SEATTLE — More than 300 million people suffer from depression globally, and it is the leading cause of disability. Most people who suffer mental illness (including depression) live in poverty, have poor health and are subjected to abuse. They often do not have the same status in their communities due to the stigma associated with the disease and have reduced access to civil rights, social participation, education and healthcare. Depression in developing countries is a great issue.

Most countries do not provide enough in mental healthcare access and funding. In more developed nations, five percent of the government health budget may go to mental health; in more impoverished nations less than one percent is often budgeted for mental health.

It behooves society to invest in depression treatment. For every dollar spent treating depression and anxiety, the economy sees a $4 return in labor. Indeed, across 36 nations, $1 trillion was lost every year due to depression and anxiety.

Depression in developing countries looks different than in more developed ones. The causes of depression are disturbing: conflict, torture, epidemics and death can be a normal part of life. In addition are the stresses of daily life in developing nations: poverty, food insecurity, loss of children and homelessness. These are all linked to depression.

One review looking at studies of 80,000 refugees showed a connection between torture and depression. Doctors Without Borders most commonly diagnosed Syrian refugees in Lebanon with depression and anxiety. One study based in rural Pakistan found that 50 percent of women evaluated had depression. This was attributed to early marriage and motherhood, multiple pregnancies and adjusting to a new life not chosen by them.

Furthermore, there are not enough mental health professionals in developing nations. In Uganda, there is only one psychiatrist for every million people. In Indonesia, the ratio is one to 10 million. Neither country offers government funding for mental health. Sierra Leone and Liberia each only have one psychiatrist for the entire country. Even worse, Liberia only had one mental health facility, compared to Sierra Leone having none.

To give perspective to these statistics, consider two developed nations: the U.S. and the U.K. The U.S. has thousands of mental health facilities and one psychiatrist for every 12,000 citizens. In the U.K. the government designates 10 percent of its healthcare budget to mental health and the country has one psychiatrist for every 5,652 people.

Fortunately, the World Health Organization and many NGOs work to reduce depression in developing countries. The World Health Organization recommends a practice known as “task shifting,” where it gives less specially trained healthcare workers basic mental health training to work with people experiencing depression. The belief is that treatment by minimally trained professionals is better than no treatment.

Examples of organizations using this concept are the Lady Health Workers in Pakistan and Strong Minds in Uganda. Lady Health Workers supports expecting mothers in Rawalpindi, Pakistan and it recorded a significant reduction in depression and resulting disability. In Uganda, Strong Minds uses Group Interpersonal Therapy (GIPT) which is, essentially, a talk therapy. After 16 weeks of GIPT, participating Ugandans noticed a 94 to 97 percent cure rate of depression.

Some more NGOs include Learn to Live in Indonesia, Community Association for Psychosocial Services in Sierra Leone and the Carter Center in Liberia. Each organization targets mental health in a unique manner. Learn to Live offers mental health care, while the Carter Center helps change local policy and reduce stigmas about mental health. Community Association for Psychosocial Services helps victims of torture and conflict.

One in 10 people will suffer from severe depression. Sometimes, those who do suffer cannot actually remember what happiness feels like. By becoming deeply focused upon the emotional pain of depression, people become apathetic and lose hope. This loss of hope can make depression insurmountable. While the statistics and environment of depression in developing countries are different from developed ones, depression feels the same globally and should be addressed in all nations.

– Mary Katherine Crowley

Photo: Flickr