Poor countries neglect mentally ill

Hundreds of millions of people in poor countries suffer from untreated mental health disorders that could be helped with inexpensive care, the World Health Organisation (WHO) said.

The United Nations agency launched guidelines for primary care doctors and nurses to treat patients debilitated by depression and psychosis as well as neurological ailments including epilepsy, Alzheimer's disease and other dementias.

Healthcare for $2

"We face a misperception that mental health care is a luxury item on the health agenda. But it costs $2 (about R13) per person per year it is one of the best buys," said WHO Director-General Margaret Chan.

The $2 figure is the average cost of providing treatment in developing countries, which WHO says account for 75% of people with mental health and neurological problems worldwide.

Its 100-page clinical guidelines, the "Mental Health GAP Intervention Guide," aim to help health care workers to assess and treat patients suffering from symptoms including anxiety, delusions, memory loss, suicidal thoughts and seizures.

Patients can be treated through low-cost community services or in smaller units staffed by medical assistants, rather than in specialised hospitals, it says.

Stigma and abuse

"We have been very free of commercial influence. It is easy to fall in the trap of recommending drugs for every illness," said Shekhar Saxena, director of WHO's department of mental health. He led a team of 200 experts in drawing up the guide.

Mental health problems often go undiagnosed and victims often endure stigma and discrimination, according to WHO.

"Human rights are abused in a large number of countries, developed and developing. In fact it happens more often in specialised care settings than in primary care," Saxena said.

African countries in particular lack psychiatrists and must rely on communities and primary health workers for care.

Psychiatrists rare in Ethiopia

Ethiopia, which has an estimated 85 million people, has just 16 psychiatrists, yet one in three people there suffer a mental health problem at some point in their life, according to Girma Amare, an Ethiopian diplomat.

Nigeria, Africa's most populous nation with 150 million people, also said it lacked trained psychiatric personnel.

Traditional healers still preferred

While orthodox psychiatric practice has grown considerably, many patients still seek help first from traditional healers and religious places of worship, according to Nigeria's charge d'affaires Cecilia Olufolake Yahaya.

"Most Africans adhere in varying degrees to the belief in the supernatural causation of mental illnesses," she said.

"Stigma remains a serious problem, with many cases of human rights violations like chaining or beating experienced by people with mental illness. Mental health problems remain a huge stigma in Nigeria with most people, even families of victims, choosing to ignore them in the hope the problems will simply go away."

(Reuters Health, Stephanie Nebehay, October 2010)

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