GENEVA – The family of a Democratic Republic of Congo soldier spent two years trying to find him without success, only to discover he had been imprisoned not for doing anything wrong but because he suffered from a mental illness.
“When we talk about disease, we forget that it affects humans. People who need to be hospitalized should not be put in prison,” said Dr Jean Kaseya, the soldier's brother and director of the Africa Centers for Disease Control and Prevention (Africa CDC).
Kaseya was speaking at the launch of the Africa Mental Health Leadership Programme, which aims to establish a cohort of mental health champions across the continent, on the sidelines of the World Health Assembly in Geneva this week. The initiative, supported by the Wellcome Trust, aims to train health leaders to understand and address mental health “from a public health and human rights perspective”.
While the program won't help Kaseya's brother, who died in 2020 shortly after his family discovered him, it hopes it will benefit some of the estimated 120 million Africans who suffer from mental health issues.
On the African continent, mental health is a backwater of health programs, with only 2% of the health budget allocated to it. This neglect is reflected in the significantly lower number of annual mental health outpatient visits in Africa, at just 14 per 100,000 people, compared to the global average of 1,051 per 100,000 people.
This underinvestment has resulted in a significant shortage of mental health workers: 1.4 per 100,000 people in Japan, compared to a global average of 9 per 100,000 people.
For example, Burkina Faso has only 12 psychologists.
Outdated policies
“Mental health policies in Africa are largely outdated and poorly implemented,” Kaseya said at a launch event attended by several African health ministers, including from Burkina Faso, Burundi and Cape Verde.
“This programme will create a cohort of leaders who understand and can advocate for context-specific, evidence-based approaches to mental health in their countries,” said John-Arne Röttingen, CEO of the Wellcome Trust.
Wellcome's Mental Health Programme, which has funded numerous African mental health research projects and initiatives, focuses on anxiety, depression and psychosis. Arne emphasised that an integrated approach, where scientists work with policymakers, is essential to ensure that research is addressing the right questions and achieving breakthroughs in tackling these conditions.
“That's why we are so pleased to be working with Africa CDC on this program,” Arne said.
A cross-cutting human rights approach
Marc van Ommeren of the World Health Organisation (WHO) said at the launch that effectively addressing mental health required multi-sectoral collaboration across different sectors.
He explained that suicide prevention means working with the Department of Justice on gun control, working with the Department of Agriculture to limit access to dangerous pesticides that are banned in many countries but still available on the African continent, and educating young people to equip them with the life skills to deal with life's challenges.
David Bainbridge, executive director of CBM Global, an international organization that advocates for disability inclusion, said the program will “not only have a significant impact on the large treatment gap in access to mental health services, but also on applying good public health practices to reduce the causes and negative health consequences of mental illness.”
“We emphasise the need to take a human rights approach to mental health, which means that in addition to the personal suffering that comes from experiencing mental health symptoms, we are particularly concerned about the experiences of stigma, social exclusion and abuse experienced by affected people, who are often denied access to fundamental rights such as family life, livelihoods and personal autonomy and freedoms,” Bainbridge explained.
Michael Njenga, Africa coordinator for CBM Global, said including people with experience of mental illness in policy-making was crucial to successful implementation.
Some countries ban people with mental illness from voting or running for office, and in Kenya attempting suicide is considered a “minor offence”, Njenga added.
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