Sunday, March 08, 2009

Community-based Mental Health Programs: Back to Basics

In the report ”Integrating mental health into primary care : a global perspective,” the World Health Organization and the World Organization of Family Doctors bat for the integration of mental health care program with primary health care since it results in greater access to much needed services.

The report resonates with truth, considering that confinement in mental asylums or rehabilitation centers is a common treatment modality for mental disorders. For poor countries dealing with fund scarcity and the lack of specialists, a psychiatric hospital-based approach alone may not work. However, there are cost-effective models of community- and home-based programs that work well.

Community-based mental health program
A community-based mental health program is not meant to replace the treatment and services offered in hospitals; it rather complements these services by making these more accessible to the people.

Such a program is also more culturally appropriate and capitalizes on the tightly-woven social fabrics of most Asia-Pacifi c countries. The involvement of the
community and family members in caring for a patient helps ease stigma and provide a more healing and nurturing environment for a patient.

The Hidden Battlefield

The destruction brought about by war and armed confl icts transcends the structure of cities and communities and encompasses the mortality and overall well-being of those who engage in it and those who are dragged into it. The victims, the perpetrators, and defenders may not share the same goals in war but they all share the trauma and suffering surfacing from such violent events.

The effects of war, according to a study by R. Srinivasa Murthy and Rashmi Lakshminarayana of the Regional Offi ce for the Eastern Mediterranean of the World
Health Organization (WHO), are varied and some are not even included in most available literature.

The known effects, the study said, included endemic poverty, malnutrition, disability, economic/social decline and psychosocial illness, among others. The
authors said that only when confl icts and mental health problems are fully understood can effective strategies be developed to deal with the effects of war.
"The effects of war include long-term physical and psychological harm to children and adults, as well as reduction in material and human capital. Death as a result of wars is simply the 'tip of the iceberg,'" the authors said.

Thursday, March 05, 2009

Intended Death: A look at suicidal behavior

The World Health Organization (WHO) noted that suicide is taking the lives of more and more people worldwide. In the year 2000, the WHO revealed that approximately one million people died from suicide, representing a mortality rate of 16 per 100,000 or one death every 40 seconds.

In the last 45 years, it also noted that suicide rates have increased 60 percent worldwide; suicide is now among the three leading causes of death among those aged 15-44 (both sexes). These fi gures, however, do not include suicide attempts that are up to 20 times more frequent than completed suicide.

Further, suicide worldwide is estimated to represent 1.8 percent of the total global burden of disease in 1998, and 2.4 percent in countries with market and former socialist economies in 2002. Although suicide rates have been traditionally highest among the male elderly, rates among young people have been increasing to such an extent that they are now the group at highest risk in a third of both developed and developing countries.

Sunday, March 01, 2009

Untangling the Mental Haywire

Globally, an estimated 450 million are suffering from mental and neurological disorders such as epilepsy, dementias (e.g. Alzheimer’s disease, vascular
dementia), and bipolar affective disorder. According to the 2001 World Health Report entitled “Mental Health: New Understanding, New Hope,” depression ranked fourth in the global disease burden; it is projected to jump to second place by 2020.

In the Asia-Pacific region, an estimated 13.7 million have dementia; as the region’s population ages, the number of those with dementia is expected to hit 64.6
million by 2050.

Substance addiction, whether alcohol, drugs, or tobacco, is also considered a mental health issue. Asia accounts for close to 55 percent of amphetamine-type stimulants (ATS) abuse worldwide, and majority of ATS addicts are youth. Alcohol abuse, on the other hand, account for 5.5. percent of the Asia-Pacifi c region’s burden of disease. In some Pacifi c countries, the percentage of alcohol-related abuse and violence is staggering: in Papua New Guinea, close to 90 percent of emergency room trauma are due to alcohol; while in Guam, 62 percent of murders are also alcohol-related.