EVERY year, 10th October is observed as 'World Mental Health Day' globally. The World Federation For Mental Health (WFMH) initiated Global Mental Health Awareness Campaign in 1992. This year, the 17th World Mental Health Day will be observed in more than 100 countries and the theme is “Mental Health in Primary Care: Enhancing Treatment and Promoting Mental Health” -- which is very relevant to our national mental health service perspective. The day will be observed in our country at least by National Institute of Mental Health, Dhaka at government level and by a number of NGOs on non-government level.
Our national attitude towards mental health and illness is very frustrating. Mental patients are regarded as burden on our family and society. The tendency of the family members of mental patients is to hide it rather than discuss and seek help from metal health professionals. The general idea is that, mental health treatment is costly and some even consider it a useless investment. But if they use the existing government mental health services (which must be expanded) at token cost, in most cases mental patients could be converted into productive manpower. We do not mind spending money for chronic physical illnesses but always hesitate in case of mental illness. The problem is attitudinal.
WHO, back in 1948 defined health as “A state of complete physical, mental and social wellbeing, and not merely absence of disease or infirmity". But even after 60 years, mental and social component of heath is ignored in our country.
Mental health is more than absence of mental disorders. It is conceptualized as a state of wellbeing in which an individual can realize his or her own abilities, can cope with the normal stress, can work productively and fruitfully and is able to make contribution to his or her family.
Most diseases of medical science are preventable and treatable and a few are curable. This is also true for mental illnesses. The most important issue for prevention and treatment of mental illnesses is mass public aware-
ness, in which both electronic and print media can play a crucial role.
But in some TV reporting reporters broadcast incoherent speech of mental patients in mental wards which is a breach of privacy and violation of human rights. Often producers of some TV drama misinterpret the concept of mental illness or wrongly depict the issue, which create negative attitude among public rather than creating awareness. We hardly observe any TV channel arranging any talk show on world mental health day. The print media is almost similar to that of electronic media in creating awareness.
Mind is no more a myth, rather a vital portion of the body called brain. So, there is definite relationship between physical and mental illness. Recent evidences suggest that medically ill people have increased risk of behavioral and mental illness. Patients with diabetes and brain stroke have 3 to 4 times higher risk of developing depression. At the same time, mentally ill patients have com-
'Hl ’ j-t.^m ^Irr r^ r ’ i mon physical co-morbid illness like cardiovascular diseases, stroke and diabetes. This indicates the urgency of comprehensive and collaborative treatment of both physical and mental illnesses. So is the necessity of mental health awareness slogan -- “No Health without Mental Health".
Primary health care centre is the first contact centre where people seek treatment. If mental health service is integrated into primary health care package it will be easily delivered to the mass population. It will minimize social stigma and discrimination and other barriers to seek mental health services and protect human rights of mental patients. The services will be easily accessible and affordable as it could be delivered in a cost-effective manner using the existing primary health care infrastructure.
It is a common misconception that urban and rich population suffers more from mental illness. From scientific research, it is evident that no age, sex, race, religion and economic status is immune to mental illness, though
there are some differences in its prevalence rate among the above variables. The National Survey on mental disorders conducted by National Institute of Mental Health, Dhaka and WHO (2006) revealed that prevalence rate of all forms of mental disorders among adult population in Bangladesh was 16.1%. For this huge number of mental patients only around 115 psychiatrists are available which is grossly inadequate (7 psychiatrists per 10 million population!). This is why integration of mental health services into primary hearth services package is desperately needed -- which is also the main theme of world mental health day this year.
Finally, most important issue is the change of attitude to consider mental illness as other physical illnesses, and go for identification, management and rehabilitation of mental patients in time.
Dr. Zillur Rahman Khan is Mental Health Physician, Department of Psychiatry, Dhaka Medical College Hospital.
E-mail: mzrkhan@gmail com