Mental health management
Tuesday, 12 January 2010
THE National Mental Health Institute let it be known recently that 16 per cent of adults aged eighteen and above in Bangladesh suffer from some kind of mental disease. Given the fact that the voting population is 81.0 million (8 crore, 10 lakhs), this means the number of mentally ill is about 12.8 million (one crore, 28 lakhs, six thousand). Extreme cases make up to 0.1 per cent of the total sufferers while most -- 15 per cent -- are diagnosed as mildly ill, usually from various anxiety and depressive disorders. The NMHI figure for addiction-induced mental disease is 0.6 per cent only, although specialists in this area believe it to be much higher.
It is for various 'experts' to argue over the methods employed to arrive at these data, but the overall picture is that far too many people are stressed enough to be considered 'mentally ill.' Most are administered psychiatric drugs rather than psychological, nutritional and other holistic therapies. And herein lies the danger. Careless use of mental disease medications can wreck people beyond recovery, and even make them suicidal. Adverse drug reactions (ADR) reports, compiled by medication-related consumer rights activists, testify to such hazards. Critics say the 'medical industry' often trivialises dangerous side-effects as they are bent on boosting business more than healing people. Many big pharmaceutical companies manage to win loyal physicians who test newer and newer products on their patients and rarely are ADRs considered. The worrying fact is all kinds of psychiatric drugs are available over the counter and even half-baked doctors have been found to prescribe them without hesitation, and without follow-up. This aspect of the medical industry needs to be regulated, A serious study, to assess the extent to which iatrogenic illnesses are growing as a result of wrongly prescribed drugs or over-medication of right ones, is urgently required in Bangladesh.
According to the NMHI, the number of mental health specialists in the country -- only 117 -- is way below the requirement for such a vast population, although, some 4,500 general practitioners, six thousand 'health workers', 150 nurses and 172 imams have been specially trained for the purpose. In addition, sixty doctors have received training to deal with post-disaster mental traumas. NMHI sources reportedly deplored the fact that there is only one institute of its kind for the whole of Bangladesh apart from Pabna Mental Hospital and some 'model' hospitals here and there, including special departments in the Medical colleges and hospitals. But infrastructure alone is no guarantee that the health deliverers would be functioning sincerely and efficiently enough to make a difference in the lives of those perceived to be mentally challenged. It would perhaps be more cost-effective to institute alternative therapies like counseling, diet and exercise, prayer or meditation, as is being recommended by holistic practitioners worldwide.
The role of balanced nutrition in particular should not be ignored in the restoration and maintenance of mental health. Bangladesh is one of the world's most poorly fed nations, despite all the hype about 'food security'. Balanced diets, after all, mean much more than stores full of grain. In the zeal for export-oriented enterprises, Bangladesh's policy makers have not been addressing the issue of the nation's dwindling diet in terms of both quantity and quality of energy-yielding (carbohydrates), body-building (proteins) and protective foods(vitamins and minerals). These together constitute a balanced diet and it is the greatest single factor in securing good health, in body and in mind, starting from the mother's womb. It is therefore vital that knowledge about what constitutes a balanced diet is disseminated and access to essential food items guaranteed for all.
It is for various 'experts' to argue over the methods employed to arrive at these data, but the overall picture is that far too many people are stressed enough to be considered 'mentally ill.' Most are administered psychiatric drugs rather than psychological, nutritional and other holistic therapies. And herein lies the danger. Careless use of mental disease medications can wreck people beyond recovery, and even make them suicidal. Adverse drug reactions (ADR) reports, compiled by medication-related consumer rights activists, testify to such hazards. Critics say the 'medical industry' often trivialises dangerous side-effects as they are bent on boosting business more than healing people. Many big pharmaceutical companies manage to win loyal physicians who test newer and newer products on their patients and rarely are ADRs considered. The worrying fact is all kinds of psychiatric drugs are available over the counter and even half-baked doctors have been found to prescribe them without hesitation, and without follow-up. This aspect of the medical industry needs to be regulated, A serious study, to assess the extent to which iatrogenic illnesses are growing as a result of wrongly prescribed drugs or over-medication of right ones, is urgently required in Bangladesh.
According to the NMHI, the number of mental health specialists in the country -- only 117 -- is way below the requirement for such a vast population, although, some 4,500 general practitioners, six thousand 'health workers', 150 nurses and 172 imams have been specially trained for the purpose. In addition, sixty doctors have received training to deal with post-disaster mental traumas. NMHI sources reportedly deplored the fact that there is only one institute of its kind for the whole of Bangladesh apart from Pabna Mental Hospital and some 'model' hospitals here and there, including special departments in the Medical colleges and hospitals. But infrastructure alone is no guarantee that the health deliverers would be functioning sincerely and efficiently enough to make a difference in the lives of those perceived to be mentally challenged. It would perhaps be more cost-effective to institute alternative therapies like counseling, diet and exercise, prayer or meditation, as is being recommended by holistic practitioners worldwide.
The role of balanced nutrition in particular should not be ignored in the restoration and maintenance of mental health. Bangladesh is one of the world's most poorly fed nations, despite all the hype about 'food security'. Balanced diets, after all, mean much more than stores full of grain. In the zeal for export-oriented enterprises, Bangladesh's policy makers have not been addressing the issue of the nation's dwindling diet in terms of both quantity and quality of energy-yielding (carbohydrates), body-building (proteins) and protective foods(vitamins and minerals). These together constitute a balanced diet and it is the greatest single factor in securing good health, in body and in mind, starting from the mother's womb. It is therefore vital that knowledge about what constitutes a balanced diet is disseminated and access to essential food items guaranteed for all.