Globally, one in four people are affected by mental health issues, yet mental health receives considerably less attention than other health indicators, particularly in resource-scarce countries. Earlier this year, the Japan Times reported that the amount spent annually on mental health services across 148 resource-scarce countries was less than Americans spent on Halloween costumes for their pets in 2015. According to the same article, less than one percent of aid funding to these countries is allocated to treat mental health issues.
October 10 is World Mental Health Day—a day designated by the World Health Organization (WHO) to raise awareness of mental health issues around the globe. The WHO estimates that 75 percent or more of the population in some low-income countries is affected by neurological, mental, and substance abuse disorders, with the majority of those affected lacking access to treatment services. A mere one percent of the global health workforce works in mental health.
Addressing the mental health care gap poses a unique challenge to international aid organizations and volunteers, as the understanding and perception of various mental and neurological disorders differs greatly across cultures. In Bhutan, HVO has partnered with the Jigme Dorji Wangchuck National Referral Hospital (JDWNR Hospital) and the Royal Institute of Health Sciences to create a culturally sensitive training program for aspiring Bhutanese mental health care providers. This collaboration also has a goal of increasing access to services in remote, rural settings. Volunteers to this project site have found the experience personally enriching and professionally eye-opening:
“The volunteer experience was very personally rewarding. It not only made [me] aware of the limitations of mental health treatment in [a] completely different environment, but made me rethink how limited mental health [care] is in the USA,” wrote Kenneth Cauthern, MSSW, LCSW.
“It is necessary to be open to different cultural expectations and norms and what might seem inappropriate in our home settings, is not the case here. Similarly, what we might think is common knowledge at home, may not be at all understood here…Our lack of understanding of local customs, beliefs and values can also pose a significant barrier,” wrote Barbara Giorgio, BEd, GDRelStu, GDTESOL, MEd, BPsychHons, PGDClinPsych. Giorgio went on to elaborate that, although there are times when HVO volunteers must act as “agents of change,” at other times they must be “partners in mutual understanding and respect of each other’s specific knowledge and expertise.”
Through cross-cultural collaboration, HVO is working to address the mental health care gap in a way that is both sustainable, and relevant in the context of local needs, resources, beliefs, and values.