Tag: global mental health

Mentally under-resourced

Global Mental Health is a movement that has come a long way. We have amassed evidence that people with mental health problems can access care, support and treatment that make most conditions manageable in their local context. We know that people do not need access to high levels of mental health professionals for the bulk of their care and support. We know how important it is to tackle stigma and discrimination to ensure people are able to access their rights and we have growing evidence of how to do so. We have a voice at the top table: the UN is committed to mental health care provision and national governments are making commitments around the world. We have high profile supporters and backers, both celebrities and global corporations. We have a raft of civil society organisations, led by inspirational people who are making waves in their local communities and countries.  And yet… we have so much still to do.

These local civil society organisations are running on very limited resources. They are new, small and, for the most part, struggling to access the resources they need to grow as organisations. Many would fall over with the loss of a handful of key individuals. There are no representative structures in place internationally, regionally or nationally to support people with mental health problems to speak out and access their rights. There are very limited resources globally to support the development of these organisations and help the global infrastructure that is needed to develop. There are few sectors where organisations are working to embed mental health into critical areas of work such as education, public health and sports.

So, what do we need to do? Traditionally, to support such a global sector you would give to one of the high-profile organisations who fundraise for work in that sector. Or donate to a public appeal or lend time and energy to fundraise such a cause. This is not currently an option, there are no public appeals, there are no organisations fundraising, there is nowhere to donate. If I were a well-intentioned student wanting to fundraise to support the development of services and support for people with mental health problems in the global south then I have no one to fundraise for. If I were a senior person in the financial sector who had my own experience and wanted to support others facing similar challenges in the global south I will struggle to make my donation. If you were an organisation seeking to improve the wellbeing of your staff and looking to choose a charity of the year working at the grassroots to improve mental wellbeing you would have to work pretty hard to find someone to support.

I have worked with several of the leading new initiatives in global mental health (citiesRISE, Time to Change Global, Librum) and been CEO of BasicNeeds. My background includes running a pioneering perinatal mental health charity, providing dementia care services and setting up humanitarian relief programmes. I want to develop a mechanism that will enable public and corporate donations to find their way to civil society organisations in the global south who are working to protect the rights of people with mental health problems. If you want to help, or have ideas, or can introduce me to people who might want to support the set-up of the venture then get in touch now.

Relationships and Mental Health

Relationships are, for me and many others, the most wonderful things in life. Our loves, friendships and associations give meaning and significance to our lives. It is, therefore, unsurprising to me that they are so critical to our mental health and wellbeing. As a result, they should form the foundation of any community-based health system.

From the start of life, our earliest relationships give us a working model for what to expect from other people as we move out into the world. Eye contact and cooing with a baby is a wonderful thing for an adult but also critical for the baby who is still trying to make sense of the jumble of stimuli and experiences. As we grow, the support and positive feedback from parents, carers, family and friends helps to develop our confidence and sense of self. This early social and emotional foundation enables us to navigate the often chaotic array of interactions we experience at school as we sit among a group of peers all trying to work out who we are, how others perceive us and how we can best relate to one another.

The ability to form and sustain close relationships, and the more distant associations, is critical to our longer-term welfare and happiness. Evidence shows that the quality of our closest relationships and the number of our wider associates is a critical factor in how happy and healthy we are. In any aspect of life, it is clear that relationships form the basis of negotiations, business deals, partnerships and good team-work.

Later in life, the number of relationships we have as we step into retirement is a strong predictor of how long, and how healthily, we will live. Sustaining an array of friendships and social contacts into later life is key to enjoying a time of life that can offer considerable freedom but also risks increasing isolation. Relationships with people across a spectrum of ages can help to insulate us from the inevitable losses and challenges of later life.

What does this mean for global mental health policy and practice? Pathways of diagnosis, care and treatment are clearly needed for good population mental health. Similarly, support groups, peer networks, mental health literacy, user representation, and stigma reduction campaigns all need to be a core part of what we do to try and promote good mental (and physical) health in our populations. But, for me, the foundation stone has to be relationships or social connectedness to use a term from research. Programmes and interventions that promote greater social interaction and strengthen social connectivity are critical.

Inevitably, any community will have an array of groups: social, faith, artistic, sporting and so forth. Programmes should seek to build on these, increase their reach and inter-connectivity. Identify where there are gaps or barriers to these groups forming and sustaining and try to address them. Support the array of people who will be driving and developing these groups. The world is, in my experience, full of inspiring people who are doing wonderful things at the local community level. Finding these people and supporting them through a variety of means will pay dividends. By increasing the number of groups, by strengthening the groups that exist and through building links between different groups you can lay a foundation for positive mental health and well-being that is cheap, sustainable and highly rewarding for everyone involved.

The above work does not need psychiatrists, psychologists, counsellors, mental health nurses, or even a formal health system to be in place. What it does, is lay a foundation on which those more formal services can be overlaid if and when funding is available. It offers a setting into which mental health literacy and anti-stigma initiatives can be easily added. One into which low-level psychological support or group support programmes can be inserted. It offers a foundation which provides people with interesting, rewarding and engaging activities to do. What could be simpler, or more valuable for us to do?