Mental Health In An Unequal World

“Your mental health is everything prioritize it. Make the time like your life depends on it, because it does."- Mel Robbins. It is okay not to be okay. We all feel the stress resulting from COVID-19. Stress often comes with various factors such as our jobs, or lack thereof, our relationships or lack thereof and life itself. Most if not all of us have been there; experiencing a lack of interest in our jobs, family, avoiding social activities and family, not wanting to get out of bed or being overly anxious about life. Sadly, for those with mental health issues this phase is a fixed state of being and becomes problematic. We live in highly stressed time; especially in this era of the novel coronavirus which is ever mutating. For almost two years many of us have been in a bubble of sort as we have had to isolate and quarantine ourselves from contracting the highly transmittable and deadly COVID-19. As inhabitants of this planet we have not been the same since. Our lifestyles have changed drastically as we have had to adapt to mask wearing, social and physical distancing, COVID-19 vaccine; vaccine hesitancy and nationalism and temperature checks and sanitization of hands. Our mental well-being have been negatively impacted, some of course more than others. Frontline workers, students, people living alone, and those with pre-existing mental health conditions, have been particularly affected. Prior to COVID-19 many persons were already dealing with their mental health, what this pandemic has done and continues to do is to exacerbate already comorbidities. Unfortunately, due to the pandemic many hospitals have had to dedicate more space and time to COVID patients; this regrettably has left a void in the care and management of those patients with mental health issues. This mental health wellness void has contributed to many persons falling deeper into depression. Many persons are not in a good place regarding their mental well-being. A World Health Organization (WHO) survey conducted in mid-2020 showed that services for mental, neurological and substance use disorders had been significantly disrupted during the pandemic. According to the World Health Organization (WHO), close to 1 million people have a mental disorder. The WHO declares that depression is a leading cause of disability worldwide and is a major contributor to the overall global burden of disease. Globally, it is estimated that 5% of adults suffer from depression. Globally, one in seven in the category 10-19 years experience a mental disorder, most of which are undetected and untreated. WHO added that people with severe mental disorders such as schizophrenia tend to die ten to twenty years earlier than the general population. One in every 100 deaths is by suicide. It is the fourth leading cause of death for young people aged 15-29 years. World Mental Health Day is recognized every year on 10 October. The theme this year is Mental Health in an Unequal World. Colossal and Strutural Inequalities The United Nations (UN) states that although gaps exist globally, there has been steady progress seen in the adoption of policies, plans and laws, as well as improvements in capacity to report regularly across years on a set of core mental health indicators, the report found. Despite this, the percentage of government health budgets spent on mental health has scarcely changed during the last years, still hovering around two per cent. The Mental Health Atlas 2020 also shows massive inequalities in the availability of mental health resources and their allocation between high- and low-income countries and across regions. According to the UN report, which includes data from 171 countries, none of the targets for effective leadership and governance for mental health, provision of mental health services in communities, mental health promotion and prevention, or targets for strengthening of information systems was achieved. In 2020, just 51 per cent of the World Health Organization 194 Member States reported that their mental health policy or plan was in line with international and regional human rights instruments, way short of the 80 per cent target. And only 52 per cent of countries met the target relating to mental health promotion and prevention programmes, also well below the 80 per cent target. The only 2020 target met was a reduction in the rate of suicide by 10 per cent, but even then, only 35 countries said they had a stand-alone prevention strategy, policy or plan, the report stated. More encouraging was the increase in countries reporting mental health promotion and prevention programmes, from 41 per cent of Member States of the United Nations in 2014 to 52 per cent in 2020. Men and Mental Health COVID-19 has brought about a mental health crisis for men. Feelings of anxiety and helplessness have become commonplace under the pandemic. Substance abuse and suicide rates among men have increased. The male ego oftentimes prevents men from seeking medical care; mental health well-being is an extension of one’s overall health. In many instances a male will bear physical pain from ill-health before he seeks medical attention. Unfortunately, in most if not all societies there is a stigma associated with those who seek mental health care. The society looks down on those who suffer from mental illness. Ironically, the church which is supposed to be a place of hope and refugee also engages in some form of discrimination against those members who have mental health issues. Regrettably, some churches also judge their members who have mental health problems by stating that their faith is weak or that they lack faith. A colleague who has been diagnosed with Generalized Anxiety Disorder (GAD) disclosed that it is important for men to be comfortable with their psychologists. He suggested that if the male who is seeking mental care does not readily identify with or ‘click’ with his or her therapists the sessions will be counterproductive. Paul, aged 48 was recommended to a clinic which has a mental health unit by his general practitioner recently. Paul disclosed that he has always had mental health issues since his teenage years. Paul added that he was prescribed medication and cognitive therapy was recommended by the psychiatrist. He added that he visited the therapist at the Bellevue Hospital; Bellevue is a