Mental health treatment deficiency in Bangladesh

Barrister Solaiman Tushar :
The mental health challenges in Bangladesh remain unmet due to a lack of awareness and a shortage of mental health professionals. Patients cannot get adequate treatment for mental health problems if they need immediate treatment. People may suffer mental problems and depression for different reasons like broken or unhealthy relationships, unemployment, economic crisis, family dispute, job-related problems, drug addiction, pre or post-maternity, etc.
An estimated 10,000 Bangladeshi people die by suicide annually. Mental health stigma is common throughout Bangladesh and there are many superstitions surrounding mental health conditions. Many people are left powerless, desperate for support, and dependent on traditional healers and faith leaders for ‘cures’. This leads to malpractices, human rights abuses, and unnecessary deaths.
Myths such as that a mental health episode is caused by evil spirits can lead communities to affix deeply oppressive social stigma on people with psychosocial conditions. People with mental health problems often live in isolation and are excluded from their communities. Sometimes they are hidden away or even abused by their families. Others often ostracize people suffering from mental health conditions, leading others to hide their mental struggles and suffer in silence without help. Some people turn to traditional healers for cures. These traditional practices sometimes amount to human rights abuses and may have fatal repercussions. Traditional healers are more prevalent in the countryside where a trained mental health specialist is hard to come by. In rural areas, “village doctors with no formal training provide 65 per cent of healthcare.
It is unfortunately true that there are a total of 270 psychiatrists while there are not more than 500 psychologists at present to serve the vast number of mental health patients in Bangladesh. Another major concern is that those health services are mostly urban-based. According to a 2018 survey on mental health jointly conducted by the government and the National Institute of Mental Health (NIMH), the overall prevalence of mental disorders among the population 18 years and above was 18.7 per cent. The prevalence of disorders was highest among those 60 years and older at 20.2 per cent. A study published found that 14,436 people in Bangladesh had taken their own life since March 2020, 70 per cent more than Covid-19 claimed during that period.
Mental healthcare in Bangladesh is enormously inadequate owing to a lack of public mental health facilities, scarcity of skilled mental health professionals, insufficient financial resource distribution, and societal stigma. These shortcomings are sustained by the absence of effective stewardship to execute adequate mental health policies. Mental health expenditures by the Bangladeshi government are 0.44per cent of the total health budget of all expenditures on mental health, and 67 per cent is dedicated to mental hospitals. Less than 0.11 per cent of the population has access to free essential psychotropic medications. According to 2019 research published in the International Journal of Mental Health Systems, the National Institute of Mental Health (NIMH) is the only national-level mental health institute in Bangladesh. NIMH is located in the capital city and provides specialized mental healthcare services for the whole population of Bangladesh.
The quality of health care is poor in both the public and private sectors in Bangladesh. There is little assessment of the quality of provider care, low levels of professional knowledge, and poor application of skills. Bangladesh does not have a formal body for the arbitration of complaints against health providers. Hospital or clinic authorities address complaints and disputes independently, without involving the government or legal entities. In addition, there is no human rights review body to inspect mental health facilities, nor is there a specific mental health authority. The National Institute of Mental Health (NIMH) is the only Bangladeshi national-level mental health institute (and has an academic faculty). NIMH is situated in the capital city and has a 200-bed specialized mental hospital that caters to the whole country with a population of 168,663,460.
The NIMH has a serious lack of resources in terms of functional medical equipment and physicians appointed, which negatively impacted the service quality. According to the 2019 research outlined within this report 16.1per cent of adults suffer from mental health problems in Bangladesh but there are only 200 beds available in the capital city where the appellant will be expected to seek treatment for mental illness within the National Health Service. Such lack of access has been very poor among those that due to refugee trauma and violence such as the Rohingya have had very little access to mental health provisions within refugee camps.
At the moment, government hospitals are still busy with Covid-19 and Dengue patients. Besides this, all necessary tests and treatments are not possible in government hospitals due to the high number of patients and limited available resources. Therefore, mental health patients need to take treatment in private hospitals. In Bangladesh, private hospitals are always expensive for all types of patients. Based on the information above, it is true there is not adequate mental health treatment available in Bangladesh. In Bangladesh, there is no special arrangement Like UK, USA, EU. In order to solve these major people, it is necessary to appoint more psychiatrists and psychologists. We need more Mental Health hospitals as well.

(The writer is a member of the Honourable Society of Lincoln’s Inn and Dhaka Bar Association).