No Health without Mental Health

Depression is one of the leading contributors to the global burden of disease in close proximity to ischemic heart disease. It is also a major cause of disability worldwide. Other mental disorders like substance abuse and psychotic disorders have shown to contribute to the global burden of disease in a significant way as well. Despite these well-established facts, mental illness remains marginalized in the majority of developed nations. As opposed to the growth witnessed in funding and resources granted for research in other, more “recognized” diseases, mental illness has suffered a decline in this vital support.

In developing countries, the situation is even worse with long term hospitalizations, infrequent contact with mental health providers, use of old medications with poor safety profiles and few, if any, rehabilitative therapies. The stigma of mental illness extends beyond the public to include health care providers making mental health an undesirable profession exacerbating the poor services.

In Kuwait, an oil rich country with a total health expenditure as a percentage of our GDP at the lower end of Eastern Mediterranean nations (WHO, 2003) but comparable to many of our immediate neighbors, the situations needs further assessment. Mental health is stigmatized among the public, health care providers and policy makers. The need for mental health workers (i.e. qualified social workers, psychologists, psychiatric nurses, and others) is compensated by a continuous supply of unmotived psychiatrists who cannot deliver the integrated mental health care expected from any psychiatric institution. Furthermore, mental illness is an almost unrecognized diagnosis in tertiary care facilities and clinics. The lack of proper mental health research, although not surprising, further hinders needed interventions. Educational institutions including Kuwait University have abandoned the only psychiatric hospital in the country causing further deterioration in the services. The absence of community services makes social integration of the mentally ill a mission impossible.

Hope is in the horizon with our new psychiatric hospital and its management. The hospital is a state-of-the-art facility that took the government almost twenty years to build and is slowly replacing the old facilities. It contains playgrounds, dedicated space for rehabilitation and a music therapy room! If the new facility will be used to its full potential and as it was designed for, it will certainly create a positive change to the services provided.

After decades of stagnation, the new, young management is rapidly making changes to both staffing and organizational structure. The true challenge lies in creating a body for psychiatry within an ailing health system.

“Mental health problems do not affect three or four out of every five persons but one out of one” - Dr. William Menninger