Depression a leading cause of global ill health

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One in four of us suffer from mental health illnesses. Yet, in today’s world filled with technology and faster ways of communication, silence continues to surround this topic. Societal barriers and stigma often get in the way of patients seeking timely care.

That’s why yearly campaigns such as the ongoing global mental health awareness month are important to bring to the forefront the need to treat this illness like any other, without adding layers of stigma to the condition, especially since patients are most in need of support , understanding and love.

More than 450 million people suffer from mental disorders worldwide, and one in four will develop a mental or behavioural disorder during their lifetime. These disorders include schizophrenia, bipolar affective disorder, depression, alcohol and other drug disorders and a range of anxiety disorders. The prevalence of mental and behavioural disorders is about 10 per cent for the adult population worldwide. Twenty per cent of adolescents under the age of 18 suffer from developmental, emotional or behavioural problems. Given the scale of the global prevalence of the illness, it should be a conversation that we can have without closing the doors.

Mental Health Strategy

In a major step to recognise rising prevalence of mental health disorders and to tackle the condition holistically, Dubai Health Authority (DHA) recently launched the first comprehensive mental health strategy for Dubai. The initiative, called Happy Lives, Healthy Communities, was launched in line with Dubai Health Strategy 2016-2021.

Dr Nadia Dabbagh, Consultant Child and Adolescent Psychiatrist at Rashid Hospital, and Programme Lead for the Mental Health Strategy at DHA, highlights that the implementation plan is divided into waves based on the priorities, needs and resources and according to the four pillars of the strategy. The pillars are: legislation and governance; promotion, prevention and early intervention; service delivery and finally recovery; and patient empowerment programmes.

“Dubai’s mental health strategy is underpinned by guiding principles that are based on international, evidence-based research and best practice, as well as incorporating the views of local subject matter experts working in Dubai,” says Dr Dabbagh. “The key guiding principles include respect for the rights and needs of service users and their families, prevention and early intervention across the life span including vulnerable groups, recognition of the spectrum of mental health difficulties and the need for equitable service delivery across the health continuum with a commitment to a recovery-oriented approach and social inclusion.”

Overcoming stigmas

Dr Khawla Ahmed Al Mer, Acting Head of Psychiatry Department at Rashid Hospital, says that stigma and lack of awareness are the main barriers to early diagnosis and treatment. This often means patients and their family members endure unnecessary suffering until they finally approach mental health professionals. This also means higher chances of prolonged treatment and a higher risk of complications.

Al Mer says that the majority of the patients the hospital’s psychology and psychiatry department receives come to the clinic only after their conditions have deteriorated significantly and rarely in the initial stages. “With the new law and the focus on early detection as well as continuum of care, things will change for the better and I believe we will see more patients earlier.”

Although there are effective, treatments for depression, according to the WHO less than half of those affected (in some countries, fewer than 10 per cent) receive treatment. Barriers to effective care include stigma, isolation and discrimination surrounding mental health issues.

“Mental health is a disease like any other and if we learn to accept it as we accept any other disease we will be able to reduce the suffering of those with the disease,” says Al Mer. “We have a community mental health team at Rashid Hospital for patients with chronic mental health conditions where follow-up and regular treatment is a challenge. Our team visits their homes to provide medical, social and psychological support. This programme has helped chronic mental health patients lead a near normal life with many of them travelling again and going back to work or college.”

Dr Samia Abul, consultant psychiatrist at Rashid Hospital, explains one of the major reasons for depression and anxiety is stress that is not controlled. “Stress could be due to several reasons such as financial reasons, but when that goes uncontrolled for a long time it can lead to depression. Depending on the number and severity of symptoms, a depressive episode can be categorised as mild, moderate or severe, and treatments are available to tackle all kinds of depression. The first line of treatment is not always medicine. It can simply be a few counselling sessions. However, the point is that the patient and family members need to reach out in time to minimise the effects and complications of mental illness.”

Promotion of positive mental health

The intensive promotion of positive mental health and wellbeing at an individual level and within families, organisations and communities is a key component of the Mental Health Strategy. This means learning to relax and unwind, taking up more leisure and pleasure activities, managing stress effectively and not stressing others by our behaviour. “The message is clear. In today’s fast-paced world, we need to find some downtime. After all, your body is controlled by your mind.”