– The world is actually in the throes of two pandemics. The first is COVID-19. The second is the wave of stress and anxiety, depression and substance use it has unleashed around the world. Most mental health disorders are treatable.
This so called “second pandemic” is raging in poor and wealthy countries alike. But across Africa, and in much of the Global South, people facing mental health crises have nowhere to turn.
The reason is that governments and aid agencies are not making the investments needed to provide these services. In the lead up to “World Mental Health Day,” the World Federation for Mental Health recently released new statistics on the share of health budgets that nations and international donors devote to mental health.
It is miniscule – between one and two percent – even though the WHO calculates that every US$ 1 invested in scaled-up treatment for common mental disorders such as depression and anxiety returns US$ 5 in improved health and productivity.
On the African continent, the consequences of underinvestment are especially glaring. Here, at least 90% of those with mental health problems are not getting the necessary treatment. My own country, Malawi, illustrates the chasm between what is needed and what we are able to provide. I am one of four registered clinical psychologists here and there are just three psychiatrists.
Malawi has a population of 18 million.
The consequences of untreated mental health problems are serious. According to the latest figures released for World Mental Health Day, one person dies every 40 seconds by suicide. And in Malawi, the police have just released new statistics showing suicides between January and August of this year have shot up by 57% compared with the same period last year.
Fear, and the loss of the livelihoods, loved ones, and companionship, that give life meaning and purpose, are leaving people bereft. The need for mental health counseling and care far exceeds what we are equipped to give. The question is what is to be done?
I believe the best, and perhaps only, viable option is to invest in the networks and social support systems that already help troubled people endure suffering and make sense of their lives.
In countries like mine, it is faith leaders that they turn to.
This safety net is already firmly in place. Here, and in many other parts of Africa, faith is woven into everything. Churches or mosques can be found in every village and often on every street corner. Public meetings begin with prayers.
When they encounter personal problems, including depression, anxiety or substance use, people ask faith leaders to help them cope. Faith can often offer strength and solace. Indeed, the link between faith and mental health is well established. Researchers have found correlations between religious faith, and hope, optimism, satisfaction, self-esteem, and a sense of meaning in life.
But bipolar disorder, clinical depression, and many other ailments require a level of care and intervention that faith leaders are not prepared to offer. Many tell me they are grappling with complex and frightening problems that worry them. One lamented, “all I can do is pray for them and I don’t know what else to do.”
Others perform exorcisms for mental illnesses, trying to get rid of the demons they believe are to blame. The idea that people with psychological or neurological disorders are possessed by demons stigmatizes them further. In these cases, faith traditions can deepen people’s suffering, force them to endure in secret, or be cast out of their communities, and denied access to treatments that could change or even save their lives.
Faith leaders are already on front lines in countries like mine and this is not about to change. So why not give them the tools to navigate this treacherous terrain? With basic mental health literacy they could learn to recognize, understand, manage, and even prevent mental health disorders. They would know the symptoms of anxiety, depression, or psychosis, the resources available, and where people can go for treatment.
Would African clerics, steeped in religious doctrine and faith, be amenable to this? Those who talk with me not only need, but want this knowledge. Elsewhere, programs like this are already proving effective. Studies show that faith leaders have welcomed and benefitted from this kind of training, and that it has influenced the kind of advice they give.
Mental health literacy training already empowers primary care providers to provide patients with the care, information, support, skills, and resources needed to face mental health challenges. Governments, aid agencies, and NGOs should create and fund these trainings. Umbrella religious councils and associations should work with them to ensure that the trainings are as useful, relevant, and widely accessible as possible.
The need is overwhelming. In countries like Malawi, there are simply not enough mental health professionals to go around. The local faith community can help fill this void. Armed with more knowledge, faith leaders can play a pivotal role in promoting global mental health and reaching those who desperately need mental health services. The theme of this year’s World Mental Health Day, is “Mental Health for All: Greater Investment – Greater Access.”
We do need to invest much more, and training faith leaders in mental health literacy is one way we can do it now.
Chiwoza Bandawe is a clinical psychologist with the University of Malawi, College of Medicine. He has several publications in international journals and has published three mental health education books.