Mental Health Policies: A Look Around the World
“At the root of this dilemma is the question of how we view mental health...Whether an illness affects your heart, your leg, or your brain, it’s still an illness and there should be no distinction.” - Michelle Obama
We live in a world where more people suffer from some kind of mental disorder or anxiety that one might envisage. Although the term ‘mental health’ is used ubiquitously today, many people are still apprehensive or unaware of the implementation of mental health policies across the world. The framework of mental health policies around the world has always been capricious due to a stigma attached to the term ‘mental illness’. To combat this stigma against mental health, raise awareness, and eventually prevent the occurrence of mental disorders, the World Health Organization conceived a Nations For Mental Health plan in collaboration with its specialised agencies like UNICEF, UNDP, UNHCR, ILO, UNDCP, and UNESCO. The plan, which recognizes the need to address and devise policies on mental health, is the first of its kind.
One of the biggest misconceptions that one might envisage is that first world countries like the United States of America and Canada have robust and effective mental health systems. According to the American Psychiatric Association, over 68 million Americans have experienced a psychiatric or substance use disorder in the past year. This is one of the highest rates among high-income countries. According to The Commonwealth Fund, the United States also has "some of the worst mental health-related outcomes", including the highest suicide rate in the world. The problem however is not a shortage of medicines or psychiatrists. Mental health specialists and their work remain inaccessible to many due to ineffective policy. Studies show that 15% of Americans who experienced anxiety and emotional distress could not afford professional help. Mental health policies also fail to provide enough information on evidence-based psychotherapy. According to a 2012 Statistical report, while 91 per cent of Canadians were prescribed the medication they sought, only 65 per cent received the therapy they felt they needed. Access to evidence-based psychotherapy is limited which causes patients to indulge in medication which they might not require. Limited mental health policies, even in high-income countries, impede the normalisation of psychological disorders and mental health in general.
Due to rampant misinformation, religious stigmas, and mental health illiteracy, in China alone, 72.3 percent of people with depression, anxiety or other problems are not even aware of their disorder. And according to the Indonesian Ministry of Health, it is estimated that 90 percent of Indonesians interested in mental health services cannot do so due to a shortage of mental hospitals and mental health professionals. The Mental Health Act (2014) of Indonesia also allows a guardian "to admit a child or an adult with a psychosocial disability to a mental hospital without their consent, and without any judicial review." People have been forcefully admitted to religious healing centers by their families because of misconceptions around mental health that are entrenched in Indonesian society, and embedded in the nation’s policies. Not only can patients be admitted without their consent, they may be restrained with chains and denied access to toilets during their stay at these facilities. However, the MHA contains many loopholes to be resolved. For instance, it continues to dispossess people with psychological disorders and disabilities of their legal capacities.
The lack of normalisation of mental health in countries including China and Indonesia has made it an incendiary topic. And, if countries with developed economies like the U.S. and Canada are struggling to effectively, let alone humanely, deal with mental health from a legislative standpoint, how are countries with fewer resources to put toward mental health going to fare? A key problem is that mental health policies in developing nations imitate those in the West, and the absence of specialists and hospitals in poorer countries results in even more patients going untreated.
Some governments, however, have managed to implement policies that are effective in improving the mental health of their populations. In Uganda for example, interpersonal therapy has been used to treat people in rural areas. It is also extremely important for countries around the globe to take inspiration from the Positive Education Model of Luxembourg to support the mental wellbeing of children from a young age. Studies show that a hectic and unpleasant education system discourages creative thinking and tends to induce stress and anxiety in children.. The Positive Education Model of Luxembourg aims to support mental well being, increase life satisfaction, and tackle problems like suicide, depression, substance abuse, and eating disorders.
Non-governmental organisations are also uniquely positioned to help provide health services to communities that do not have them guaranteed by the government. Such organisations can engage in policy-based advocacy to hold governments accountable for promises made. In a report by Letters to Strangers+Zimbabwe published in November of 2020, it was found that while the minister of finance of Zimbabwe budgeted ZWL$200 million for the free distribution of sanitary products to girls in rural areas, no such products have been provided. The students and teachers involved in the study are keenly aware of the risks one runs when forced to improvise menstrual materials, but without sufficient access to sanitary products, people who menstruate have no other option. The role of the NGO in this situation is to edify politicians that control the flow of resources and call attention to intersecting issues, like hygiene and mental health.
For many years, countries have failed to acknowledge the absence of mental health policies and stigmas on mental health. However, with the help of studies, science, and social media, many countries have left no stone unturned and have actively taken steps to draft mental health policies and spread awareness about it.
