What is mental health?
Mental health is not just the absence of mental disorder, it is defined as a state of well-being in which the individual is aware of his or her own capacities, can deal with normal stress in life, can work in a fruitful and productive way and is capable of contributing to his or her community.
What we need to remember:
- Around 450 million people currently suffer from such conditions, placing mental disorders among the leading causes of ill-health and disability worldwide
- Mental health is an integral part of health; in fact, there is no health without mental health
- Mental health is more than the absence of mental disorder
- Mental health is determined by socioeconomic, biologic, and environmental factors
The Problem Worldwide
The World Health Organization (WHO) demonstrated that mental and neuropsychiatric illnesses and disorders due to drug abuse are a reality in every region of the world. This contributes to early morbidity and mortality, especially as physical disorders (caused by mental illnesses) are not properly treated. Suicide is also highly represented, as it is the second cause of mortality among young people in the world. Psychiatric disorders are shown by consideration of disability years to have a huge impact on populations (14% of global mortality).
The impact of mental disorders on people’s lives, their families and their communities is huge. People who develop a mental disorder are confronted with a severe loss of their functional capacity and this leads them and their families into an impoverished state.
In most countries, mental disorders are not seriously attended; 40% of countries do not have mental health laws. Lack of a proper living situation and imprisonment are common situations for people with mental disorders, which aggravate their marginalization and vulnerability.
Due to a negative perception and hostile attitude of general population, the mentally ill people often see their basic rights violated. Most of them cannot assert their juridical rights and suffer from labor and educational discrimination. They can also be victims of unhealthy and inhuman living conditions, physical and/or sexual abuses, abandonment, and sometimes aggressive and humiliating treatments from health service providers.
It is true, however, that awareness of these diseases is rising, but global response is still insufficient.
the situation in guatemala
The WHO estimates that more than 25% of Guatemala’s population (3,250,000 inhabitants) will suffer from some of kind of mental disorder in their life. It is estimated that the amount of mental illnesses and epilepsy is 1.5 times greater than the amount of parasitic or infectious diseases. The proportion of mental health specialists in Guatemala is very low, with 0.54 psychiatrist per 100,000 inhabitants and only five psychiatrists working outside of Guatemala City. Guatemalan people can only count on 2.3 mental health workers per 100,000 inhabitants, a figure that contrasts heavily with the 52.3 mental health workers per 100,000 inhabitants available in high-income countries.
There are no facilities for primary mental health care available at the community level. More importantly, people’s lack of knowledge and false beliefs around mental diseases (witchcraft, curses, distrust, fear of contagion, craziness) dissuades most of them to seek for clinical attention.
Clinical personnel of primary care level lack of training in psychiatry (mental health training is less than 1% of the medical school curriculum), and there are no resources for primary health providers to give psycho-social help. Furthermore, the current drug supply system does not provide sustainable acquisition systems or adequate distribution routes.
ALAS Pro Salud Mental was born as a result of this situation. Considering that the number of private initiatives (non-profit organizations, foundations or international organizations) attending exclusively mental health problem is very small, we intend to be a model and to improve both local and national situation in the near future.
Guatemala, and more specifically the department of Sololá (ALAS’ current geographic focus), have been confronted to several natural disasters over the past few years. Hurricanes Mitch (1988) and tropical storm Stan (2005) made thousands of victims, to cite a couple. Moreover, the department of Sololá naturally presents high risks of flood and landslides given it surrounds the Lake Atitlan. Because of their poor living conditions, local people are even more vulnerable to natural disasters.
Those disasters are extremely traumatic for the population and can affect their mental health, notably due to the death / disappearance of relatives, neighbors, and friends or the destruction of their home. In the investigation, it has been discovered that the impact of those disasters can lead to Prolonged Grief Disorder (PGD), post-traumatic stress and other psychiatric disorders (or a combination of those disorders). It can also result in other issues such as violent behavior on the social or family life.
THE ARMED CONFLICT
From 1960 and for 36 years, a civil war was raging in Guatemala, which took an end when the president Alvaro Arzú signed the peace agreement.
Guatemalan inhabitants have been profoundly damaged by the war, which saw hundreds of deaths, systematic humiliations and rapes, plunders and burning crops, kidnapping and social cleansing. As a result, women and children in rural Guatemala abandoned their homes and took refuge in towns, in the mountains or in the neighboring country of Mexico.
This war left important psychologic and emotional consequences in the population, which led to the appearance of several psychiatric disorders that require specialized intervention.