Written by Emily Foltz.
Amid tireless efforts to rid the world of common medical challenges such as malaria, TB, and HIV/AIDS, mental illness has stealthily stolen the stage as the leading cause of disability worldwide and accounted for 13% of the global burden of disease in 2004. Globally, suicide is the second most common cause of death among young people according to the WHO Mental Health Action Plan established in 2013.
The same report notes that worldwide spending on mental health is less that US $2 per person, and it is less than $0.25 per person in low- and middle-income countries. Most of these funds are spent on stand-alone mental institutions, despite their known poor health outcomes and common human rights violations. Mental illnesses are projected to cause US $16.3 million of lost economic output from 2011-2030. With few treatment options, the soaring burden of disease, and increasingly drastic measures taken by individuals, they way mental health is currently approached has not proved sufficient.
Jamkhed is no exception to this alarming mental health trend. CRHP has been researching mental health in Jamkhed communities since 2003, and we have found that 30-50% of mental illnesses relate to neuroses such as anxiety, depression, substance abuse, stress, trauma/violence-related reactions, and psychosomatic illnesses, etc. While cranial chemical imbalances are part of the problem of mental illness, social factors often trigger or exacerbate biologic reasons for mental illness. Such social factors prominently feature gender pressures, abuse, and socioeconomic hardship.
Local boys participating in CRHP’s Adolescent Boys Program revealed they want to be better members of society, but face stressors of the culture such as emotional suppression, physical, emotional and mental changes, work expectations, and considerable alcohol abuse amongst local adult male populations. Through our Adolescent Girls Program, we have seen firsthand how the girls’ privileges are parentally restricted in response to fear of violence common against girls, causing them to live in fear, isolated from peers, and lacking confidence. Thus a range of biological and social factors play off one another and result in the ever-growing, ever-suppressed number of cases of mental illness. When asked during a mental health training session how many VHWs had had someone in their village commit suicide in the last month, almost every hand in the room went up.
In order to effectively change the course of mental illness both in Jamkhed and globally, something needs to change. With the help of a grant from the Paul Hamlyn Foundation, CRHP has launched a new Mental Health Program aimed to do just that: change how mental health is perceived and cared for in local communities. Beginning in April 2014 and continuing for two years, this program is aimed at providing care for those already suffering from mental illness while working with the entire community to improve the mental health of the area.
The cornerstone of this project is the Barefoot Counselor. Currently, women from 10 CRHP Project Villages are being trained at CRHP to understand mental health, recognize mental illnesses, provide counseling for community members, and know when to refer serious cases to the hospital. Critical to changing to attitude surrounding mental illnesses is educating counselors, and through them Jamkhed communities, on mental health.
The reason it is important to be able to detect and treat mental illness is not to single people out of the community, but rather improve the health of the community as a whole. Just as countless organizations, including CRHP, have worked to eradicate physical illnesses like leprosy, the goal is a healthier society. Health encompasses all parts of life. It is not merely physical well-being, as CRHP founders and communities stated so long ago, health is the coalition of mental, physical, and spiritual well-being. By training these Barefoot Counselors, villagers will have resources for the first time to know and educate other community members about mental health and illness. Through sharing of this information, Barefoot Counselors will work with their communities to reduce stigma and provide counseling and treatment services.
In the coming months, the Barefoot Counselors will leave the classroom and take their training to the villages. Throughout this transition, the counselors will be supported by CRHP’s Mobile Health Team and a newly appointed psychiatrist to begin in-village counseling and treatment programs. Stay tuned for more updates on this exciting and important new CRHP program!