The Scars that can’t be seen: Mental Health around the World

Mental health issues are under-treated in developed nations. The issue is more neglected in developing countries due to constrained budgets. Mental illnesses are invisible and so are often overlooked. Charlotte Fraser discusses the issue here.

Despite a common perception that mental illness is higher in countries with higher GDP, mental and neurological disorders affect every community, age group, and socio-economic strata around the world. Mental disorders can be triggered by conflict, economic crisis, health epidemics, earthquakes and more – no sector of society is immune.  However, most of the people affected – 75% in many low income countries – do not have access to the treatment they need. In a time when the world is facing multiple ongoing conflicts, guerrilla wars, insurgencies and the largest refugee crisis since World War Two, governments need to take mental health repercussions seriously.

The social and human costs of mental health

The cost of mental health disorders is high. On a macro-economic level, The World Bank statistics state that mental health illnesses are the fifth leading cause of the overall global disease burden. They account for 7.4% of years lost due to disability and early death and over the next 20 years, lost economic output due to mental health problems will reach $16 trillion – that is equal to 1% of global GDP.

As we learn more and more about the complexity of the brain, researchers and professionals are gaining increasing insight into how mental disorders affect us. Researchers of PTSD (Post Traumatic Stress Disorder) are making huge steps towards diagnosing and treating the condition by understanding it primarily as a physical illness – a breakthrough that could revolutionise treatment for PTSD and for other anxiety disorders.

However, despite such breakthroughs there remains a large gap between the researchers in the laboratory and the understanding of mental health in everyday life. Stigma, lack of awareness, misunderstandings and sometimes a fear of these ‘invisible illnesses’ is still ripe when it comes to mental health disorders. Only recently in the UK, a celebrity-backed campaign launched urging the government to increase mental health funding and increase equality of importance so that mental health illnesses are treated the same as physical health illnesses.

DUP Photos / Creative Commons License

DUP Photos / Creative Commons License


In countries with less developed health systems, stigma is more pronounced. It is not uncommon to see the mentally ill tied up, segregated and cast out from social life. This Al Jazeera interactive highlights one story among many of the way the mentally ill are treated with fear. Popular concerns that mental illnesses are contagious often leads to those suffering to be put into different houses – segregation which can often increase the severity of the illness for the sufferer. It is ironic that whilst the UK campaigns for mental illness to be treated with the same importance as physical illness, in many countries around the world mental illness is often conflated with physical illness to the detriment of those suffering. Whilst the UK searches for equality between the two, in other countries that very conflation is increasing stigma, misunderstanding and fear.

So, what is being done?

There is evidence that increased spending on mental health has obvious positive results. For example, in Britain, a study suggested that for every one pound spend on mental health, the economy regained a recurring 37p per year in benefits from increased productivity and reduced health care bills – about the same return as cardiovascular research. Research such as this should be enough to convince even the most sceptical that funding mental health initiative is of benefit to all.

From the grassroots to the World Health Organisation

There are some important efforts emerging at the grassroots level tackling mental health. In a Turkish town where many Syrians have fled the war, a group of teachers are using innovative methods to help children who have been traumatised by war to overcome their trauma. Children who have seen their parents shot in front of them struggle to process the complex and brutal world they are growing up in and this is having negative repercussions on their mental health. Holistic and creative therapies, and not just medication, are imperative to support these children to make sense and overcome the horrors they have witnessed as such young ages.

Similarly, where mental health understanding is in fledgling stages, the visibility of psychologists visiting people in their homes and in the community will change perceptions and the stigma of mental health – particularly where the traditions and rituals of witch doctors are firmly cemented and where modern medicine is viewed with fearful scepticism. This will not change mental health perceptions or stigma overnight, but with time understanding of mental health will evolve and the stigma associated with disorders will slowly decrease.

Similarly, at the international level, the WHO (World Health Organisation) Mental Health Gap Action Programme (mgGAP) aims at scaling up services for mental, neurological and substance disorders, especially for low and middle income countries where healthcare is already strained. The WHO’s Mental Health Action Plan 2013-2020 recognises the importance of mental health and its four major objectives aim to increase access to integrated mental health and social care services in the community, increase promotion and awareness of mental health, strengthen system of research and evidence and establish effective leadership and governance for mental health. A major event on mental health in spring 2016 will draw more global attention to the mental health case as noise increases for mental health to be included in the Sustainable Development Goals, the newly agreed global development agenda which aims to tackle the most pressing problems in the word today.

However, for mental health to really be addressed, a concerted effort from the top down and the bottom up need to unite. Top down efforts can pressure countries into putting mental health further up the priority list and grassroots initiative support small groups directly at risk. There needs to be concerted political will inside countries themselves to really ensure that mental health initiatives operate on the scale they need to and with adequate resources to make a  significant difference. In today’s tense global environment where wars and conflict leave deep scars, mental health needs to be taken seriously. Hopefully with increased pressure from the top down and commitment from the grassroots up, governments will put money behind integrated and comprehensive mental health initiatives and the scars left by such turmoil will slowly fade.

The views expressed in this article are those of the author and do not necessarily represent the views of Development in Action.


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