By Shailendree Wickrama Adittiya
Commemorative days are often given themes in order to draw attention to pressing issues and raise awareness in a more focused manner. This year, the theme for World Mental Health Day, which is today (10), is “Make mental health and wellbeing for all a global priority” and the World Health Organisation (WHO) stated that this year’s commemorative day will give us the opportunity to rekindle efforts to protect and improve mental health.
According to the World Health Organisation, many aspects of mental health have been challenged, especially with the Covid-19 pandemic, which has created a global crisis for mental health, fuelling short-term and long-term stresses.
Added to the impact of the Covid-19 pandemic is growing social and economic inequalities, protracted conflicts, and violence and public health emergencies. In the local context, discussions on mental health are crucial, as the ongoing economic crisis can have a severe impact on one’s wellbeing. While people face uncertainty about their futures, as many are losing their income and jobs, they also struggle to feed themselves and their families and afford their children’s education. In addition to this, shortages in the country, from food to fuel to medicine, have put livelihoods and lives at risk.
However, stigma and discrimination continue to be a barrier to social inclusion and accessing the right care. Considering these factors, raising awareness about mental health and wellbeing in today’s context is imperative. The World Health Organisation has this year also shed light on mental health issues people face in the workplace.
Mental health in the workplace
On 28 September, the International Labour Organisation (ILO) and the World Health Organisation (WHO) issued a joint policy brief on new measures to tackle mental health issues at work. According to the joint statement, an estimated 12 billion workdays are lost each year due to depression and anxiety. This costs the global economy close to $ 1 trillion each year.
In addition to this, the World Mental Health Report published by WHO in June showed that one billion people lived with a mental disorder in 2019, of which 15% were working age adults. These mental health issues are amplified by discrimination and inequality, as well as harassment, including bullying and psychological violence or mobbing.
This is made worse by the Covid-19 pandemic, which triggered a 25% increase in general anxiety and depression globally. However, the ILO-WHO joint statement notes: “In 2020, governments worldwide spent an average of just 2% of health budgets on mental health, with lower-middle income countries investing less than 1%.”
The statement adds that the ILO Occupational Safety and Health Convention (No. 155) and Recommendation (No. 164) provides legal frameworks to protect the health and safety of workers.
“However, the WHO Mental Health Atlas found that only 35% of countries reported having national programmes for work-related mental health promotion and prevention.”
Expansion of services locally
In Sri Lanka, there is some hope as mental health services are seeing some expansion. According to the World Mental Health Report 2022, a comparison between 2004 and 2021 shows acute inpatient units going from 10 to 25, outpatient clinics at hospitals going from 10 to 26, child mental health clinics in general hospitals going from two to 26, child mental health units going from zero to two, and mental health helplines going from zero to one.
In terms of human resources, the number of psychiatrists increased from 36 to 136, child psychiatrists increased from one to 10, forensic psychiatrists increased from zero to two, and medical officers of mental health increased from 40 to 223.
The data included in the World Mental Health Report 2022 is sourced from the Health Ministry as well as unpublished data by the Directorate of Mental Health.
In the report, WHO also highlighted the country’s ban on pesticides to prevent suicide, stating that when the Government drew up the Control of Pesticides Act in 1980, pesticide poisoning accounted for more than two-thirds of all suicides in the country.
“By 2016, the annual suicide rate had fallen more than 70% to 14 per 100,000. The Ministry of Health continues to work on suicide prevention in multiple departments and the overall suicide rate now stands at around 25% of its peak.”
The WHO goes on to state: “Together, the bans are estimated to have saved 93,000 lives between 1995 and 2015, at a direct cost to the Government of $ 43 for each life saved. Thousands of lives continue to be saved every year.”
While efforts are being made to expand Sri Lanka’s mental health resources and reduce suicides, one can’t help but wonder if the country’s health sector and mental health professionals are equipped to handle the mental health issues that will without doubt surface due to the economic crisis.