A study has revealed that the prevalence of depressive and anxiety symptoms among persons with disabilities is 73.8% and 62.6%, respectively, 55% suffer from symptoms of both.
Besides, women are 3.21 times more likely to suffer from depressive symptoms compared to men, according to the findings of the survey titled “Prevalence and Predictors of Mental Health Conditions among the Persons with Disabilities,” conducted by the icddr,b and the Centre for Disability in Development (CDD).
Another study titled “Impact analysis of individual non-specialized focused MHPSS service for the vulnerable population of the Rohingya community”, conducted by Handicap International - Humanity & Inclusion found that, after completion of the individual mental health and psychosocial counseling services, 29% of the people faced the same problems again after six to 10 months of the discharge. It also reported that 27% of people mentioned manifesting different kinds of psycho-social problems.
The study also reported that 84% of respondents effectively cope with their symptoms using the gained interventions, whereas this effectiveness has been found in 81% of the total persons with disabilities coping with their symptoms.
A roundtable discussion was held on Wednesday titled “Mental Healthcare Systems and Service in Bangladesh: Addressing Rights of the Most Marginalized Population to Mental Health Services,” where the participants highlighted the rights and importance of mental health services for persons with disabilities. The event was jointly organized by CBM Global Disability Inclusion, CDD and Handicap International-Humanity and Inclusion, in association with Dhaka Tribune at a hotel in Banani.
The panelists said inclusive services should be established from upazila health complexes to community clinics throughout the country. Through public-private partnerships, the challenges must be overcome and solved through realistic policy implementation, they added.
At the program, Farhana Naznin, MHPSS technical specialist, Handicap International Bangladesh, and Taslima Akhter Keya, Coordinator, CDD, presented the keynote presentation.
Challenges, solutions
The keynote highlighted the challenges in the current system, field experience and research (findings highlighted from four field researchers) and made some recommendations. It also focused on what could be the solutions to the problem of gaps in getting mental health services for the marginalized community.
The keynote also presented that only 0.49% of the mental health workforce has adequate training, and there are 0.16 psychiatrists for every 100,000 people, 0.34 psychologists for 100,000 and 0.4 nurses for 100,000 people.
Around 302 physicians, psychologists and counselors have been trained under the WHO’s mental health Gap training program after the Rohingya influx, reported in the keynote. Meanwhile, the DGHS trained 10,030 general practitioners, 4,500 nurses and sub-assistant community medical officers to provide mental health services. However, most of the workforce is concentrated in urban areas, especially in Dhaka.
Dr Esrat Jahan, technical unit manager, HI Bangladesh, said according to the National Mental Health Survey 2019, 18.7% of adults need mental health services. However, especially in rural areas, mental health services are nearly nonexistent or limited and also lack of awareness of mental health rights, she added.
Abdullah Harun, focal person of the mental health program at ADD International, said: “It is a very common scenario that there is no separate space for people with disabilities at the country's upazila health complexes and community clinics. Even if we find it in some places, the design is not right, the measurement is not right, so it is not working.”
He also stressed the need for a multisectoral approach in addressing the challenges of acute workforce shortage and inadequate service delivery in mental healthcare, particularly for marginalized group of people.
Dr Md Robed Amin, Line Director, Non-communicable Disease Control, DGHS, said: “There is very limited accessible healthcare infrastructure for persons with disabilities in Bangladesh. However, the situation is improving day by day.”
Dr Avra Das Bhowmik, Director, National Institute of Mental Health (NIMH), said: “We need a lot of root-level data to work. We should also train local leaders trusted by people, like religious leaders or traditional healers. In this way, they can provide accurate information to the people who need mental health services.”
AHM Noman Khan, executive director of CDD, expressed his gratitude for the substantial support provided by NIMH in implementing mental health-related programs of CDD.
He said: "Based on our extensive experience working with caregivers of individuals with disabilities, we have observed that a significant number of caregivers have varying degrees of mental health needs. Therefore, it is crucial to prioritize the provision of mental health support for these caregivers, particularly mothers, as this aspect is frequently overlooked."
Muhammad Mushfiqul Wara, country director, CBM Global Disability Inclusion, Bangladesh Country Office, said: “We should prioritize collaboration with the government in making the services available at community clinics. Taking practical actions in doing that should be stressed.”
Rajesh Chandra, country director, HI Bangladesh, stressed concerted efforts by GO, NGOs and civil society to address barriers and challenges in ensuring mental health services for marginal communities. He also expressed HI’s commitment to translating policy commitments into actions along with government and other actors through a multisectoral engagement approach.
Reaz Ahmad, executive editor, Dhaka Tribune, moderated the session, which brought together various stakeholders, including government officials, mental health experts, physicians, and local and international organizations.