Photo : Collected
Every year, World Mental Health Day is observed across the world, including Bangladesh, on October 10 to raise awareness on mental health issues. Like previous years, various programmes will be held to observe the Day in a befitting manner this year in Bangladesh.
According to World Health Organization (WHO), the Day is an opportunity for people and communities to unite behind the theme ‘Mental health is a universal human right” this year to improve knowledge, raise awareness and drive actions that promote and protect everyone’s mental health as a universal human right.
The World Federation for Mental Health (WFMH), an international multi-professional NGO, including citizen volunteers and former patients, took the initiative of observing the Day in 1992.
In Bangladesh, many people are suffering from mental health-related problems due to leprosy, which is a chronic, progressive bacterial infection caused by the bacterium Mycobacterium leprae. It primarily affects the nerves of the extremities, the skin, the lining of the nose, and the upper respiratory tract.
If it isn’t treated, it can cause severe disfigurement and significant disability. Leprosy is not a curse. It is treatable and its treatment is available for free in the country. Showing any kind of discrimination to anyone only because of this disease is a big offence.
Leprosy has long term consequences for impairment and stigma. This includes a major impact on mental health. Depressive disorders and anxiety disorders were found to be very common among persons affected by leprosy. Feelings such as fear, shame and low self-esteem are also experienced by those affected, and their children.
Individuals affected by leprosy often experience rejection, shame and social exclusion, with consequences for mental health. Stigma, prejudice, and discrimination can also prevent people with the symptoms of leprosy from seeking and accessing medical help, which delays diagnosis and treatment.
As the disease is surrounded by stigma, society tends to discriminate against those infected. It takes a toll on the patient’s and their family member’s emotional well-being. The symptoms also can bring a lot of shame to the person affected. It has been found that the patients show depressive disorders, anxiety, and suicidal thoughts. It brings a lot of mental distress to the patients. It leads the person to have low self-esteem, fear, sadness, anger, and low quality of life.
Previous reports by the UN Human Rights office highlight that people with mental health conditions and those with psychosocial disabilities experience disproportionately higher rates of poor physical health and reduced life expectancy.
According to a study report (2020) on mental health status of leprosy victims by The Leprosy Mission International Bangladesh, leprosy, in its own, is a highly stigmatized and disgraceful term; disability is the other concern that widely victimized by stigma and discrimination. When that two factors implant together in someone’s life, will drag immense adverse impact on his/her psychological strength and quality of life. These can lead major psycho-social impairment.
The study assessed that the mental health and quality of life was major concern for the people affected with leprosy-disability. Increased understanding and systematic, well thought and pragmatic intervention to be deployed to properly address the physio-psycho-social impairment for people with leprosy-disability are highly desirable in the existing situation and local context.
Furthermore, these findings highlight the need for enhanced socio-psychosocial support for improving the quality of life for both the groups. It is expected that this study will help facilitate the formation of early intervention program, targeted at those who are expected to be diagnosed with mental illness, such as mild or moderate levels of psychological distress. The study also suggested an appropriate programme approach for the people with leprosy-disabled those require early intervention, which is important, as delay in getting help and support for mental health problems could cause severe impairment and also can provide high impact on Quality of Life adversely.
During her Dhaka visit in February this year, UN Special Rapporteur on the elimination of discrimination against persons affected by leprosy and their family members, Alice Cruz, in a statement said that ‘the situation of persons affected by leprosy in Bangladesh indicates that the country’s outstanding economic growth is not reaching the entire population’, calling for drafting anti-discrimination laws to formally recognise leprosy as a prohibited ground of discrimination.
She observed that leprosy victims face discrimination and various deprivations, including health services. She noted that the Bangladesh government was committed to actively engaging with the international human rights system to protect the fundamental rights of persons affected by leprosy.
According to World Federation for Mental Health, discrimination, harmful stereotypes and stigma in the community, family, schools and the workplace prevent healthy relationships, social interactions and the inclusive environments needed for the well-being of all members of society.
Early detection and management would inhibit the deformity that can prevent worsening the Mental Health Condition and Quality of Life of the persons affected by leprosy. Besides, providing employment, financial self- sufficiency, and financial assistance for them can contribute in the promotion of their mental health status and quality of life.
In order to prevent and mitigate the mental health impact of leprosy, interventions are needed to strengthen coping mechanisms of those affected, to treat mental health conditions such as depression in this population, and to change negative community attitudes towards those affected by the disease, as stigma is a key contributor to mental ill health.
To end leprosy-related stigma, there is a need to implement a combination of effective contact- and education-based anti-stigma strategies aimed at the reduction of leprosy-related stigma. Peer counselling or ‘psychological first aid’ for individuals or families tackles stigma by restoring a sense of identity, promoting dignity and providing an opportunity to meet other people affected by leprosy. The stigma needs to be broken and the discrimination needs to be stopped. We, as a society, need to come forward and help those who are suffering.
Mental health is basic human right for all people. Everyone, regardless of their location, has a right to the highest attainable standard of mental health, says WHO, adding that good mental health is vital to our overall health and well-being. WHO called for ensuring that mental health is valued, promoted, and protected, and that urgent action is taken so that everyone can exercise their human rights and access the quality mental health care they need.
The leprosy issue should get priority to the policy-makers for the sake of national interest. Hence, effective anti-leprosy programmes should be launched. It is imperative to keep adequate financial allocation in the budget to make the anti-leprosy programme successful.
Md. Sazedul Islam is a freelance journalist
Messenger/Disha
