E-Kantipur

Mental health is the most stigmatised and neglected area of public life. Therefore, there is a need for collaborative effort in combating social stigma, to promote awareness and to ensure quality services for people affected by mental health problems. There has as yet been no successful campaign to bring satisfactory results in the mental health sector. The millions of people whose human rights and social dignity are taken away, and who cannot imagine recovery from mental health problems remind us of the failures of the existing mental health system. Its social, economic and human costs are enormous and uncalculated, but they are also preventable. 

When I first became engaged with mental health activism, I could not have imagined such a restricted, alienated and ineffective system that consistently fails to engage public with its knowledge of treatment. In absence of proper public knowledge about mental health, this sector continues to be ‘no one’s concern’. During a recent global health meeting in Washington DC—jointly organised by the National Institute of Mental Health (NIMH), National Institutes of Health (NIH) and the US Department of Health and Human Services—I began to gain greater understanding of the shortcomings within the sector.

To my understanding, mental health is heavily guided by the medical research, understanding and practice, but the long-term social consequences of mental health problems for individual and families are overlooked and dismissed by the existing mental health system. What knowledge mental health clinicians and researchers have gained is not properly communicated to the public. There is no effective communication between professionals, mental health academics, researchers and society. Therefore, ordinary people are often disengaged or disinterested in this sector. Mental health professionals often do not appreciate the cost of public disengagement: there is hardly any space for ordinary people to engage themselves and develop careers in the mental health sector.

Many people from a non-medical or clinical background regard working in the mental health sector is ‘suicidal’. I myself have been witnessed this as a reality. The sad part is that universities and research institutes are not fulfilling their social obligation to create opportunities for ordinary people who struggle to make a career in this area. People who engage in this sector out of passion and commitment cannot survive for long due to lack of support and career opportunities. The tragedy of the mental health sector is that it cannot motivate ordinary people to engage with the system. I think that this is the leading cause of failure of the whole mental health setup.

The NIMH’s meeting was about “building research capacity and collaboration in global mental health”. There were discussions about creating more space and opportunities for ordinary people to work professionally in the mental health sector. In the meeting, some modalities of partnership and collaboration were presented. “EMPOWER”, an initiation of the London School of Hygiene and Tropical Medicine, a research collaboration between university researchers and civil society organisations was claimed as being one of the most acclaimed examples of creating opportunity through partnership.

Restricting opportunities in the mental health sector invites more tragedy for individuals and society. Therefore, we need to urgently create a more vibrant and lively mental health sector where people from all walks of life can contribute their expertise to ease human suffering. Without creating a system that can effectively engage and interact with the public at large, we cannot tackle our growing mental health challenges. Therefore, the first step towards a more functional mental health system is to create more scope and opportunities in global mental health where people see opportunity, share responsibility and can engage, develop expertise - providing long-term contribution.

I remain convinced that without mass involvement in the mental health sector, our achievements in the field will only ever be limited. How can we encourage the public to help shape and promote mental health agendas? In this regard, the role of universities, research institutes, and donors who can develop sustainable programmes are critical. Mainly, there must be a collaborative effort in setting up research and advocacy agendas in global mental health. Furthermore, we need to create a support base for civil society organisations to undertake mental health advocacy more effectively.

In the context of the existing capacity of civil society to tackle mental health problems, I believe the future looks bleak. On the one hand, individuals and grassroots movements involved in the mental health sector lack the essential skills to negotiate effectively at policy-making level and on the other, mental health knowledge generated by research institutes and universities have failed to fire public imagination to value mental health.

While reviewing the current mental health scenario across the world, there is a need of radical reform. The highest goal of researchers, academic institutes, and health systems must be to protect human dignity, prevent loss and ensure health and wellbeing, and the systems currently in place are falling short on these targets.

For the sake of these universal values, we must no longer allow the mental health sector to remain in its current state. While ensuring medical excellence, we must start to broaden the scope and opportunity for ordinary people to play an effective role in global mental health policy and implementation. This is the key to combat mounting mental health challenges.

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