Peter Bellini: Global Mental Health and the Church, Part I

Today's piece is written by Rev. Dr. Peter J. Bellini, Assistant Professor of Evangelization in the Heisel Chair and President's Associate for Global Partnerships at United Theological Seminary. It is the first in a three-part series.

The United Methodist Church has a theological statement in the Book of Resolutions 2012 on ministries in mental health that opens:

We believe that faithful Christians are called to be in ministry to individuals and their families challenged by disorders causing disturbances of thinking, feeling and acting categorized as "mental illness." We acknowledge that throughout history and today, our ministries in this area have been hampered by lack of knowledge, fear and misunderstanding. Even so, we believe that those so challenged, their families and their communities are to be embraced by the church in its ministry of compassion and love.[1]

According to a World Health Organization report in 2012 entitled “Depression: a Global Public Health Concern,” one in four persons suffers from a mental disorder, and among mental disorders, depression is the most prevalent. Depression is the leading cause of disability worldwide in terms of total years lost due to disability.[2] Depression, as well as other mental disorders, adversely impacts the ability of affected persons to perform at work, school, and in the family.

The World Health Organization (hereafter referred to as WHO) estimates 350 million people of all ages around the world suffer from depression, contributing significantly to the overall global burden of disease.[3] Lack of treatment compounds the problem. Less than half of the persons afflicted with depression, and in some countries less than 10%, receive any kind of treatment.[4] Lack of treatment is due to a lack of resources, including education, diagnostic tools, psychiatrists, psychologists, therapists, medication and support systems. Lack of resources is directly connected to the poverty and underdevelopment of such countries. Misdiagnosis is also another contributor to improper treatment. Untreated or improper treatment of depression can lead to other more dangerous mental disorders and often to suicide. The WHO cites that over 800,000 persons commit suicide every year, and it is the second leading cause of death globally in 15-29 year olds.[5]

Depression is not the only mental disorder that afflicts persons globally. Anxiety, bipolar disorder, schizophrenia, dementia, autism spectrum disorder and other mental and developmental disorders are on the rise as well, and countries face the similar challenges in treating these disorders. There are many individual and social factors that determine risk: genetics, perinatal infections, nutrition, stress, environment and environmental hazards, individual cognitive-behavioral coping skills, trauma, life crises, national policies, social protection, standards of living, work conditions and community support among others.[6]

Many of these factors are part of the larger systemic issue of poverty and underdevelopment. The WHO has identified a mental health care gap between high-income countries and low- and middle-income countries. In low- and middle-income countries, 76%-85% of persons with mental disorders receive no treatment, while in high-income countries the figure is 35%-50%.[7] When it comes to treatment of mental disorders, substance abuse, and neurological conditions four out of five persons in low-and middle-income countries do not receive them. The resources are often not available, and when some resources are available, many of these countries allocate less than 2% of their overall health budgets for mental health.[8]

For example in Sierra Leone where I have ministered, the WHO cites that there is no mental health policy or national mental health program and thus no allocated funds in the budget beyond taxation as the primary source for funding. There are also no benefits paid for persons with disability due to mental disorders. However, a mental health policy and programming are currently being developed.[9] The Mental Health Atlas put out by the WHO also cites that in Sierra Leone “Regular training of primary care professionals is not carried out in the field of mental health. There are no community care facilities for patients with mental disorders. Some traditional healers and general practitioners provide mental health care in the community setting.”[10] Much of the lack of treatment is due to the poor socio-economic conditions in Sierra Leone. Sierra Leone ranks 181 out of 188 countries in the 2015 Human Development Index.[11] Poverty is clearly a factor in their ability to minister mental health care.

Having detailed the scope of the problem in this post, I will turn to how the church can respond in my next post.

---

[1] “Ministries in Mental Health, Theological Statement” from the Book of Resolutions 2012. Accessed January 20, 2016, http://www.umc.org/what-we-believe/ministries-in-mental-illness.

[2] “Depression: a Global Public Health Concern,” World Health Organization, 2012. Accessed January 20, 2016, http://www.who.int/mental_health/management/depression/en.

[3] “Depression, Fact Sheet No. 369,” World Health Organization, October 2015. Accessed January 20, 2016, http://www.who.int/mediacentre/factsheets/fs369/en/

[4] WHO, “Depression, Fact Sheet No. 369.”

[5] WHO, “Depression, Fact Sheet No 369.”

[6] “Mental Disorders, Fact Sheet No. 396,” World Health Organization, October 2015, Accessed January, 20, 2016, http://www.who.int/mediacentre/factsheets/fs396/en/

[7] WHO, “Mental Disorders, Fact Sheet NO. 396.”

[8] WHO, “Mental Disorders, Fact Sheet NO. 396.”

[9] World Mental Health Atlas, 2005, WHO. http://www.who.int/mental_health/evidence/atlas/profiles_countries_s1.pdf?ua=1

[10] World Mental Health Atlas, 2005, WHO.

[11] United Nations Development Program: Human Development Reports, Human Development Index, 2015,  http://hdr.undp.org/en/countries/profiles/SLE