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Mentally Ill Suffer Medieval Treatment Across the Globe

Stephen Leahy

UXBRIDGE, Canada, Jul 22 2011 (IPS) - A young girl in Somalia sits chained to a tree. Women in the Ukraine wander aimlessly in the halls of a decrepit psychiatric hospital. Those are the startling images in a recent article by a global panel calling the world’s attention to the extent and tragedy of hundreds of millions suffering from mental illnesses and who go untreated in the global south.

Grand Challenges Canada responded to that call Thursday, announcing 20 million dollars in funding specifically for research proposals to tackle the issue of mental health in developing countries.

“This is the first investment in response to the global panel’s call for action,” said Peter Singer, CEO of Grand Challenges Canada.

“Mental illness in low- and middle-income countries is perhaps the most neglected of the ‘neglected diseases’,” Singer told IPS.

Mental disorders such as schizophrenia, depression, epilepsy, dementia and alcohol dependence represent 13 percent of all diseases worldwide, more than heart disease and cancer combined, the global panel of 422 experts reported in the Jul. 7 issue of the journal Nature.

The panel was convened by the Grand Challenges in Global Mental Health initiative and funded by the U.S. National Institute of Mental Health and the Global Alliance for Chronic Diseases in London.

Some 450 million people are afflicted with mental disorders, and more than 75 percent live in the developing world. In a recent survey, the World Health Organization found up to 85 percent of patients with serious mental disorders did not receive any treatment in the past year of their illness.

In 83 percent of low-income countries, there is no primary care treatment of Parkinson’s disease, which causes dementia. In 25 percent, there are no anti-epileptic drugs, the panel reported.

“Finding solutions means doing research, and there is extremely little research funding for mental health in low- and middle-income countries,” said Abdallah Daar, co-leader of the panel and chief science and ethics officer of Grand Challenges Canada.

“Mental illnesses are really the grandest of the challenges,” Daar said in a release.

Europe has 200 times as many psychiatrists as Africa, but no one can afford to bring that level of care to Africa or many other low-income countries, said Singer. “Innovation is what is needed to improve treatment and access to mental health services,” he stressed.

The need for home-grown innovation is paramount, according to Singer. There simply isn’t enough money to meet the need in poor countries using the same approaches taken in richer countries to treat mental illness, he argues.

“Services in many countries are at a very basic level, if they exist at all. We are looking for treatment innovations by researchers in the developing world who best know the reality in their countries,” he said.

Singer and Grand Challenges Canada are hoping for revolutionary breakthroughs in terms of treatment and access to mental health services.

Ten years ago, most of Africa was without phone services, but the solution was not to copy what Europe or North America did by building a costly network of land lines. Innovation brought the mobile phone and now Africans not only have phone service but are using it in new ways such as transferring funds with Mpesa (M for mobile, pesa is Swahili for money), said Singer.

The money to fund Grand Challenges Canada comes from Canada’s 228- million-dollar Development Innovation Fund, which was designed to support collaborative research into solutions to global health challenges. This forms part of Canada’s recently increased commitment to overseas development assistance.

Grants of a million dollars or more will be awarded to the best proposals from social, scientific, business researchers for significantly improved treatment and increased access to care for patients.

Successful proposals will include treatment practices for remote area health workers, ways to reduce the cost and improve the supply of drugs, affordable community-based care, or the development of mobile and other technologies like telemedicine to increase access.

Equally important are proposals to address the issue of stigma, discrimination and social exclusion of those with mental illness.

“Everyone knows someone who has a mental disability, be it depression or something else,” said Singer. “It is not acceptable on any level to chain a child to a tree or lock people up as treatment for mental illness. We need to find new and better solutions.”