ACCRA, Ghana- It is widely held that depression and other common mental health conditions are afflictions experienced by people living in wealthy and developed countries. While depression levels are very high in industrialized countries, with about one in five people in the United States experiencing depression at some point in their lifetime, depression in low and middle-income countries is an emerging global health issue. The World Health Organization reports between 16 percent and 49 percent of people in the world have neurological or psychological conditions and the vast majority of these individuals live in low and middle-income countries. While people in these countries are fortunate to have close family ties and strong communities they experience significant hardships. Being displaced from home due to war, fearing violence and disease, and extreme poverty all contribute to depression.
Postpartum depression occurs as frequently if not more frequently in Africa as it does in high-income countries. A recently study investigating postpartum depression Ghana found two thirds of mothers with sick babies in Ghana were at high risk for postpartum depression. Postpartum depression poses health risks for both mothers and babies. Postpartum depression is associated with poor nutrition, diarrhea, and repertory problems in babies in low and middle-income countries and children whose mothers experienced depression were twice as likely to be underweight. Risk factors in women are low social support, poor health and a history of domestic violence. There is much less recognition of postpartum depression in African countries than in the U.S., this means that maternal depression often goes undiagnosed and untreated.
Depression is associated with poverty in both developed and developing studies. Several factors make the poor vulnerable to depression. These include insecurity, hopelessness, rapid social change, violence, and poor health. Common mental disorders are also associated with direct and indirect costs such as being unable to work due to depressions. This means the cycle of poverty continues and mental health conditions do not improve. If the head of a household hold is too depressed to go out and run their farm, the ramifications are very serious. They may not be able to feed their children and feelings like guilt and inferiority fuel depression.
In order for depression and other common mental health issues to be addressed mental health has to become a part of the global health agenda. Mental illness must be considered as important as other poverty related disorders. In order for policy and practice changes to take place, there must be research on the occurrence of depression in low-income countries. Part of the problem is there is not enough funding for mental health research in the developing world. In the U.S., there are many institutions that fund mental health research, for example the National Institute of Mental Health. Research does not produce the same profit that health care practice does so many clinicians are not motivated to spend their time conducting research.
Fortunately, the global health community is beginning to realize the importance of mental health treatment in the developing world. A study published by the Journal of the American Medical Association (JAMA) found that interpersonal therapy was very effective in treating depression in women in rural Uganda. In Pakistan community health workers attended a two-day course on listening and cognitive behavior therapy. They then used these techniques when meeting with pregnant women and new mothers.
– Lisa Toole