4 Barriers to Accessing Mental Health Services Around the World
Almost 1 billion people around the world live with a mental disorder.
The COVID-19 pandemic has not only led to an intense focus on global health, but it’s also made clear the need to invest in mental health around the world.
Pandemics, in short, are very stressful. The coronavirus outbreak has no doubt led to increased fear and anxiety, while social distancing measures are isolating and can increase a sense of loneliness, according to the Centers for Disease Control and Prevention.
To make matters worse, people around the world have lost their jobs, meaning financial concerns are top of mind, sleeping and eating patterns have been disrupted, and many have felt an overall sense of doom for much of 2020. The pandemic has likely been even harder on people who were already experiencing mental health issues before it hit.
Having access to mental health services is a vital part of having access to good health and well-being overall — the aim of Global Goal 3 — but people around the world continue to be denied this right for a number of reasons.
1. Access to Mental Health Care Services
Around the world, there are barriers to accessing mental health treatments for a variety of reasons, but in some cases, services and medication are not available at all. Low-income countries have an average of 0.1 psychiatrists and 0.3 psychiatric nurses per 100,000 people, according to World Health Organization (WHO) data from 2014-2016.
“Close to 1 billion people across the globe have a mental health disorder. Despite the levels of mental ill health, very few people have access to quality services,” Elisha London, founder and CEO of United for Global Mental Health, told Global Citizen. “In low- and middle-income countries, over 75% of people with mental health conditions receive no treatment whatsoever.”
2. Stigma and Misinformation
People sometimes avoid seeking help for mental illness for fear of being stigmatized and discriminated against. And in some cases, misconceptions around mental health disorders make this concern even worse.
In Ghana, for instance, due to a lack of available medication and treatment options, people with mental illnesses are sometimes chained to trees outside for years at a time.
There are only three hospitals and 13 psychiatrists for the 30 million people in Ghana, the Guardian reported.
“Since we ran out of medication, the only thing on offer is the chain,” Stephen Asant, a psychiatric nurse from Tamale, in northern Ghana, told the Guardian.
“Most people in the north do not understand the concept of mental illness,” he said. “So many do not know what to do and in most cases they abandon the person, or they take them to prayer camps. Maybe someone who has knowledge about mental health advises them to take the person to the hospital. But even there there is no medication.”
3. Lack of Policy
“There is a crisis of inaction on mental health. Despite rising conversation in some parts of the world, the step-change in investment to provide people with the support they need is not occurring,” London said. “Less than 2% of national health budgets are spent on mental health and global development assistance for mental health has never exceeded 1% of global development assistance for health.”
The WHO’s Mental Health Atlas 2017 showed that there had been progress made in mental health policy-making, but more policies are still needed in various countries around the world — and updates need to be made to existing, outdated policies, too.
“International and national investment in mental health has been stifled as it is still often considered a novel investment stream for many funders,” London said. “This is compounded by stigma, lack of available financial resources, limits on human resource capacity, and prioritization of competing health concerns.”
4. The Cost of Mental Health Care
In countries with mental health care professionals available, many people still struggle to access treatment due to its cost. Even in countries with universal health care like Canada, most people need to pay for mental health services through insurance or out of pocket.
And even with financial assistance, mental health treatment can be expensive — if a diagnosis necessitates therapy or medication, for instance, the fees can really add up.
“The world is talking about mental health — but talking is not enough. Global action on mental health is stagnant,” London said. “We need real movement on mental health funding and access to services, so that everyone, everywhere has someone to turn to when their mental health needs support.”