There are just two psychiatrists covering the whole of Laos, a country in south-east Asia with a population of seven million people. Dr Chantharavady Choulamany is one of them. To mark international women's day, she provides a rare insight into the challenges of providing and accessing mental health support in a country with such limited resources.
Encouraging people to talk about mental health can be challenging at the best of times. Yet this challenge is magnified even further when you live in a country where stigma surrounding mental health is high and accessing the most basic treatment could mean travelling hours to the nearest clinic or hospital.
This is currently the case in Laos, where there are only two psychiatrists to serve the entire population. I'm one of them, serving also as the Laos Programme Manager for the global mental health charity BasicNeeds.
Strengthening local skills
I've devoted my life to ensuring people affected by mental illness and epilepsy receive increasingly better support and treatment. Through capacity-building work (strengthening skills, facilities and processes) in both hospital and community settings, more people with mental illness can now be assessed, diagnosed and referred to the nearest support clinic or hospital to receive treatment for their condition.
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Mental health has recently received renewed focus on the global stage, with the World Health Organisation choosing ‘Depression’ as its theme for World Health Day in 2017. Nevertheless, high-profile platforms to talk about mental health are still relatively rare, especially in Laos where mental health is a neglected area. So when I received a phone call inviting me to speak at the TEDxWomen 2017 Conference in November last year, I seized the opportunity with both hands.
“Mental Health is for All” was the name of my presentation. I encouraged people to take greater care of their mental well-being and emphasised the need for health professionals and communities in Laos to work together to break down barriers to positive mental health.
I told delegates what I can briefly tell you now, the story of a male service user who has lived with schizophrenia for nearly twenty years. Since gaining access to the right treatment and support, his condition has now stabilized. He successfully earns a living as a security guard in Vientiane Province.
Exploding myths and stigma
Sharing success stories demonstrate that with the correct treatment, people’s lives can be transformed and recovery is often possible. There are many misunderstandings about the causes of mental disorders in Laos, that need to be dispelled.
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It is challenging being a psychiatrist in a country with limited mental healthcare resources. It can be very difficult at times because we can see there are large unmet needs which we don’t have the necessary capacity to address. This means we have to make the most of every last resource available to maximize our impact.
Despite the constraints, I am deeply optimistic about the improvements we are making and very pleased with the successes that have already taken place. If we are determined to work together, not only by increasing access to mental healthcare, but also with great heart, we can finally change attitudes towards mental illness for the better.
Throughout my career, including leading BasicNeeds’ work in Laos, I have overseen several life-changing mental health projects: doctors have been trained on mental health best practice, counselling skills have been taught to groups of Buddhist monks and I've delivered livelihoods (work) projects and self-help groups for people with mental illness and epilepsy.
However, momentum for this important work can only be maintained by continuing to advocate globally, at all levels, for further investment and support for those affected by mental illness - a message which may at last be gaining traction.
BasicNeeds is an international NGO working to improve the lives of people with mental illness and epilepsy around the world. It has been operating in Laos since 2007.
TEDxLaneXangAveWomen is part of the worldwide series of TEDxWomen conferences and was held in Laos on the 4th November 2017 in Vientiane Capital. At the event, five Lao female speakers shared their inspiring experiences of how they became successful leaders in their respective fields.