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Mental health literacy in developing countries

Published online by Cambridge University Press:  02 January 2018

M. H. Mubbashar
Affiliation:
Rawalpindi General Hospital, Rawalpindi, Pakistan
S. Farooq
Affiliation:
Rawalpindi General Hospital, Rawalpindi, Pakistan
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Abstract

Type
Columns
Copyright
Copyright © Royal College of Psychiatrists, 2001 

The article on mental health literacy by Jorm (Reference Jorm2000) was interesting and stimulating and we were encouraged to see reference to the mental health literature in developing countries. However, it portrayed a rather incomplete and negative view of the situation. It has rightly been pointed out that the beliefs in supernatural causes of mental disorders are more widely held and traditional sources of help, such as spiritual healers, are preferred over medical advice for a range of mental health problems in these countries. It was not mentioned, however, that mental health literacy is perhaps part of general literacy. In some developing countries where more than half of the population may be illiterate the dimensions of mental health literacy are totally different from those in Western countries. One corollary of this is that mental health professionals will have to adopt innovative approaches to mental health literacy.

The community mental health programme in Pakistan is an example. With a literacy rate of about 40%, it was not conceivable to adopt the approaches discussed by Jorm (Reference Jorm2000). The innovative approaches adopted instead ranged from creating awareness at all levels of health personnel, including primary health care physicians, schoolchildren and teachers in the community, and collaborating with other sectors like traditional faith healers. One interesting attempt in this direction was to create awareness among schoolchildren and their teachers. We believe that the schoolchildren in rural areas are the eyes and ears of the community. In a study evaluating the effect of the school mental health programme it was shown that knowledge, attitudes and superstitions about mental health problems significantly improved in a group of schoolchildren, their friends and neighbours after implementation of the programme, compared with a control group (Reference Rehman, Mubbashar and GaterRehman et al, 1998). More recently, the work has been extended to the detection of disabilities by children (Reference Gater, Saeed and MubbasharGater et al, 1999). This article, which gained the Barker Memorial Award, clearly showed the impact of improved mental health literacy through the strong messenger force of children in the rural community. An interesting impact of improved mental health literacy was its effect on general health indicators such as maternal mortality, infant mortality and the immunisation of children, which were significantly improved following integration of the mental health awareness campaign within primary health care (Reference Maqsood, Saeed and MubbasharMaqsood et al, 2001). Similarly, educating the traditional faith healers assisted tremendously in identification and referral of people with mental illnesses for proper psychiatric treatment (Reference Saeed, Gater and HussainSaeed et al, 2000). These are just a few examples of indigenous projects undertaken in the community, which highlight innovative approaches to mental health literacy in a developing country.

Recently, the issue of the role of the World Health Organization in improving mental health literacy in developing countries has been debated (Reference Mubbashar and SaeedMubbashar & Saeed, 2000) and directions for developing cost-effective and sustainable mental health programmes have been outlined.

Footnotes

EDITED BY MATTHEW HOTOPF

References

Gater, R., Saeed, K., Mubbashar, M. H., et al (1999) Detection of disabilities by school children in rural Pakistan. Tropical Doctor, 29, 151155.Google Scholar
Jorm, A. F. (2000) Mental health literacy. Public knowledge and beliefs about mental disorders. British Journal of Psychiatry, 177, 396401.CrossRefGoogle ScholarPubMed
Maqsood, N., Saeed, K., Mubbashar, M. H., et al (2001) Impact of community based mental health programme on general health care. Lancet, in press.Google Scholar
Mubbashar, M. H. & Saeed, K. (2000) Round table: setting the WHO agenda for mental health – WHO can help to combat mental health illiteracy. Bulletin of the World Health Organization, 78, 507508.Google Scholar
Rehman, A., Mubbashar, M. H., Gater, R., et al (1998) Randomized trial of impact of school mental health programme in rural Rawalpindi, Pakistan. Lancet, 352, 10221025.Google Scholar
Saeed, K., Gater, R., Hussain, A., et al (2000) The prevalence, classification and treatment of mental disorders among attendees of native faith healers in Rural Pakistan. Social Psychiatry and Psychiatric Epidemiology, 35, 480485.Google Scholar
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