Sunday, October 10, 2021


The state of mental health in the country Today is World Mental Health Day

Online Desk

Update: Sunday, October 10, 2021


The state of mental health in the country Today is World Mental Health Day

Mohammad Olid Siddiqui Talukder: Mental health is a popular word in the world in recent times. Mental health problems have increased in Bangladesh as well as other countries of the world due to the impact of Novel Coronavirus (Covid-19) epidemic. Mental health problems are on the rise, not only among adults but also among children.

Studies have shown that about one-third of the country’s people suffer from mental health problems in various ways. But mental health care services are still neglected in the country due to lack of necessary medical facilities.

Although there are mental health risks among people of different professions and ages, the reality is that so far there is no management of mental health treatment at the district and upazila level of the country. Apart from the National Institute of Mental Health in the capital, some medical colleges in the country have medical facilities but there are various crises. At the same time there is not enough manpower. There is no initiative to create skilled manpower. Above all, there is neglect of mental health among the common people due to lack of strong publicity. Due to the lack of district and upazila based mental health care services, people are still leaning towards weeding, watering and various kinds of superstitions.

The last survey on mental health management infrastructure was conducted in 2015. According to the survey, there are only 220 psychiatrists in the country. It is also reported that there are about 50 trained clinical psychologists.

According to the 2006 World Health Organization Assessment Instrument for Mental Health Systems report, mental health care providers employ 0.49 health workers per 100,000 people. Of these, there are 0.83 million psychiatrists, 0.198 psychiatric nurses, 0.008 psychologists, 0.002 social workers, 0.003 professional therapists and 0.300 other health workers (support staff, medical staff). Etc.) Zero point 029 people. As no such survey was conducted in Bangladesh later, the details of the current field management infrastructure could not be ascertained. However, experts say that it is important to keep in mind that population growth has not stopped as long as the rate of infection has not stopped.

Although various statements have been made on the management of mental health care from the public and private levels, according to experts, Bangladesh has achieved the Mental Health Act-2016, Mental Health Policy and Mental Health Strategic Plan since independence, which is yet to be implemented. Although there is talk of equity and justice, integrated services, evidence-based care and quality assurance in mental health policy, there is no visible initiative for the promotion and improvement of those who provide mental health services. All in all, the country is at risk of mental health.

Experts say that not only the government budget should be increased, but also mental health services should be ensured by forming separate units if necessary. At the same time, a public awareness campaign should be launched to eradicate the misconceptions and superstitions about mental health. It is necessary to bring the marginalized people, senior citizens and small ethnic groups under the purview of mental health services through coordination with the officials of the concerned agencies. Experts also say that mental health care from the primary school level to the university level needs to be made important as well as the public needs to be made aware of this service quickly.

Mental health care system of the country

According to the data of two government organizations, there is a shortage of specialists and manpower to provide mental health treatment in the country. According to the Department of Health, there are currently about 500 doctors and health workers in the country, including specialists for mental health treatment. However, according to the latest National Mental Health Survey 2018-19, there are only 260 psychiatrists in the country. In other words, there is only one specialist for every 93,000 patients in the country.

However, the services of these experts do not match in all parts of the country. According to the information received from the Ministry of Health and Family Welfare, Department of Health and Department of Health Education, despite the golden jubilee of independence, mental health services have not been able to reach the district and upazila level in the country so far.

Mental health care is provided in some government medical colleges in the country. Patients are treated at the National Institute of Mental Health in the capital. It has a capacity of 200 beds for residential patients. Outpatient services are also provided. Besides, there is only a 500-bed mental hospital at Hemayetpur in Pabna.

Under the direction of Prime Minister Sheikh Hasina, work is underway to turn Pabna Mental Hospital into an international standard post-graduate institute. However, no statement has been received from the concerned authorities as to when it will be launched.

Mental health care has not yet been ensured in some of the country’s divisional cities. To provide mental health services at the upazila level on behalf of the Ministry of Health

Though there was talk, no progress was made.

