,Michelangelo had OCD and Pablo Picasso suffered from clinical depression.[xi]Literature benefitted greatly from men like Charles Dickens, Ernest Hemingway and John Keats, who all suffered from depression. Even in politics, men like Abraham Lincoln[xii]suffered from depression. However, stigma restricts many people from engaging in these fields and from embracing their different abilities
A country’s economy will also benefit from better mental healthcare; mental illness costs the Canadian economy more than $50-billion a year and research shows that such illnesses hit people hardest in their prime years of work. As Michael Kirby, a former Canadian senator and advocate for better mental-healthcare pointed out, combatting mental illnesses will help governments avoid a “lifetime of problems and costs.”[xiii]
Evidently, the attitudes of states and people towards mental illnesses severely hinder the overall development of countries.
Thomas Insel, who has led the National Institute of Mental Health, USA, since 2002, stated that one in every twenty people becomes disabled by their mental disability. He feels thatconsidering the fact that 75%of mental illnesses onset by age 24 - the answer to this problem is early detection and intervention. This will prevent mental illnesses from disabling people to the point where they have no quality of life and cannot continue to work. This has worked with heart diseases, which have reduced by 63%, reducing the mortality rate by 1.1 million deaths a year and with AIDs where an average of 30,000 deaths are averted a year.[xiv] He says that the knowledge to cure many mental illnesses exists, and thatthe main problem is stigma.Therefore, to see similar results with mental illnesses, they need to be approached in the same manner as physical illnesses. The common perception is that people who are mentally ill cannot contribute to development and this stigma makes it difficult for those with mental illness to get jobs and be an active part of society.
For decades, countries and organizations have been focused on creating awareness and an environment of acceptance for those with mental disorders. Unfortunately, people’s perception seemsto be unaffected by campaigns and speeches. The arts on the other hand have a strong influence on culture and views. Instead of simply giving people the information they need, books like ‘the perks of being a wallflower’spark empathy in them.
We may think that we do not conform to these archaic notions and biases against the mentally ill. Unfortunately, this culture is ingrained in all of us. You would have no reservations in telling people that your mother suffered from a heart attack, or that you have diabetes. However, if your mother suffered from schizophrenia or you suffered from depression, would you make that knowledge public?
Governments have a role to play in re-thinking their approach to healthcare; prioritizing combating mental illnesses in their development policies; advocating acceptance through the arts and other effective means; and empowering communities on how to deal with mental disabilities.
However it is our tendency to treat mental illnesses as forbidden secrets that is one of the biggest barriers to progress. Therefore, changing our own perceptions should be the first step. If we can openly and shamelessly admit it if we, or those close to us, have psychological problems, we will begin to oust the stigma in our own social circles. The domino effect is stronger than most people give it credit for; you start treating mental illnesses like you would any physical illness, and others around you will begin to do the same.
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