According to the WHO, mental and substance use disorders are the leading cause of disability worldwide. The inclusion of mental health and emotional well-being in the Sustainable Development Agenda (2015), was an important step in bringing more visibility to this ignored area of healthcare. However, much remains to be done.
Across the world, and mostly so in low and middle-income countries, millions of people affected by mental health problems remain unable to access professional help. Many countries lack a basic legal framework to protect those with a disability. Investment in mental health services remains insignificant. Care facilities are severely depleted of qualified, trained staff. This combined with the social stigma attached to mental illness, often leaves people living with a disability and their loved ones feeling excluded and isolated, with nowhere or no one to turn to.
Improving access to high-quality mental health services and supporting the social inclusion of those affected by mental illness in low income countries is an urgent priority. It is a long, but achievable journey in which different actors have a role to play, from top end governmental officials, to service providers, health professionals, and local communities. In this process, UiH focuses on strengthening the knowledge, skills and competencies of those providing direct care to people in need – nurses, occupational therapists, doctors and other allied health professionals. Working alongside mental health care providers and educational organisations, we encourage the training of a resilient, competent healthcare workforce, able to contribute to positive changes in the lives of those affected by ill mental health.
UiH’s approach focuses on five key areas essential to achieving effective change and sustainable results:
Sharing skills and knowledge in mental health care is central to UiH’s work. Most of our field-based activities include face-to-face training programmes for students, practicing staff and informal health workers in specialist clinical skills where these are absent and in greatest need. UiH also invests in those with no health qualifications who assume the role of health advisors and carers within communities, ensuring everyone has access to basic mental health care services. Most of our capacity building interventions follow a training-the-trainer approach and include mentoring and supervision support systems.
II. Community Outreach
People living in remote and rural areas experience great difficulty in accessing mental health services. Geographical isolation and the inexistence of trained health care staff are some of the main obstacles faced by those based in regions far from major urban areas. UiH is committed to supporting community outreach mental health-based clinics following a multidisciplinary model of care in which nurses, occupational therapists and other health workers play a central, leading role.
III. Psychoeducation & Prevention
Preventive interventions are essential to modifying risk exposure and strengthening the coping mechanisms of individuals and communities. For those affected by mental illness and emotional problems, stigma is a major cause of discrimination and exclusion. Misconceptions around risks, causes, treatments and recovery hamper the prevention of mental health disorders, the promotion of mental well-being and the provision of effective treatment and care. Addressing risk factors, raising awareness of mental health issues and offering education and information to those seeking and receiving support, their families and carers, is vital to changing perceptions and encourage positive change. Culturally appropriate prevention & psychoeducation are integral to the role of every mental health professional and to the successful delivery of all our programmes.
A significant proportion of people with mental disorders reside in low and middle-income countries. However, much needs to be understood about the real impact of mental illness in individual and community life, and best ways to provide treatment to those in need. UiH encourages research on the morbidity and prevalence of specific mental health related problems and together with local organisations, finds sustainable answers for challenges encountered.
UiH supports the capability of local governments, mental health care providers and local healthcare workforces. Through its different in-country activities and together with our partner organisations, we identify barriers and enablers to good practice, support the creation of effective mechanisms of clinical governance, and encourage self-sufficiency and autonomy. All our programmes aim at empowering future mental health care champions, and in bringing sustainable changes to local mental health care practice rather than creating long term dependency from international aid development.