This Christmas, the international mental health charity BasicNeeds are asking people to spare a thought for those with mental illness who remain wrapped in chains in various corners of the world.
For Francis in Ghana, West Africa, mental illness meant having his leg shackled through a hole carved in a log for nearly two years and kept in a closed dark room. Across the world in Lao PDR, South-east Asia, Sihanath, a mother of five, was forced to resign as a nurse due to her mental health condition, leaving her disappointed and feeling useless to her family. Sadly, such unnecessary suffering is the case for many who live with mental health conditions in some of the world’s poorest communities. [Editor's note: Ghana is one of Africa's more prosperous economies - but not everyone has benefited.]
"BasicNeeds Ghana and its partners were instrumental in getting the new Mental Health Law (Act 846) passed by the Parliament of Ghana this year."
The World Health Organisation (WHO) estimates that there are more than 450 million who live with mental disorders globally of which three quarters live in the developing world. Stigma, inadequate funding, and poor healthcare systems prevent people from accessing much-needed treatment. Many live in extreme poverty, facing isolation and rejection. The impact of untreated mental illness on families is huge, leading them to resort to human rights abuse of shackling and chaining their loved ones in order to get on with their everyday lives. It is 70 years since the Universal Declaration of Human Rights, and yet there are so many people living with mental health conditions who are prevented from exercising choice, pursuing opportunities and planning for a future.
Founded seventeen years ago, BasicNeeds developed a way of reaching the poorest to improve their mental health that uses meaningful work and community-based support, as well as treatment to help improve lives. Over 700,000 people across 15 countries have benefitted from our programmes and many now lead transformed lives. Interventions are designed to address medical, social and economic needs, taking into account the local context, involving in-country partners and using a self-help group model.
BasicNeeds also supports people and communities to advocate for care, treatment, and rights within their own countries. The Mental Health Society of Ghana (MEHSOG), a user-led movement is a good example of this. MEHSOG consists of members from over 204 self-help groups in Ghana, all participants in BasicNeeds Ghana’s mental health and development programme. It is now a registered national association advocating for the needs and rights of people with mental illness. BasicNeeds Ghana and its partners were instrumental in getting the Mental Health Law (Act 846) passed by the Parliament of Ghana in recent years. This law provides an institutional and policy framework for the delivery of community-based mental healthcare across the whole country. BasicNeeds Ghana is now working closely with the Ghana Health Service to ensure sustained service delivery through government health systems within this framework.
On an international level, BasicNeeds welcomes the WHO QualityRights initiative – a toolkit that is designed for use in low- and middle-income countries and provides practical information for improving quality and human rights standards in mental health care. In Lao PDR, the BasicNeeds team has been working closely with the Provincial Health Department to train health staff in the knowledge and skills to deliver good quality mental health care in district hospitals. BasicNeeds Lao PDR was invited to draft the ‘National Strategy for Mental Health by 2020’ in collaboration with WHO country office at the invitation of the Ministry of Health. The National Strategy was consequently approved and BasicNeeds are supporting its implementation. This work includes developing a three-year curriculum to train young graduate Lao doctors in mental health and adapting international training manuals for the Laotian context. This work will help to strengthen the mental health workforce in the country.
With regular treatment and support, Francis is now able to manage his illness. He works as a primary school teacher and advocates for better mental health understanding in his community. Sihanath felt her confidence return after going through the BasicNeeds programme in Laos and is now able to engage in farming and sells her produce in the local market. She is proud of herself and feels worthy of her family again.
Francis and Sihanath were fortunate to receive help while many others with mental health problems are still shackled, locked up and denied their basic rights. As the world grasps the magnitude of this global challenge, focusing on cost-effective solutions to achieve large-scale impact is imperative. BasicNeeds’ tried and tested community-based model provides a solution to unshackling the chains and breaking the stigma on mental health.
As our thoughts turn to Christmas, if you are unwrapping presents on Christmas day spare a thought for those who remain wrapped in chains and make a donation to BasicNeeds.
Image: Self-help group meeting in Ghana - © BasicNeeds Ghana