Tanzania: Who - More Finances Vital for Better Mental Health

EARLY this month, Tanzania joined the rest of the World to mark the World Mental Health Day observed on 10th October every year to raise awareness of mental health issues around the world and mobilize efforts in support of mental health.

This year's theme was "Move for Mental Health: Let's Invest" as efforts are intensified to advocate for increased international and domestic financing for mental health and well-being.

In her message in Dar es Salaam, the World Health Organization (WHO) Regional Director for Africa, Dr Matshidiso Moeti, said that such an investment is urgently needed.

Globally, one in four people will be affected by a mental disorder at some point in their lives, and in the WHO African Region, government expenditure per capita on mental health is less than 10 cents.

Most mental health services are paid for directly by patients and their care givers. For low-income households and other vulnerable groups, the cost of this essential care can cause financial hardship.

In working together to attain universal health coverage, people must ensure patients affected by mental health issues are not left behind. The Covid-19 pandemic has brought out more than ever, how mental health is integral to overall wellbeing.

Restrictions on movement and gathering, job losses, deaths of loved ones, and widespread Covid-19 infections have led to fear, anxiety and depression. There are reports of upsurges in intimate partner violence and suicides.

"Mental health needs in the African Region are significant. Fifteen African countries are among the top 30 globally for suicide per 100,000 people. Although many countries have developed national mental health policies, the availability of services is often limited to specialized institutions in capital cities," she said, adding that: Globally there are nine mental health workers per 100,000 people.

In the African Region, this falls to 0.9, and among this workforce one third are non-professional workers, meaning there is a severe shortage of psychiatrists and psychologists in African countries.

Some countries are making progress, such as Cabo Verde, Kenya, Mozambique, Rwanda and Uganda where governments have committed to decentralizing mental health services, moving away from institutionbased care, and strengthening care at primary health and community levels.

"At WHO we are working with governments to review mental health legislation and related policies, and to build capacities using the MH-Gap approach, a task sharing strategy where primary health care workers are trained and then supervised in managing common mental disorders," she said, revealing further that: Zimbabwe was selected to be part of the WHO Director-General's Special Initiative for Mental Health to strengthen these services.

A national assessment of the mental health services was carried out in 2019 and virtual consultations to develop a plan of action have so far engaged over 100 stakeholders.

In the context of Covid- 19, stakeholders are working with governments and partners to include mental health care as part of continuity of essential health services, and they are providing psychosocial skills training for first responders.

In a survey led by WHO and United Nations Children's Fund (UNICEF) in East and Southern Africa, responders reported depression and anxiety, especially when working in high-risk settings or without personal protective equipment.

In response, stakeholders have developed a guide for responders to be able to recognize signs of distress in themselves, their colleagues and those they interact with. The guide provides self-help techniques, and tips on listening, de-escalating tense situations, and referrals.

In a global survey led by WHO on mental health and Covid-19 between June and August, 27 of 28 African countries that responded, indicated mental health and psychosocial support was included in the national Covid- 19 response plan, but only 17 had funding for the planned activities.

This reaffirms the importance of this year's theme of investing in mental health. Dr Moeti made the call on governments, partners and communities to promote social interventions, such as strengthening peer support, re-integrating long-stay patients into communities, and equipping caregivers with the knowledge and resources to better support people with mental disorders.

She also called on employers to invest in staff wellness programmes and training in psychological first aid, insisting that: "There are basic steps we can all take to improve our mental health: getting plenty of sleep, eating healthy food, avoiding alcohol, exercising, socialising, and developing strategies to manage stress and anxiety. I ask every person to invest in your mental health and well-being, and to be supportive of those around you."

In August this year, the United for Global Mental Health, World Federation for Mental Health and WHO issued a joint press release, stating that mental health is one of the most neglected areas of public health. Close to 1 billion people are living with a mental disorder, 3 million people die every year from the harmful use of alcohol and one person dies every 40 seconds by suicide.

And now, billions of people around the world have been affected by the Covid-19 pandemic, which is having a further impact on people's mental health. Yet, relatively few people around the world have access to quality mental health services.

In low- and middle-income countries, more than 75 per cent of people with mental, neurological and substance use disorders receive no treatment for their condition at all. Furthermore, stigma, discrimination, punitive legislation and human rights abuses are still widespread.

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