Mental health status of the people of the country:
– According to the data of the National Mental Health Survey 2018-19, 14 percent of the people under the age of 18 in the country are suffering from mental illness. Of these, 5.9 percent suffer from neurodevelopmental disorders, 4.5 percent from anxiety disorders, and the rest from behavioral disorders and other mental illnesses. 94.5% of them do not get any treatment.

Among adults, the rate is 18.6 percent. Among adults, 7.8 percent suffer from depression and 4.5 percent suffer from anxiety. In addition, 2.1 percent of the country’s population has mental health-related physical problems, 0.9 percent sleep problems, 0.6 percent OCD, 0.6 percent brain structural problems, etc. Among women suffering from mental health problems (18 per cent) 3more than men (18 per cent), but 92.3 per cent of adults do not receive any treatment or seek medical attention, according to the survey.

The survey found that smokers have a 41 percent higher risk of mental health problems. According to the National Mental Health Survey, mental health problems are less prevalent in rural areas (16.2%) than in urban areas (16.6%).
Superstition is the biggest obstacle in the treatment of these mentally ill patients. The rate of superstitious women is higher than that of men. Of those who seek treatment, 58 percent seek treatment from a psychiatrist. The rest seek treatment from general practitioners. Of these, 58 per cent went for treatment and 33 per cent went to various psychiatrists. The remaining 23 percent are taking treatment in Ayurvedic, Homeopathy etc.

The mental health situation in the country due to the Kovid-19 epidemic, according to the
World Health Organization, the Kovid-19 epidemic has a major impact on human mental health. The general public, especially front-line fighters, doctors, nurses, law enforcement, and lawyers, have succumbed to Kovid and many have suffered mental health problems. A study titled The Annals of Global Health – 2020 on the effects of the Kovid epidemic on mental health found that 84 percent of people worldwide suffer from depression, 6 percent from panic and 61 percent from stress. Bangladesh is no exception. In the first 15 days of June 2021, the non-governmental organization Aanchal Foundation conducted a survey on 2,026 young people in the country titled ‘Youth Thoughts on Suicide and Mental Health’. The survey included 1,293 females, 831 males and two transgender people.

According to the survey, 63.5% of young people say that their mental stress has increased during the Kovid-19 epidemic. At that time, 21.3 percent of young people thought of committing suicide. 36.1% of people have thought of suicide, but have not attempted suicide. 3.6 percent said they tried to commit suicide, but failed. 7.3 percent have suicidal thoughts, they have also prepared suicide materials but in the end they have backed down.

Fifty-seven percent of these young people said they were able to tell people close to them about depression. The remaining 44.3% said they did not find anyone beside them to express their depression or emotional turmoil, according to a survey by the Real Foundation.

Not only among the youth, but also among various professionals, the Covid-19 epidemic has increased mental instability. From June to December 2020, a survey was conducted on the psychological impact on doctors and other health workers working in the hospital designated for the treatment of Covid-19. The Department of Psychiatry of Bangabandhu Sheikh Mujib Medical University (BSMMU) conducted the survey on the psychological impact of doctors and other health workers.

According to the survey, about 21 percent of physicians and 6 percent of collaborating health workers are affected by the Kovid-19 epidemic. In addition, 16 percent of doctors and about 8 percent of collaborative health workers suffer from depression.

The survey found that doctors and health workers who worked for more than six weeks had more symptoms of anxiety and insomnia. About 6 percent of doctors and 1 percent of healthy people suffer from insomnia. About 9.5 percent of physicians and about 2 percent of health workers suffer from posttraumatic stress disorder (PTSD) or post-traumatic stress disorder.

About 25 percent of survey participants already had a physical illness (high blood pressure, diabetes, asthma, etc.). It shows that about 6 and a half percent of doctors and 1 percent of health workers suffer from insomnia.

Post-traumatic stress disorder (PTSD) or post-traumatic stress disorder affects about 9.5 percent of physicians and about 2 percent of health workers, according to the survey. The results of the survey, compared to the 2019 Mental Health Survey conducted by the National Institute of Mental Health, show that physicians and health workers suffer more from depression than the general population.

