As WHO prepares to commemorate World Health Day with the theme “Depression: Let’s Talk”, it’s an opportune moment to reflect on mental health services in Sri Lanka and how to prioritize mental health in future.
Sri Lanka’s transformation of mental health services over the past 15 years has been nothing short of remarkable. Since the devastating tsunami in 2004, the country has experienced a dramatic change in the provision of mental health services, with increased political commitment, funding and a shift in priorities.
Mental health services were strengthened and expanded. Specialized clinics focus on inpatient and outpatient services, child mental health, gender-based violence, substance abuse and rehabilitation, making a diverse range of mental health services more accessible than ever before.
Increasingly stressful lifestyles
The structure of mental health services changed significantly – moving from institutionalized care to community care. Sri Lanka currently has 217 outreach clinics, which provide mental health care at the community level, covering almost every health division in the country.
The number of mental health workers dramatically increased over the past 15 years with new training programmes and professional posts created within the Ministry of Health, Nutrition and Indigenous Medicine.
Prior to the tsunami, 36 psychiatrists worked in Sri Lanka, by 2016 this figure had doubled to 77 psychiatrists. During the same time period, the number of Medical Officers of Mental Health rose from 34 to 205.
This has made a tremendous impact on outreach services for mental health patients, leading to increased coordination and better follow up at the community level.
Despite the impressive progress, mental health services in Sri Lanka face many challenges.
Social stigma prevents people from accessing mental health services.
World Health Day 2017 gives us the ideal platform to begin an important conversation on mental health with a strong focus on depression.
Three hundred and fifty million people suffer from depression throughout the world. The majority of whom do not receive treatment. As people lead increasingly stressful lifestyles, depression is on the rise. It is the leading cause of disability, causing an estimated loss of US $ 1 trillion to the global economy each year through lost productivity.
WHO estimates that 800 000 people in Sri Lanka suffer some form of depression.
However, depression can be prevented and treated. Talking is a vital first step towards recovery. A problem shared is a problem halved.
Mild depression can be treated without medication, whereas moderate to severe depression may require medication coupled with psychotherapy or counseling.
Depression among new mothers is much more common than most people realize. About 15 % of new mothers experience postpartum depression. New mothers must be supported in the household as they go through profound changes in their bodies, their lifestyles, and relationships within the family and beyond.
Depression is also common among adolescents and young people. They go through many changes in their short lives, which can sometimes be overwhelming. Faced with pressures from exams, finding friends and fitting in, young people encounter stress and anxiety, which if untreated can lead to depression. Talking to children about their worries and offering support is an important step towards recovery.
How to increase access to mental health services?
While Sri Lanka has made excellent progress on the provision of mental health services, the public must be inspired to access these services.
People must learn to recognize the symptoms of depression early. Depression involves persistent sadness and a loss of interest in activities normally enjoyed. People with depression may experience disturbed sleeping patterns, changes in appetite, and feelings of guilt, low self-worth, tiredness and lethargy. Depression can lead to substance abuse. At its worst, depression can lead to suicide.
People must be encouraged to discuss their thoughts, feelings and worries openly with families and friends, so depression can be identified early and treated.
The tragedy is when people needlessly suffer in silence, and the problem is exacerbated. Beginning a conversation may be the first step towards recovery. It will also help break down the social barriers and stigma surrounding mental health issues.
The World Health Organization is shining the international spotlight on depression for World Health Day, we must act now to ensure the dialogue on depression continues, as we move towards achieving positive mental well-being.
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