State of young mental health in Bangladesh
Let's start with two stories: (a) Tanvir, a college student addicted with his tab. He is always busy with playing online games and connected with all types of social media. He has no interest to study, eat even sleep. His behaviour became very rude, body is very thin, and face is pale. (b) Mehbuba, first year student of a university is very friendly and has already made some new friends. Suddenly, she got some unexpected text in her Facebook with threat of disclosing and spreading her private photos which are hacked with the help of her friend. Now she is passing her days with great depression and anxiety.
Incidentally, the theme of 2018 World Mental Health Day is: "Young people and mental health in a changing world." Why are young people of particular concern for commemorating world health days in 2018? Do we consider, the young people of Bangladesh may have the possibility to suffer from the problem of mental health?
Young people, especially university students are a group at high risk of having mental health problems, as university is a major life transition, and can be both exciting and overwhelming. According to World Health Organization, "Adolescence and the early years of adulthood are a time of life, when many changes occur, for example, changing schools, leaving home, and starting university or a new job". In this stage, students must manage multiple academic and social pressures as well as they must also navigate developmental challenges as they transit to adulthood. These challenges are different from previous generation, since society is not similar as present. Some of the remarkable stress are the pressure of financial crisis, career tension, poor CGPA, probability of dropout from university, failure in love, parental demand and the most important is the potentially negative consequences of the use of digital technology and social media.
In some cases, if not recognized and managed, these feelings can lead to mental illness. As a healthy person is not just one without disease or infirmity. A healthy person must be physically, mentally, emotionally and even spiritually balanced. Mental health is a healthy state of mind.
The use of technology must have many benefits but it can also bring additional pressures. Young people are spending most of their day on the internet experiencing, social media, cyber-crimes, cyber bullying, violent and horror films and playing violent video games which often affect their mental, psychological and emotional health. Cyber-crimes and bullying are the factors contributing to young people's ill-health. Harmful use of alcohol and illicit drugs among adolescents is a major issue in our countries and can lead to risky behaviours and eating disorders which cause damages to the brain. Young adults are at the age when serious mental illness can occur and yet they are taught little to nothing about mental illness and wellbeing.
How much are we prepared to tackle this situation in Bangladesh? How many universities have counselling service for new students? If we have any, there is evidence that there are many more students who do not seek treatment for mental health problems. Unlike other physical illness, mental illness is not easily detected. It is mainly sickness of the mind. It is no secret that mental illness is a sensitive issue for many Bangladeshi people, especially because of the discrimination that still strongly exists today. The fear and shame of being entitled a mad (Pagol), or crazy person, is enough to prevent people from seeking treatment. There is even stigma towards doctors who are interest in psychiatry.
Different universities from developed countries are trying to measure the state of mental health of their new students and managing a working group to support students transitioning from a university. What we are doing and managing for them in Bangladesh? Now it has become a big concern.
Mental Health Atlas of WHO stated that mental health expenditures by the government health department/ministry of Bangladesh are 0.44 per cent of the total health budget. Mental hospital expenditures are 35.59 per cent of the total mental health budget. Total number of mental health outpatient's seat are 60 which is 0.04 for per 100,000 and the number of seats reserved for children and adolescents are only 2.
Most disappointing news is that there is no special bed service or community residential service or special mental hospital for adolescent in Bangladesh. Bangladesh still does not have a comprehensive mental health policy to strengthen the entire health system. Besides, the most crucial challenge is the lack of a dynamic and proactive authority to plan and execute policies for further strengthen and improve overall mental health cares. Bangladesh needs a comprehensive mental health policy which can contribute significantly to strengthen the entire mental health development initiatives in both public and private sectors.
Furthermore, WHO report pointed out some of the root problems in medical education. Approximately, 4 percent of the training for medical doctors in Bangladesh is devoted to mental health. For example, almost no primary healthcare doctors have received any refresher training in mental health. The number of professionals that graduated from academic and educational institutions in psychiatry is very low and a large portion of these graduated psychiatrists emigrate out of the country.
According to the representative of WHO, people in Bangladesh do not consider mental health to be a disease. Yet a 2011 National Institute of Mental Health report found there are 14.5 million adults- including these women at the Pabna hospital with mental disorders in the country. Nearly 20 per cent of children aged 12-17 have a mental illness. From this scenario, we can assume the immense gap between demand and delivery of mental health services in Bangladesh.Mental health is currently seen an 'invisible problem' in international development to being framed as one of the most pressing development issues of our time, included on the 2015 UN Sustainable Development Goals, and framed as lying at the heart of global health (Patel, 2014).
Addressing mental health among students can have a positive effect on mental health in later life. Ensuring young mental health is a societal concern. The concern should encourage early actions to ensure young mental health. By detecting early, at a critical transition point in young people's lives, we can avoid the long-term risks associated with poor mental health, which can have far-reaching consequences for the next generation. So we need more research to address the issue of young mental health. Spring comes among the young those are suffered from mental illness like Tanvir and Mehbuba suffer.
Md Helal Uddin, Lecturer (Sociology), GED Cell Eastern University and he can be reached at: firstname.lastname@example.org