People affected by mental illness are underserved, face stigma, and often lack advocacy (Hernandez, 2011). The case of mental health is complicated because even the international health community has constantly ignored mental health conditions, specifically persons who display symptoms associated with psychosis, such as social withdrawal, delusions, incoherence, hallucinations, and/or catatonia, symptoms that reflect ‘craziness’ in people (Bopaiah, 2016).
Figures from the World Health Organization (WHO) approximate that depression, schizophrenia, bipolar disorder, and alcohol use-related disorders affect about 450 million persons globally, reflecting nearly 12% to 14% of the world burden of the condition, which is evaluated using disability-adjusted life years (DALYs) (International Medical Corp, n.d). Alternatively, the measure relies on a specific number of years of healthy life lost to illness. Apart from the loss of healthy life, mental illness also affects families economically and emotionally, and consequently, there is associated loss of productivity and stability in society.
Economic
Typically, however, mental health is only allocated less than 4% of the annual world health funding while its health burden is larger than HIV and malaria, which receive more allocations (Bopaiah, 2016). Also, individuals responsible for budget execution are least likely to focus on the most critical types of mental conditions, including psychotic illnesses. These figures raise critical economic and resource allocation questions about global efforts to control the most severe forms of mental conditions.
Ethical consideration
Notwithstanding achievements realized in healthcare outreach to other underserved persons, including sex workers, refugees, individuals living with HIV, criminals, warlords, and even Ebola victims among others, even healthcare workers who have worked in some of the most dangerous locations around the world are normally not interested in providing mental health services.
Given the rampant stigma associated with mental illness and limited knowledge about causes and best treatments for various mental health conditions, many healthcare providers at best do not focus on them or tend to violate the human rights of such patients, which raises serious ethical issues in healthcare practices. For example, some data from the WHO on mental health indicate that most patients are locked up in cells for several months without necessities, limited human contact, and live in squalor states (Bopaiah, 2016). In some instances, the same healthcare workers who are meant to offer treatment and care do perpetrate some of these abuses.
Cultural constraints
Mental illnesses have been linked to genetic factors. However, symptoms often tend to be culturally specific, raising cultural challenges for care providers. In African cultures, for instance, mental cases are usually associated with witchcraft or excessive smoking of bhang and Koro is common in Japan, while the US psychosis cases are usually paranoia of some events. This implies that treatment effectiveness tends to be idiosyncratic. That is, treatment options for one patient could be completely irrelevant for another patient with the same symptoms because of cultural constraints.
Infrastructures and interdisciplinary team support
Variations in these experiences present put developing nations in difficult situations because they lack sufficient infrastructures to meet the standards often advanced by the West. Moreover, most emerging nations lack any effective national approach to mental health. Social support and interdisciplinary team support are greatly missing in most care plans.
The currently available interventions have worked to control psychosis, especially in developed nations. However, these gains have diminished because of the side effects of anti-psychosis medications, which are associated with excessive weight gains, leading to other chronic health issues, such as obesity and diabetes. This implies that Western medication, although effective for instant psychosis relief, requires further improvements and collaboration with other interdisciplinary teams from the rest of the world to ensure culturally responsive actions.
Non-governmental
Today, however, some organizations have recognized mental health problems and intervened (Bopaiah, 2016). International Medical Corps, for instance, offers mental health and psychosocial support to individuals who have suffered war trauma. Also, Partners in Health introduced a depression screening system while Bring Change 2 Mind promotes mental health public awareness through organized campaigns. These initiatives are insufficient given the global magnitude of the disease.
A Strategic Action Plan for Mental Health
The Team
The team consists of civil society groups, Ministries of Health, and international health partners, including donors. The Ministry of Health in the respective countries will take the management role. The team will be engaged through clearly defined actions, which reflect a strategy for mental health and psychosocial care that strives to develop the capacity of care providers to enhance quality and accessibility to care services.
Communication
Interdisciplinary communication strategies will be based on trust, coordination, collaboration, team effort, and interdependence while respecting individual roles and autonomy, contributions and consensus to manage cultural variations.
Technologies
Appropriate technologies that promote team learning, communication, knowledge sharing, skills acquisition, effective analysis of data, and decision-making would be adopted to enhance outcomes.
The Mission
Enhanced accessible to and provision of quality mental healthcare services based on national and global provisions by creating broad, culturally and linguistically applicable mental health programs that promote the use of local human resource capacity and support health systems
Objectives
- Advocate for increased funding for mental health, specifical psychosis
- Start a global coalition of physicians, governments, researchers, patients, and mental health advocates to develop agendas for funding and support while fighting stigma
- Strengthen management, governance, and leadership for mental health, specifical protection of human rights, health promotion and prevention, and social care services
- Enhance knowledge sharing, information systems, and evidence-based care research for mental health
Strategies
These strategies focus on the development of mental health and social care services that improve local capacity to drive quality care and service accessibility and provision.
- Human right protections
- Fighting stigma
- A wide variety of psychosocial supports
- Promoting evidence-based research
- Work with donors, such as the USAID, the UKAID, the Bill & Melinda Gates Foundation, and others, as well as health organizations, including Bring Change 2 Mind, International Medical Corps, and Partners in Health
Budget in US Dollars (millions)
Timeline
This is a five-year action plan based on sustained programs.
Available Resources
- Limited resources are currently available
- Massive funding is necessary to support the action plan
Partners
The preferred partners are governments, the USAID, the UKAID, the Bill & Melinda Gates Foundation, Bring Change 2 Mind, International Medical Corps, and Partners in Health, the WHO, the Red Cross, and other local organizations
Outcomes
- Increased funding, service provision, protection, awareness, use of evidence-based outcomes and advocacy
- Reduced stigma
- A global collaboration
Evaluation
Assessment conduct after every two years to determine changes.
Issues
Barriers are attributed to cultural differences and disease complexity. The nature of mental health exposes care providers and patients to physical injuries and assaults.
Nurse
Nurse makes a difference through cultural competency care while the roles include training other nurses on cultural beliefs about mental conditions.
References
Bopaiah, M. (2016, March 30). Time for Global Action on Mental Health. Stanford Social Innovation Review.
Hernandez, B. L. (2011). Foundation Concepts of Global Community Health Promotion and Education. Sudbury, MA: Jones & Barlett Learning.
International Medical Corp. (n.d). Mental Health: The Invisible Burden.