Today the 10th of October 2010, is the World Mental Health Day. This year the world commemorates the occasion under the theme: "Mental Health and Long Term Physical Illness: The Need for Continued and Integrated Care."
This is in recognition of the fact that mental health and long term illnesses have major impact on each other and should be viewed holistically. For instance, depression affects an individual's ability to undertake health-promoting behaviors. Equally chronic conditions such as HIV/AIDS, diabetes, cancer and cardiovascular diseases can have a profound impact on individual’s mental health; and could subsequently affect his or her ability to participate in treatment and recovery. This cycle of events does not end with the patient. Family members and caregivers of people with chronic diseases may also be affected psychologically and therefore, neglect their own health.
As we commemorate this day, I wish to underscore the importance of mental health and long term physical illnesses as they fit into the concerns of the World Health Organization. Globally, over 12.5% of disease burden is caused by mental and neurological disorders [1]. Though there is limited evidence on mental health problems in the African Region, studies from a few countries indicate that one in six patients visiting the health service has at least one mental, neurological or behavioral disorder [2].
It is gratifying to note that since the adoption of the Regional Strategy for Mental Health 2000 by the forty- ninth session of the Regional Committee; more than 30 countries in the Region have developed mental health policies and plans. WHO and Partners have supported countries to initiate programs based on enhancing treatment and promoting holistic care.
Although the Alma-Ata and the Ouagadougou declarations on Primary Health Care call for the promotion of equitable distribution of health workforce and services this is yet to be achieved in the area of mental health. In the African region mental health services are still concentrated in a few specialised institutions mainly in urban areas; and as a result availability of services is limited and the access to mental health care remains low.
It is encouraging to note that some countries[3] have initiated community based care for people suffering from long term illnesses such as HIV/AIDS, diabetes, Epilepsy and Depression. This type of approach links the home based care to institutional care thereby providing a continuum of care.
Despite some successes being recorded in mental health there are persisting problems such as the inability to provide an integrated care and the existence of social stigma that discourages patients from seeking early care. Shortage of specialized personnel and limited access to medicines contribute to the problem. For example, for every ten million people living in the WHO African Region, there are only six psychiatrists and sixty seven psychiatric nurses[4].
I would like to call upon all governments, partners and communities, to advocate for improved services and care for people with mental illnesses and long term physical illnesses. Communities need to be supported to increase their awareness and knowledge on mental health so as to reduce stigma associated with this disorders. Governments should improve mental health facilities, create services at all levels of the health pyramid and empower communities to recognise mental illness and refer those affected for appropriate and timely treatment. It is essential to initiate and sustain rehabilitation programs for the mentally disabled which will facilitate their reintegration into the community. Such initiatives will contribute to the reduction of stigma and exclusion, thus alleviating the suffering associated with mental illness.
On this day we are again reminded that WHO Constitution defines health as “a state of complete physical, mental and social well- being and not merely the absence of disease or infirmity” meaning that health care provision should address the physical, mental and social conditions
I thank you all.
1 Regional strategy for Mental Health, 2000-2010, pp 4
2 Report of the Round table on mental health , global action plan (mhGAP), for African countries , Abuja 23 Oct 2009, unpublished,
3 Benin, DRC, , Cote d’Ivoire, Ethiopia, Mauritius, Mali, Nigeria Kenya, Lesotho, Uganda ,Tanzania , Rwanda, Senegal South Africa, Zambia and Zimbabwe
4 Report on the evaluation of the implementation of the Regional Strategy for Mental Health , July 2010, unpublished