Mental health achievements in Bangladesh

Mental health is a state of well-being when both your body and your mind are in balance, and you are able to deal with the difficulties and challenges that come your way and easily find joy, peace, and happiness once the challenge is overcome.

For many people though, the challenges often remain for too long – the pain of losing someone you dearly loved, being diagnosed with a chronic disease like cancer or a heart condition, losing your family/home/job or feeling like you failed to meet expectations. All those things and more can trigger so much intense stress and maladjustment, that if it goes unchecked and untreated, it may lead to a chronic disease, a mental health disorder. WHO defines health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity".

The majority of people are able to cope and get back to life as normal, but for the many who cannot, they begin to experience intense detachment from reality (experiencing delusions, pervasive sadness, uncontrollable fears, intense anger and/or fantasies and hallucinations). For those individuals, there is limited help and treatment in every country in the world. Those who suffer from mental health disorders and the brave professionals who learn to treat them are chronically stigmatized, under-appreciated and under-paid.

Mental health conditions, substance use disorders, suicide, and neurological disorders like dementia affect more than a billion people annually, account for an estimated third of the global burden of disability and result in 14% of global deaths. (Vigo et al., 2016). There has been increasing global recognition of the importance of mental health and the significant global burden of mental health conditions in both developing and developed countries. More than 80% of people experiencing them are living without any form of quality, affordable health care. Due to negligence and ignorance, we have high levels of mortality through suicide and increased comorbid medical conditions. According to a study published in 2016, it is estimated that 14.3% of deaths worldwide, or approximately 8 million deaths per year are attributable to mental health disorders.

The 7th Five Year Plan (FYP) and Vision 2021 of the Government of Bangladesh recognized the urgency of addressing mental health and developed a comprehensive system of care that can be implemented within our well tiered health infrastructure. This plan emphasized that proper health is essential not only for physical well-being but also for economic livelihood. To realize the vision of the 7th FYP, the Ministry of Health and Family Welfare is implementing its 4th Health, Population and Nutrition Sector Programme (4th HPNSP) from January 2017 to June 2022. The 4th HPNSP's objectives include strengthening governance, institutional efficiency, expanding access and improving quality within the universal health care system. To achieve the SDGs target, the Ministry of Health and Family Welfare has committed to ensuring that mental health is a priority in the 4th HPNSP.

It is important to note that Bangladesh is among the first few countries in the WHO South-East Asia Region to place mental health as one of its top 10 priority health conditions. Mental health programming in Bangladesh has undergone several phases of evolution. Bangladesh passed a new Mental Health Act in 2018; is working on finalizing a Mental Health Policy; and has developed a National Strategic Plan after conducting a thorough situation analysis involving both professionals and those with lived experiences. The focus of the Mental Health Act is to protect the dignity of citizens with mental health conditions, provide them with healthcare, ensure their right to property and rehabilitate them.

The law has 31 sections and will oversee the direction, development, expansion, regulation, and coordination of mental health related issues and duties entrusted to the Government. The National Mental Health Policy 2021 which is currently under final approval, provides an overarching direction by establishing a broad framework for action and coordination, through common vision and values for programing and mental health service delivery. Although still under review, this policy document acknowledges the significance and importance of relevant and useful local knowledge and practices, and adheres to global and regional thinking, taking into perspective the Bangladesh context.

Across the globe in most nations, mental health treatment is underfunded and lack a well-designed system of care within the health system primarily due to a limited understanding of how to treat adequately, severe social stigma, and complication of the conditions. The situation is similar in Bangladesh, where mental health has been a low priority in both health services delivery and planning for many years now. To address these issues, developing a comprehensive and multi-sectoral National Mental Health Strategic Plan was the only way forward to ensure access to quality mental health care services across the nation.

Saima Wazed, a licensed School Psychologist, is currently Clinical Instructor for the Department of School Psychology at Barry University. Additionally, she is Advisor to the Director General of WHO on Autism and Mental Health, Member of WHO's Expert Advisory Panel on Mental Health, Chairperson of the National Advisory Committee on Autism and NDDs in Bangladesh, Thematic Ambassador for "Vulnerability" of the Climate Vulnerable Forum, and Chairperson of Shuchona Foundation.

Nazish Arman is Lead Content Developer of Shuchona Foundation.

The article was first published in Inter Press Service