| Mission Statement
To support
member countries in South-East Asia in the promotion of mental health and the
reduction of the burden associated with mental and neurological disorders,
including substance abuse and harm from alcohol, through mental health
promotion and delivery of appropriate care at all levels of society. This
will also include the collection of information on determinants of mental
health within populations for appropriate planning and effective
interventions.
Issues and Challenges
In the
Member Countries of the Region, mental health activities have generally
concentrated on hospital-based psychiatry and neurology. However, there is
increasing awareness of the need to shift the emphasis to community-based
mental health programmes. This is the renewed focus of the unit. The unit
addresses mental health issues, neurosciences and substance abuse.
The
Region is particularly affected by the problem of substance abuse. A part of
the notorious "Golden Triangle" (Myanmar,
Laos, and Thailand)
falls within the Region. India
has become a major trans-shipment point for hard drugs from Pakistan. The ill-effects of
excessive consumption of alcohol have become a major public health problem in
the Region.
There is an
urgent need to sensitize governments on the importance of mental health and
to clearly define the goals and objectives of a community-based mental health
programme. Mental health services should be integrated into the overall
primary health care system along with innovative community-based programmes.
There is also an urgent need to sensitize governments on the importance of
substance dependence, including the ill-effects of alcohol, and to clearly
define the goals and objectives to control substance dependence.
Broad Regional Strategy
In SEAR
Member Countries, mental health programmes have generally concentrated on
hospital-based psychiatry. However, there is increasing awareness in these
countries of the need to shift the emphasis to community-based mental health
programmes. The WHO Regional Office for South-East Asia
is concentrating on supporting Member Countries on the development of
community-based mental health programmes and also programmes for prevention
of harm from alcohol and substances of abuse. The programmes will be
culturally and gender appropriate and reach out to all segments of the
population, including marginalized groups.
There are
many barriers to the implementation of community mental health projects and
programmes. While some countries have developed mental health policies, there
has not been adequate implementation. Governments urgently need to be
sensitized on the importance of mental health and to clearly define the goals
and objectives for community-based mental health programmes. Mental health
services should be integrated into the overall primary health care system. At
the same time, innovative community-based programmes need to be developed and
research into relevant issues and traditional practices promoted. Communities
have to be educated and informed about mental and neurological illnesses to
remove the numerous myths and misconceptions about these conditions. But most
important, the stigma and the discrimination associated with mental illness
must be removed.
The
Regional Office is developing strategies for community-based programmes based
on five ‘A’s: Availability, Acceptability, Accessibility, Affordable
medications and Assessment.
 Availability: Services which will
address at least the minimum needs of populations in mental and neurological
disorders should be available to everyone regardless of where they live. The
key questions are: what are the minimum services needed and who will deliver
them?
Acceptability: Large segments of
populations in the countries continue to perpetuate superstitions and false
beliefs about mental and neurological illnesses. Many believe that these
illnesses are due to “evil spirits”. Thus, even if appropriate medical
services are made available, they would rather go to sorcerers and faith
healers. Populations need to be informed and educated about the nature of neuro psychiatric illnesses.
Accessibility: Services should be
available to the community, in the community, and at convenient times. If a
worker has to give up his daily wages, and travel a substantial distance to
see a medical professional who is only available for a few hours a day,
he/she is unlikely to seek these services.
Affordable
medications: Frequently, medications are beyond the reach of the poor.
Every effort should be made to provide essential medications uninterruptedly
and at a reasonable cost. Thus, government policies in terms of pricing and
the role of the pharmaceutical industry in distribution and pricing become
critical.
Assessment: Being new, these programmes need
to be continuously assessed to ensure appropriateness and cost-effectiveness.
Changes in the ongoing programmes based on impartial evaluations are
essential.
Specific Regional Strategy
 Community
mental health:
1. Development/implementation of
mental health policy
2.
Compiling information on mental disorders and mental health systems
3.
Innovative community-based management programmes for mental and
neurological conditions causing high morbidity in the community
4.
Enhancing awareness campaigns
5.
Support for research on indigenous practices and medications and
6.
Promotion of mental well-being in the community
Control of
substance dependence:
1. Facilitation of collaboration
between Member Countries and SEARO and HQ
2. Compiling information on burden
from substance dependence
3. Enhancing advocacy and awareness
campaigns
4. Innovative community-based
management programmes
5. Support for research on unique
local issues related to substance dependence
Prevention of
harm from alcohol use
1.
Empower individuals and communities to prevent harm from alcohol use
and abuse
2. Achieve a sustained reduction in
per capita consumption of alcohol, based on national multi sectoral approaches and mobilization of civil society.
Disaster Mental
Health
The Tsunami disaster of
December 2004 had a devastating impact on select member countries of
South-East Asia Region. programmes
for the mental health and psychosocial relief efforts to affected countries
were developed and implemented. Similar strategies were also successfully
implemented in the SIDAR super cyclone in Bangladesh
and Nargis super cyclone in Myanmar.
Strengthening the primary health care
system to deliver the essential mental health care
Training
of general physicians in the management of common mental illnesses
There is a scarcity of mental health
professionals in the South-East Asia Region. Most psychiatric conditions are
manageable at the community level by General Practitioners (GPs). This
training audio-visual material is designed to enable GPs to diagnose and
treat such patients in the community. Using a combination of graphics and
visuals, the film lucidly explains the signs, symptoms and management of
common mental health conditions which GPs are most likely to encounter during
their practice.
Contact Us
Dr. Vijay Chandra
M.D., PhD.
Regional Advisor,
Mental Health and Substance Abuse,
W.H.O. Regional office of South East Asia,
M.G. Road, New Delhi – 110 002
Phone: 91-11-2337-0804 ext.
26572
Fax:91-11-23370197
E-mail: chandrav@searo.who.int
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