'Cursed' mental patients face misery in Bangladesh

Many mental patients in Bangladesh face social stigma, negligence and mistreatment. (Photo by Dan Meyers/unsplash.com)

In recent years, World Mental Health Day has been receiving notable attention in Bangladesh. Public and private institutions undertake programs and activities to raise awareness about the importance of mental health and state officials boast about placing increasing priority on the sector. As World Mental Health Day is marked on Oct. 10, the sad reality in Bangladesh is that mental health is one of the least discussed and most neglected issues in the country. One reason is that many people in this impoverished country don’t consider mental disorders an illness but a “curse” or “burden.” Many mental patients face social stigma, negligence, harassment and mistreatment including beatings and being chained up due to a lack of understanding of the problem.  This is shocking and surprising in the modern world where mental disorders have become a common issue. One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill health and disability, according to the World Health Organization (WHO). In Bangladesh, about 13 million people — 16 percent of adults and 18 percent of children — are victims of mental and substance abuse disorders, a 2015 WHO study found. Such disorders are responsible for about 10,000 suicides annually, and the rate is 4 percent and 6 percent respectively for boys and girls aged 13-17. Health experts believe that the increasing proliferation and abuse of illegal drugs including yaba (methamphetamine) is causing an alarming rise in drug-related mental disorder. Against such a backdrop, Bangladesh does not have a comprehensive policy and service system for mental health and wellbeing. Bangladesh passed its Mental Health Act in 2018 to replace the Lunacy Act 1912 of the British colonial era. The law brings some positive changes including treatment, access to services and property rights of mentally challenged persons, but it has yet to be enforced. Earlier policies and action plans for mental health were flawed as they integrated mental illness with non-communicable diseases. However, a major weakness of the present act is that it does not address the massive economic burden of mental healthcare and the lack of a social insurance program covering mental health services, according to a WHO report. Health budget declines In the absence of an effective mental health policy, patients face a dismal situation in terms of services. Mental health gets only about half a percent of Bangladesh’s health sector budget, while there is less than one psychiatrist for about 100,000 people, according to British medical journal The Lancet. Moreover, the health budget continues to decline. In 2017, it dropped to 0.08 percent of gross domestic product (GDP) from 1.1 percent in 2010, which is one of the lowest rates in the world. The only specialized government hospital for mental patients in Bangladesh, located in Pabna district in the north, is understaffed and underfunded. The 500-bed hospital has only 14 doctors against its stated need of 111 doctors and experts. It is unwise to expect high-quality service from such an understaffed facility. A Bangladesh-based American photographer documented the grim life of mental patients in the Pabna hospital in a recent photo essay. In recent decades, dozens of private medical facilities for treatment of mental illness have sprung up. Despite relatively better quality and services, private facilities are expensive and often out of reach for ordinary low-income people. Moreover, people’s mindset about mental illness remains a major challenge. When a person shows some signs of mental disorder, families first try to ignore and hush up the case, fearing social stigma. Some take the person to village shamans to seek their help in casting away “evil spirits” from the “possessed person.” Sometimes family members beat and chain up a sufferer without understanding the problem, aggravating it and leaving the distressed person even more traumatized. There have been plenty of cases where family members have admitted a mentally sick member to a hospital using fake names and contact details before disappearing forever. That means families don’t want to get a sick member back even if he or she is fully cured. Many patients spend their whole lives in hospitals after full recovery as they have nowhere to go. So, apart from an overhaul of policies and action plans for improved mental health services in Bangladesh, it is perhaps even more important to take effective measures to change the public mindset about mental illness. It can be truly painful to have a family member with mental disorders. Yet we cannot deny that the person deserves sympathy, care and treatment as a human being. Indeed, recognition and protection of the rights of mentally challenged persons can be our best gift to these souls less fortunate than us. END Original Article: 'Cursed' mental patients face misery in Bangladesh

In recent years, World Mental Health Day has been receiving notable attention in Bangladesh.

Public and private institutions undertake programs and activities to raise awareness about the importance of mental health and state officials boast about placing increasing priority on the sector.

As World Mental Health Day is marked on Oct. 10, the sad reality in Bangladesh is that mental health is one of the least discussed and most neglected issues in the country.

One reason is that many people in this impoverished country don’t consider mental disorders an illness but a “curse” or “burden.”

Many mental patients face social stigma, negligence, harassment and mistreatment including beatings and being chained up due to a lack of understanding of the problem. 

This is shocking and surprising in the modern world where mental disorders have become a common issue.

One in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill health and disability, according to the World Health Organization (WHO).

In Bangladesh, about 13 million people — 16 percent of adults and 18 percent of children — are victims of mental and substance abuse disorders, a 2015 WHO study found. Such disorders are responsible for about 10,000 suicides annually, and the rate is 4 percent and 6 percent respectively for boys and girls aged 13-17.

Health experts believe that the increasing proliferation and abuse of illegal drugs including yaba (methamphetamine) is causing an alarming rise in drug-related mental disorder.

Against such a backdrop, Bangladesh does not have a comprehensive policy and service system for mental health and wellbeing.

Bangladesh passed its Mental Health Act in 2018 to replace the Lunacy Act 1912 of the British colonial era. The law brings some positive changes including treatment, access to services and property rights of mentally challenged persons, but it has yet to be enforced.

Earlier policies and action plans for mental health were flawed as they integrated mental illness with non-communicable diseases.

However, a major weakness of the present act is that it does not address the massive economic burden of mental healthcare and the lack of a social insurance program covering mental health services, according to a WHO report.

Health budget declines

In the absence of an effective mental health policy, patients face a dismal situation in terms of services.

Mental health gets only about half a percent of Bangladesh’s health sector budget, while there is less than one psychiatrist for about 100,000 people, according to British medical journal The Lancet.

Moreover, the health budget continues to decline. In 2017, it dropped to 0.08 percent of gross domestic product (GDP) from 1.1 percent in 2010, which is one of the lowest rates in the world.

The only specialized government hospital for mental patients in Bangladesh, located in Pabna district in the north, is understaffed and underfunded. The 500-bed hospital has only 14 doctors against its stated need of 111 doctors and experts. It is unwise to expect high-quality service from such an understaffed facility.

A Bangladesh-based American photographer documented the grim life of mental patients in the Pabna hospital in a recent photo essay.

In recent decades, dozens of private medical facilities for treatment of mental illness have sprung up. Despite relatively better quality and services, private facilities are expensive and often out of reach for ordinary low-income people.

Moreover, people’s mindset about mental illness remains a major challenge. When a person shows some signs of mental disorder, families first try to ignore and hush up the case, fearing social stigma. Some take the person to village shamans to seek their help in casting away “evil spirits” from the “possessed person.”

Sometimes family members beat and chain up a sufferer without understanding the problem, aggravating it and leaving the distressed person even more traumatized.

There have been plenty of cases where family members have admitted a mentally sick member to a hospital using fake names and contact details before disappearing forever.

That means families don’t want to get a sick member back even if he or she is fully cured. Many patients spend their whole lives in hospitals after full recovery as they have nowhere to go.

So, apart from an overhaul of policies and action plans for improved mental health services in Bangladesh, it is perhaps even more important to take effective measures to change the public mindset about mental illness.

It can be truly painful to have a family member with mental disorders. Yet we cannot deny that the person deserves sympathy, care and treatment as a human being.

Indeed, recognition and protection of the rights of mentally challenged persons can be our best gift to these souls less fortunate than us.

END

Original Article: 'Cursed' mental patients face misery in Bangladesh 

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