Only in the case of Kovid-19, multiple studies in the country have revealed the negative impact of the epidemic on the mental health system in the country. A study by the Arch Foundation, a non-governmental organization, on the Covid-19 epidemic found that the depression rate in the country was 32.2 percent. In the 2018-19 survey of the Institute of Mental Health, this number was only 6.7 percent.

According to a survey by the Arch Foundation, the rate of anxiety disorders in the country has increased by 47.3%. In the 2018-19 survey of the National Institute of Mental Health, this number was only 4.5 percent.
In other words, during the epidemic, the incidence of depression has increased five times more than usual and the incidence of anxiety has increased 10 times.

Studies have shown that women suffer more from mental health problems than men. Although 23.6 percent of the men in the study suffered from overall mental health problems, the rate among women was 33.1 percent. Students and the unemployed are more likely to suffer from mental health problems than others, according to a survey by the Arch Foundation.

According to the World Health Organization, one person commits suicide every 40 seconds worldwide. Most suicidal deaths are preventable. Most people suffer from some form of mental illness at the time of suicide. Suicides are on the rise because they are not treated seriously or if mental illness is not treated properly. But with good mental health treatment, people can get rid of many other problems including suicide rate. That’s why the World Health Organization calls for spending only six to seven percent of the total health budget on mental health care.

What do experts think?
Director of the National Institute of Mental Health, Prof. Bidhan Ranjan Roy Poddar told Sarabangla that there are still some misconceptions among the people about mental health system and treatment in the country. Unfortunately, it is true that this rate is not very low even among educated people. The crisis has been exacerbated by the Covid-19 epidemic. Especially people with pre-existing mental problems are less likely to seek medical attention at this time.
He said, “Yes, there is no way to deny that there is no visible initiative for mental health treatment at the district and upazila level of the country so far.” At the same time, there is no awareness program in those places. In fact, it is necessary to campaign.

Acknowledging the limited manpower, Professor. Bidhan Chandra Roy said that there is still less concern about mental health among the people of the country. And so the problems remain hidden. Although everyone treats various infectious and non-communicable diseases, there is not much in the way of psychiatric treatment. In such a situation, we always had a demand to increase the manpower. At the same time, there is a need to focus on mental health treatment in the education system.

The government must take urgent steps to protect mental health by increasing the allocation, said Professor. Bidhan Ranjan Roy.

Department of Health spokesman and non-communicable disease control branch director Prof. Robed Amin told Sarabangla, “As a doctor in the country, I don’t think mental health problems are being treated as conventional health problems yet.” And so people are not very interested in receiving health care. However, research is being conducted on our behalf. At the same time, after the finalization of the national strategy, we hope to be able to deliver mental health services at the upazila level as well.

Attempts were made to contact Health and Family Welfare Minister Zahid Malek and Health Services Senior Secretary Lokman Hossain Mian, but no response was received.

Note that World Mental Health Day will be celebrated around the world on Sunday (October 10). This time the theme of the day is mental health in an unequal world.

The World Health Organization says 32 per cent of people seeking mental health care in the UK say the situation has worsened due to the epidemic. Mental health risks have increased among children and adolescents in Italy and Spain. In Canada, alcohol consumption has risen by 20 per cent among 15- to 49-year-olds. Depression among Ethiopians tripled in April compared to previous epidemics.

In such a situation, UN Secretary General Antonio Guterres has made three important statements. In his speech, it was stated that the whole society should be involved in the protection, improvement and care of mental health as well as emergency treatment should be provided and arrangements should be made to ensure mental health care for the tax free people in the future. The World Health Organization has also developed guidelines for individuals and organizations at various levels in this regard. In particular, instructions have been given on how to take care of the child’s mind. At the same time, there has been a call for increasing allocations in the mental health sector.

Author: Acting Editor & Publisher: Bangla Post Member DUJ

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