World Mental Health Day will be observed across the world, including in Bangladesh, on October 10 to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health.
The day provides an opportunity to reduce the stigma surrounding mental illnesses, and promote resources and support for individuals facing mental health challenges.
World Mental Health Day was first observed in 1992 at the initiative of the World Federation for Mental Health (WFMH), a global mental health organization with members and contacts in more than 150 countries.
In Bangladesh, leprosy is one of the factors responsible for creating mental health problems. Leprosy is a chronic infectious disease that affects the peripheral nerves and skin, leading to physical deformities. Individuals affected by leprosy not only experience physical deformities, but also a range of emotional and psychological problems that can adversely affect their mental health, such as feelings of shame, low self-esteem, and social exclusion, which can significantly reduce their quality of life.
The condition can be worse in places like Bangladesh, where provision for mental health support after a diagnosis can be harder to come by locally. A 2020 World Health Organisation (WHO) paper reported that many people affected by leprosy have experienced anxiety, depression, and psychological distress. Some people have even reported suicidal ideation because of leprosy.
There are problems such as living with chronic pain, with little or no access to health care; losing independence when leprosy causes disability; deepening poverty and vulnerability; facing stigma, discrimination, and exclusion; and feeling worthless or ashamed because of community attitudes. These are just some of the ways leprosy can affect people’s mental health.
According to experts, leprosy has physical and psychological consequences that can lead to activity limitations, economic and physical dependence, social exclusion and stigma. All these factors are correlated and can worsen the mental wellbeing of the leprosy-affected persons.
Depressive symptoms and low self-esteem were identified among children of leprosy-affected persons. Depressive disorders and anxiety disorders were found to be very common among persons affected by leprosy.
Impairments caused by leprosy lead to emotional reactions and negative behaviours. Both the biomedical and the social trajectory can contribute to unemployment, economic and physical dependence, and difficulty with social integration.
Stigma and discrimination were frequently mentioned factors associated with psychiatric morbidity. Discrimination can result in unemployment, social and marital restrictions, low self-esteem, stress and self-stigmatization. Stigma can harm the quality of life and social participation of persons affected, and increase mental distress, depression and fear.
Several case studies revealed that social stigma was often mentioned as a reason to attempt suicide.According to a study among over a thousand leprosy-affected persons in Indonesia, 36% experience anticipated stigma.
They state that physical deformities are the main cause of stigma and disability. Because of the stigma attached to physical deformities, patients experience fear, avoidance, discrimination, and prejudice.
Poor mental health itself can have a negative impact on health outcomes, and may lead to low treatment seeking behaviour and treatment adherence.
Mental health of leprosy victims must be carefully considered in order to avoid the onset of sufferings and/or mental disorders. In order to solve the mental health issue due to leprosy, it is first recommended for taking actions to eradicate the disease.
Anti-leprosy programs should be taken up in the country along with more initiatives from the government with adequate financial allocation in the national budget.
It is urgently needed to take up anti-leprosy activities such as conducting active case search and skin camp, bringing newly identified leprosy patients under quick treatment, rehabilitation for leprosy-related disabled people, raising social and mass awareness on leprosy, arranging training on leprosy for physicians, health workers and field workers at central, zila and upazila levels, and arranging treatment facilities of leprosy complications at all the hospitals in the country.
The impact of leprosy should get priority by policymakers. Bangladesh has the fifth highest number of leprosy cases in the world according to the World Health Organization (WHO). If it is neglected, leprosy may continue to cause untold sufferings for our people, hampering our efforts to achieve national development.
Md Sazedul Islam is a freelance journalist.