What is Mental Health?
The World Health Organisation (WHO) defines health as ‘a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity’ with good mental health being defined as ‘state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community’. Globally, mental health problems are one of the worlds leading causes of disease. In 2017, 1 in 7 people (15%) were said to have one or more mental or substance use disorders and 79% of the world suicides occur in Low- and Middle-income countries.
What is the picture in Africa?
The World health assembly has committed to increase coverage for severe mental health disorders by 20% by 2020 and the 3rd sustainable development goal includes commitments to improve mental health and prevent and treat substance use disorders. However, in Africa mental health continues to be a neglected disease, with little focus on mental health as a non-communicable disease. Between 2000 and 2015 the continent’s population grew by 49%, yet the number of years lost to disability because of mental and substance use disorders increased by 52%. The need to address metal health is evident. In many countries, resources for mental health services are low. In Zimbabwe 1 in 4 Zimbabweans suffers from depression or anxiety however There are just 12 psychiatrists in a population of 14 million people. Within Africa there are 1.4 mental health workers per 100,000 compared 9% globally and in Low- and Middle-Income countries more than 80% of people experiencing mental health conditions do not have any form of quality, affordable mental health care.
Currently few countries in Africa have comprehensive mental health policies. 46% of countries within Africa did not have, or had not implemented, standalone mental health policies and only 8 African countries had updated mental health legislation. Not only this but Africa has the lowest expenditure per capita on mental health worldwide with mental health allocated on 1-3% of the health budget in most countries. Where policies and interventions exist, young people are often left out. This is alarming, as Africa has one of the youngest populations worldwide.
What are the Solutions?
Africa’s population expected to double over the next 30 years therefore it is essential that mental health services are improved. At the 2019 Mental Health in Africa Innovation & Investment conference advancing mental health policy, advocacy and human rights was highlighted as a priority. With an emphasis on taking a human rights approach to mental health. The need for mental health policies to be developed based on international human rights standards was highlighted, not only this but addressing the lack of resources available for mental health services was a top priority.
Policies must also address the current services available, evaluating their approaches and taking a community-based approach when developing policies. Ensuring the communities in need of services are listened to is essential in ensuring that services are effective. Considering the expertise of those with lived experience, as well as the communities who for years have developed their own methods of dealing with mental health were resources were unavailable. Policy makers should aim to learn from these individuals and communities. This is not only important when undertaking research but in developing policies and interventions.