Mental illness has proven to be one of society’s greatest invisible burdens, accounting for 4 of the 10 leading causes of disability worldwide. The Global Mental Health Advocacy Working Group recently honored World Mental Health Day by hosting a forum to discuss mental health needs amongst people in humanitarian crises, an extremely vulnerable group in terms of developing and dealing with mental illness.
The event’s panelists included Kelly Clements, the U.S. Department of State’s Deputy Assistant Secretary of the Bureau of Population, Refugees and Migration, Dr. Inka Weissbecker, the Global Mental Health Psychosocial Advisor for the International Medical Corp (IMC), and Dr. James Griffith, the Chairman in the Department of Psychiatry and Behavioral Sciences at the George Washington University School of Medicine and Health Sciences.
The discussion touched on three important themes in relation to mental health in emergency settings: the vulnerability of people suffering from mental illness, the critical gap in mental health services, and the detrimental social isolation that the mentally ill are frequently subjected to.
While approximately 10% of a population is traditionally at risk of developing a mental disorder under normal circumstances, this rate has the potential to double during a humanitarian crisis, meaning more people must deal with these disabilities in highly unstable environments. Furthermore, mentally ill individuals are more susceptible to stigma, discrimination, violence, abuse, and human rights violations in these circumstances.
Although there is a vast need for mental health services in emergency settings, there is a significant lack of access to quality care. The number of health professionals who can implement psychosocial interventions that effectively address mental illness is minimal during crises.
“There is a treatment gap between the people who need care and those who receive it,” said Dr. Weissbecker, who has monitored IMC’s mental health and psychosocial programs in countries such as South Sudan, Ethiopia, Sierra Leone, Syria, and Afghanistan.
A lack of healthcare professionals and mental health services often means that the burden of care for a mentally ill individual is placed on their families. Unfortunately, mental disorders are still fundamentally misunderstood around the world, causing many communities to be ill equipped to properly care for a portion of their citizens. In the absence of related health services, families resort to harmful traditional health practices that stem from local beliefs. These practices regularly call for extreme measures, such as chaining the mentally ill to trees or institutionalizing them in inept facilities, to isolate people dealing with mental disorders from the rest of the community.
By acting as natural buffers to instability and prejudice, Dr. James Griffith discussed the vital role that local caregivers, families and communities can play in treating mental illness. In accordance with this line of thought, IMC programs have integrated community involvement into their programs by hosting educational seminars that utilize local volunteers to raise awareness and social consideration for mental illness.
The panelists also addressed how this knowledge could be applied to two topics that have been making recent headlines: Ebola and the Islamic State in Iraq and Syria (ISIS). In terms of treating mental illness within extremist groups such as ISIS, the panelists were quick to correct the misconception that violence can commonly be associated with mental illness, a stereotype creating stigma and driving discrimination. According to the American Psychiatric Association, “the vast majority of people who are violent do not suffer from mental illness.”
In relation to Ebola, preventing and treating mental illness proved to be more applicable. In order to diminish emotional and psychological trauma, Weissbecker discussed the need to provide more education to people who contract the disease and their families, in order to decrease debilitating fear and prevent transmission. Reintegration services should also be offered to survivors who may be treated differently once they return to their communities. Finally, it is important to find ways to safely bury the dead, while ensuring that burials are still culturally significant.
Addressing mental health in emergencies is undoubtedly a multifaceted and complicated health challenge. Nevertheless, increased rates of mental disorders and the potential social ramifications of having such illnesses illustrate that mental illness in humanitarian crises is an urgent issue for global health. Reducing the current treatment gap and increasing communities’ understanding of mental disorders are two of the most promising tactics to improve the health status of the mentally ill in these situations. In doing so, devastating disability and demoralizing hardship can be prevented in populations that have already experienced immeasurable adversity in their lives.
Socorro Lopez is an undergraduate at the George Washington University, majoring in environmental studies and minoring in public health and geographic information systems. Her interests include environmental, reproductive, and global health. Prior to working at the American Public Health Association (APHA) as a Global Health Intern, she was part of the Collegiate Leaders in Environmental Health (CLEH) program at the Centers for Disease Control and Prevention (CDC). Socorro is originally from Roatan, Honduras and recently returned from Tanzania, where she was studying coastal ecology and doing research on water quality.