LONGMEADOW, Massachusetts — Mental Illness is an incredibly complex group of conditions and diseases that is difficult to treat over a long period of time, particularly in resource-poor settings and rural areas. Despite these obstacles, developments in treatment ideology could benefit both communities and patients.
According to the World Health Organization’s (WHO) 2013 – 2020 Mental Health Action Plan, one in four people will be affected by a mental health disorder at some point in their life. Suicide is the second leading cause of death among young people, claiming 900,000 lives annually. By 2030, depression will be the leading cause of disease burden globally.
In addition to this mounting epidemic, poverty and mental illness are closely intertwined. People of the lowest socioeconomic status are eight times more likely to suffer from schizophrenia, and about 80 percent of people with serious mental disorders in developing countries do not receive treatment. Poverty can contribute to mental health degradation, which further entrenches poverty. So how can societies heal mental illness?
Community-Based Rehabilitation (CBR) has been a therapeutic method for treating various disabilities since the 1970s. The principle of CBR is to improve quality of life for patients, ensure their participation in the community and preserve the health of the community as a whole. The program is specifically designed to combat the cyclical nature of poverty and disabilities, including mental illness. It is a highly-coordinated approach which utilizes government workers, health professionals, family members, religious leaders and educational partners.
CBR functions as a preventative measure to stop the effect of community ailments such as violence, poverty, neglect and sexual abuse (various determinants of mental health). CBR focuses on changing the stigma associated with mental illness, ensuring the basic rights of patients, fortifying social networks to prevent gender discrimination, substance abuse or domestic unrest, and advocate for evidence-based school programs that reduce violence and gender discrimination. Working alongside partners like NGOs or youth groups is key to gaining support from the community in order to heal mental illness. The evidence supporting the effectiveness of these programs is well-documented.
Evidence shows that CBR can help heal mental illness in resource-poor regions. In Jamaica, one project aided economically disadvantaged mothers in providing early stimulation for newborns and infants, which yielded higher self-esteem levels and fewer teenagers leaving school in later years. BasicNeeds Ghana is an organization that provides enhanced mental health training to traditional healers, who are responsible for 75 percent of initial visits in Ghana regarding mental health.
One program in rural India showed a statistically significant difference in compliance and health outcomes for men who participated in a CBR intervention compared to the group receiving traditional outpatient care. Problem Management Plus, a WHO intervention enacted by community health workers, showed positive results for reducing anxiety, depression and post-traumatic stress disorder in conflict zones in Pakistan.
The potential for this philosophy of healing is profound. Perhaps the best way to convey the importance of this work is through a personal story of recovery found in the Pyschiatric Rehabilitation Journal:
“To me, being recovered means feeling at peace, being happy, feeling comfortable in the world and with others, and feeling hope for the future. It involves drawing on all my negative experiences to make me a better person. It means not being afraid of who I am and what I feel. It is about being able to take positive risks in life. It means not being afraid to live in the present. It is about knowing and being able to be who I am.”
– Patrick Tolosky