Why focus on building mental healthcare systems?
We at HAI believe that there can be “no health without mental health.” While mental disorders are estimated to be the leading cause of disability globally and the largest cause of lost economic output among non-communicable diseases, per-capita spending on mental healthcare averages less than $2.00 worldwide. The World Health Organization (WHO) estimates that more than 80% of citizens with disabling mental illness do not receive effective treatment in low- and middle-income countries (LMICs).
In the countries that HAI works, access to mental healthcare is extremely limited. For example, less than 1 percent of the population in Mozambique has access to basic mental health services and national mental health expenditures constitute less the 0.2% of the total health budget. Recently, the WHO estimated Mozambique to have the highest suicide rate in Africa and the 7th highest worldwide.
What are we doing to address mental disorders?
We partner with Ministry of Health colleagues, using implementation science approaches, to improve access to, and quality of, mental healthcare services. Our goal is to improve integrated care and treatment for mental and self-harm disorders within the larger primary care system in each country we work. One important step to achieve this ambitious objective is to study the potential relationships between mental illness and other conditions, such as HIV infection, and other chronic diseases like heart disease and diabetes, in both the general population and within high risk groups; pregnant women being one, among many others. Understanding these relationships in the Mozambican context is a crucial first step to ensure the effective implementation of evidence-based mental health and suicide prevention services.
Our work also centers on the development of locally-adapted treatment approaches that are both culturally and clinically appropriate, including a local adaptation of the PHQ-9, an abbreviated depression screening tool that has been used successfully in other resource limited settings. Finally, our efforts are also focus on improving routine mental health and self-harm data; critical to ensure the provision of quality mental health services. Health workers, health managers and policy leaders all need reliable data on which to base treatment, resource allocation and policy making decisions.