specialized mental health facility located in Eastern Kingston. In Jamaica, the inequalities are reinforced in the economic situation of the population. The cost to treat mental health in Jamaica is quite prohibitive. In the private sector one might be asked to pay approximately $10,000 per session. One session usually lasts between 45 minutes to an hour. Many individuals decry the public healthcare system due to the extended wait time worsened by COVID-19. Research has also revealed that mental illness is prevalent among the LGBTQ. LGBTQ is an acronym for lesbian, gay, bisexual, transgender and queer or questioning. The lost productivity resulting from depression and anxiety, two of the most common mental disorders, costs the global economy US$ 1 trillion each year. Some of the most common mental health conditions, depression and anxiety, can be treated with talking therapies, medication, or a combination of these. Regular health checks of people with severe mental disorders can prevent premature death. The rights of people living with mental health conditions can be protected and promoted through mental health legislation, policy, development of affordable, quality community-based mental health services and the involvement of people with lived experience. It would be a positive in the work place and for employees for mental health days be legislated in industrial relations and work contracts. Mental Health and Children Children are not immune to mental illness. According to the United Nations International Children’s Emergency Fund (UNICEF), the COVID-19 pandemic has raised concerns about the mental health of a generation of children. But the pandemic may represent the tip of a mental health iceberg, an iceberg we have ignored for far too long. The State of the World’s Children 2021 examines child, adolescent and caregiver mental health. It focuses on risks and protective factors at critical moments in the life course and delves into the social determinants that shape mental health and well-being. Distressingly, social media can be a double edged sword. While social media can be utilized in finding tips to assist with mental health; social media can also contribute to mental illness if we are not careful. UNICEF added that in 2020, 47.2 million children, adolescents and caregivers with community-based mental health and psychosocial support, including targeted community awareness campaigns in 116 countries almost twice as many countries as in 2019 were reached. The scope of our work in mental health will only grow in the coming years, as will our efforts to secure investment for mental health and to tackle neglect, abuse and childhood trauma that undermine the mental health of too many children. Psychosocial Support The 2017 Global Burden of Disease database shows that depression and anxiety disorders are among the most common mental health concerns facing the population of Jamaica. Around 3% of Jamaicans have a depressive disorder and 4.1% have an anxiety disorder. Women are at a disproportionate risk for both disorders, as 3.7% have depression and 4.3% have anxiety, compared to just 2.3% of men for each disorder. Most new cases of anxiety disorders appear in Jamaicans in the 20-34 and 35-59 age groups. The society’s inability or unwillingness to adequately address mental health concerns can be measured in the low investments the society has made over the years in providing funding for this silent pandemic. In many urban areas scores of individuals, mainly men have become a danger to themselves and the wider public. We often look down at them as being mad. The language we use to discuss mental health issues matters. We must be mindful that we do not use stigmatizing language or terms, or slang which can be commonly used to describe people who may have mental health challenges. We must be careful and sensitive when using medical terms like “depression” or “bipolar”. Unless you or someone you know has been diagnosed by a professional you should stick to describing symptoms rather than speaking about a specific diagnosis. World Mental Health Day is about more than advocacy. It also provides an opportunity to empower people to look after their own mental health and provide support to others. Mental health and psychosocial support are critical to one’s overall state of wellness. The society needs to revisit how we view mental illness and implement a more robust and affordable plan to address mental health concerns. Additionally, the society needs to transform the community mental health aide programme in order to assist more with the care and management of those who are in need of assistance. Given that physical schools have been closed for almost two years we must ensure that vulnerable students can access some level of psychosocial support during this ongoing pandemic. On this Mental Health Day let us show compassion and work towards eliminating stigma and discrimination surrounding mental health. It is also important that we create safe spaces for conversations regarding mental wellness. We all need to learn how to manage stress. One stress management technique is regular exercise. One does not need to go to a gym to engage in some form of exercise and the benefits pay huge dividends. Take slow, deep breaths; or try other breathing exercises for relaxation. One can also soak oneself in a warm bath. Writing, yes writing is a stress reliever. We are encouraged take a mental health day off and do some self-care whenever we feel overwhelmed. Reaching out for help is always useful; there is no shame in seeking help. Finally, we need to attend to our spiritual well-being. There is no overall sense of health if we ignore or fail to attend to our spiritual needs. We should all establish or deepen our relationship with God. Speak to a trusted friend or family member; mental illness does not discriminate and can occur at anytime. Let’s talk. In the words of Michelle Obama, at the root of this dilemma is the way we view mental health in this country. Whether an illness affects your heart, your leg or your brain, it’s still an illness, and there should be no distinction. Wayne Campbell is an educator and social commentator with an interest in development policies as they affect culture and or gender issues. waykam@yahoo.com @WayneCamo © #WorldMentalHealthDay #MentalHealthinanUnequalWorld #OnMyMind