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World Mental Health Day is a global event that aims to promote and raise awareness about, and eradicate stigma associated with mental health conditions. It was first observed in 1992 and it is commemorated every year on 10th October. The theme of the day this year is to make mental health and well-being for all a global priority. To this, I would like to add that we should also make mental health an everyday priority because it determines how we cope with the normal stresses of life in different settings.

What is the Global Mental Health Burden?

In 2019, before the pandemic, World Health Organization (WHO) reported that 13% of the global population, which was approximately 970 million people, were living with a mental health disorder. Out of this number, 52.4% were women and 47.6% were men. An estimated 82% of the cases were in low- and middle-income countries (LMICs). [1]

Africa had the least prevalence rate at 10.9% of all WHO regions. The low prevalence rate of mental health conditions in Africa is not an indicator of low number of mental health conditions in the conditions. Rather, this can be attributed to sociocultural factors such as low understanding and beliefs about mental health that influences people in Africa not to disclose their symptoms, stigma and discrimination that also leads to underreporting of the cases.

Anxiety disorders and depressive disorders accounted for the largest percentage of cases at 31% (301 million people) and 28.9% (280 million people), respectively. These conditions are estimated to cost the global economy USD 1 trillion each year with the cost driven by lost productivity.[2] Meanwhile, developmental disorders accounted for 11.1%, attention-deficit/hyper-activity disorder (ADHD) 8.8%, bipolar and conduct disorders 4.1%, autism spectrum disorder 2.9%, schizophrenia 2.5% and eating disorders 1.4% of cases. Additionally in the same year, a record of 36 million people had drug use disorders and 55 million people had dementia.[3]

Prevalence rates vary amongst men and women. Depressive and anxiety disorders are approximately 50% more common among women than men while substance use disorders are more common in men than women. The statistics of depressive and anxiety disorders increased significantly during the COVID-19 pandemic, with countries that were massively affected by the pandemic recording the highest numbers. Mental health disorders account for one in six years lived in disability globally.

Reflections and Way Forward

Mental health has come a long way in terms of attitudes, treatment methods, and accessibility of care services. Whilst previously people used controversial terms to refer to individuals suffering from mental health conditions like crazy or lunatics nowadays there are friendlier terminologies such as  psychosocial disabilities.

In addition, there are more conversations about mental health both from health and non-health professionals, national and global mental health policies, plans, and strategies, investments in mental health, organizations committed to raising awareness about mental health, resources such as clinics and educational materials, and an abundance of online tools that are bridging the gap between patients and professionals by ensuring borderless and full-time accessibility of mental health care.

Whilst all these gains are impressive and are a testament of our good efforts, we should not be blind to existing challenges such as information, resources, service, and governance gaps. Stigma is still a huge barrier to addressing the mental health epidemic. There is a huge portion of global population that lacks basic knowledge about mental health such as how different conditions manifest, the causes, and/or where to seek medical services. This makes it hard for them to detect the conditions at an early stage and only seek medical support when the conditions have worsened. Stigma further increases the duration between detection and care.

Some countries lack mental health data: some do not collect data at all while others have incomplete data that is insufficient to inform decisions. In many LMICs, there are few mental healthcare professionals and medications for mental health conditions, and even fewer mental health care centers.

To truly promote mental health, our actions must be strategic, deliberate, comprehensive, and consistent all year long.

Mental health approaches should cater for the needs of all: No one is immune to mental health conditions. We should come up with strategies that will look into the specific mental health needs of different populations such as healthcare workers, parents, children, teachers, leaders, youths, and other categories.

This calls for the need for increased research about mental health in different populations and the intersection of different factors, knowledge sharing, and increased investment to train specialists for the different categories of people.

Gather and make mental health data comprehensive and visible to the relevant stakeholders: Mental health data is scarce and sometimes incomplete in health facilities, national, and regional levels hence the burden and the respective needs are not clearly understood. Other challenges associated with data are the greater focus on diagnosis data and very minimal on indicators, and sometimes the data taking too long to reach the relevant stakeholders.

While data collection for mental health is essential, this should not be the only goal. Data collection should be done from the grassroots, consistently and, be critically analyzed, and availed to the relevant stakeholders at all times for use in making informed decisions.

Be consistent in advancing mental health and make this an everyday affair: A month after the commemoration of World Suicide Prevention Day whose theme was creating hope through action, it is unfortunate that actions towards mental health have declined. Globally, there maybe 20 suicide attempts to every one death, yet suicide is the second leading cause of death among 15-29-year-olds. While this may not be intentional, we should bear in mind that mental health impacts our daily lives, and the causative factors occur every day hence the need for us to prioritize it and take the necessary steps towards advancing mental health every day.

We should not reserve our efforts of raising awareness about mental health only for international health days because the matters surrounding mental health cannot be exhausted in a day.

Mental health should be prioritized, and investments increased: More often than not, prioritization and investment go hand-in-hand. However, few countries in the world have developed mental health plans, policies, and strategies which leads to low investments. Mental health should be prioritized in health plans and policies and in the health financing models.

As reported by WHO, majority of people with mental health conditions in Africa do not have access to quality care. There are less than two mental health workers per 100,000 people and less than one specialist per million people in Africa. This is further compounded by the fact that 41-52% of healthcare workers reported burnout during the course of the COVID-19 pandemic[1]

It is estimated that currently, governments in Low-Income-Countries spent only USD 0.20 pppa on average, an average of 0.5% of Total Health Expenditure[2]. This proves that there is need for more investments for mental health to increase the number and capabilities of healthcare professionals, facilities, access to medicines, and other resources. Investment, however, should not be interpreted as allocation of funds to mental health only. The funds should be appropriately allocated to the relevant dockets in mental health such as capacity building, prevention, research, diagnosis, healthcare provision, and others. Accountability systems should also be established and intersectoral collaborations amongst different stakeholders such as donors, policy makers, healthcare providers, and patients encouraged to truly make a difference in mental health.

Investment opportunities in Africa

  1. Training of more mental health professionals, especially psychiatrists in the region to bridge the human resources gap.
  2. Educating and offering mental health care in different settings such as workplaces and schools and informing strategies to promote mental health.
  3. Establishing state of the art mental health facilities in new regions and improving already existing healthcare facilities, especially at primary healthcare level.
  4. Providing resources and tools such as mobile applications and websites linking patients to health professionals.
  5. Data management training and developing data management systems for use in different settings such as hospitals, schools, regional, national, and global health levels.
  6. Establishing research centers and informing activities in other industries to promote mental health.
  7. Scaling up the manufacturing and supply of medical commodities required for mental health services in the region.

References