Talking about mental health is really important. Even here in the UK, there remains a stigma towards mental health issues in society. Internationally mental health is a hugely important aspect of development, with one in four families worldwide likely to have at least one member with a behavioural or mental disorder.
Stigma and isolation
In some communities, those suffering from poor mental health can be subject to stigma, isolation, and even attacks. People are held in psychiatric institutions, often in very harsh conditions, rather than receiving any treatment or support for their condition. This includes children and young people held in institutional homes – the kind to which SOS Children seeks to provide an alternative.
Facing exclusion from their communities, this vulnerable group in society can be discriminated against, denied basic rights and receive no access to mental health care. This impacts on employment, housing and finances. For the many people with mental health issues living in poverty and isolation, it is even harder to manage or recover from their illness.
There is an additional cyclical effect where parental mental health impacts on the emotional health and well-being of the child. Children of depressed parents are 2-3 times more at risk of developing depression. Depression and anxiety during pregnancy additionally increases the risk of low birth weight and of a pre-term birth.
Maternal depression is a significant factor in determining behavioural problems in children and impeding brain development. Research shows a link between low maternal responsiveness at 10-12 months to aggression, non-compliance and temper tantrums at 18 months, lower compliance, attention-getting and hitting at 2 years of age, problems with other children at 3, coercive behaviour at 4, and fighting and stealing when the child is 6. In the UK, the long-term economic impact on society of unresolved conduct disorder can exceed £1 million for one individual over their lifetime.
The need to understand
Around the world there is varied understanding or appreciation of good mental health. In my experience, there have been children in institutional settings clearly suffering from mental health issues without any understanding or support. On one occasion, I translated medical notes for a group of over 20 children and found they listed each child as having ‘Mental Retardation’ of severity 1, 2, 3 or 4. Clearly there is some way to go in understanding and responding to mental health in these contexts.
Working with governments to influence policy and provision is essential to build long-term and sustainable systems that protect, support and provide healthcare for those suffering with poor mental health. Mental health can be managed by engaging support around the individual, as opposed to isolating them; capacity-building activities such as training can equip people and services to respond appropriately; and we know that providing local mental health services increase their accessibility and help to destigmatise mental health in the community.
Campaigning for change
The World Health Organisation’s Mental Health Action Plan 2013-2020 sets out that mental health, like other aspects of health, needs to be addressed through comprehensive strategies for promotion, prevention, treatment and recovery in a whole-government approach. There is a long way to go in providing this level of support globally, but campaigning for change and advocating for the rights of people with mental health issues are steps in the right direction.
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