A real need…
–    Addressing Mental Health
PUBLIC health stakeholders in the mental health field concur that much more needs to be done to address mental health, that mental health services should be mainstreamed into primary health care in order for there to be equity in mental health.
Mental Health Technical Advisor to the Ministry of Health, Dr. Sonia Chehil, in an invited comment yesterday, said, “One in five people are affected by a neuropsychiatric disorder or a mental health problem. This is a huge problem. One in five persons could be the person next to you. Mental Health is everyone’s concern.”

Dr. Chehil contends that the neglect and exclusion that mental health has been subjected to in the past years must be reversed if lives are to be saved.

Nearly half a billion people are affected by mental health
and neuropsychiatric disorders; and these non-communicable chronic diseases account for almost 15 per cent of the disease burden story of the world – more than cardiovascular diseases, diabetes, respiratory illness and cancer put together.

The Ministry’s Mental Health Advisor explained that mental disorders are the result of disturbances in brain functioning.

According to her, the brain is made up of cells, connection amongst the cells, and various neuro-chemicals. The neuro-chemicals provide a means for the different parts of the brain to communicate with one another. Different parts of the brain are primarily responsible for doing different things (for example: movement, sight and hearing). Most things a brain does depends on many different parts of the brain working together in a very complex but extremely organized way – much like a symphony orchestra.

She added that when a specific part or multiple parts of the brain that need to be working on a specific task is not working well; a specific part or multiple parts of the brain that needs to be working on a specific task is working in the wrong way; the neuro-chemical messengers that help different parts of the brain communicate are not working properly or are out of balance; or any combination of these – the result is a disturbance in brain functioning.

Dr. Chehil stated that if the brain is not working properly, one or more of its functions will be disturbed.

TELLTALE SIGNS
She explained that disturbed functions that a person directly experiences (such as sadness, sleep problems, low energy or numbness in a limb) are symptoms; whereas disturbed functions that another person sees (such as hyperactivity, sad facial expression, social withdrawal, etc.) are called signs – both of which can be used to determine if the brain may not be working well.

“There are few telltale signs of depression, anxiety, and alcohol abuse; and because the pain and disability caused by these conditions are not physical, most people suffer in silence and their suffering is invisible to those around them,” she said.

Symptoms of mental disorders are an expression of disturbances in the things the brain does – the brain’s functions: 
·    Disturbances in Thinking/Cognition;
·    Disturbances in Perception;
·    Disturbances in Emotion;
·    Disturbances in Signaling;
·    Disturbances in Physical functions; and
·    Disturbances in Behaviour.
·    More than 450 million people suffer from mental disorders worldwide.
·    Mental health is an integral part of health.
·    Mental health is more than the absence of mental disorders.
·    Mental health is determined by the socio-economic, biological and environmental factors.

Dr. Chehil noted that the symptoms of the mental disorders are difficult for many to understand. While the body remains intact, the core elements of the person’s personality, their talents, their emotional responsiveness, their connection to family and community, and their manner of self expression can be heavily impacted. To friends and family, the person may appear completely transformed from the person they previously knew and cared for.

She pointed out that historically
“The shame is that most of these conditions are treatable and most people achieve recovery and lead full and fruitful lives, but we need rarely hear their stories, we are often hardly willing to listen,” Dr. Chehil concludes.
STIGMA’S CONSEQUENCES
Consequently, many people with mental disorders refuse to access mental health services, or if they do, they do not receive appropriate treatment and care, are marginalized from communities, and suffer significant personal, social and vocational disability.

Dr. Chehil stressed that stigmatisation of the
mentally ill has far reaching consequences for those who suffer from these disorders.

She maintains that unless the culture of stigma and discrimination is changed, this public health scourge will continue to translate into social and economic injustice, as well as a loss of opportunity and vulnerability – a sad reality for those affected.

“Mental Health is a real need that needs to be addressed,” Dr. Chehil said, “This is one of the things that stand in the way of development and progress for mental health. We must have a dream to work towards and hope that the dream is achievable. Mental health is everyone’s concern. There is no health without mental health.”