Tag Archives: mental health

Mental Health is the centre of attention at the World Bank this year: “Out of the shadows; making mental health a global priority”

Momenta's Project Sierra Leone 2015

The human toll of mental illness has started to be widely recognised for its impact on individuals and families. There is now much more awareness of, for example depression, due to stories in the media about famous people who are talking openly about their problems. Even the once taboo subject of suicide is now more openly acknowledged in society.  When someone like the comedian Robin Williams dies by suicide, it has the effect of reminding us that at least 1,000,000 people die in this way every year around the world. In many countries suicide is one of the top three causes of death in young people, but is often ignored or even denied as an issue.

CBM, along with many other partners in global development have long pointed out that mental illness and psychosocial disability also has an important impact on communities and broader society. Mental illness does not only cause personal suffering, but often results in social exclusion and lack of opportunity for large sectors of the population to contribute to the economy and community development. Since 85% of the people with mental conditions live in the poorest countries in the world, the impact is particularly marked on these fragile economies.

By 2030, depression is expected to become the single largest contributor to disease burden globally, and even today, 350 million people around the world are affected by depression. The sheer scale of this issue, and the well documented impact on people’s ability to work and actively engage in the economic life of a country has led the World Bank to focus on mental illness at their annual Spring Meeting in Washington in April. At last year’s World Economic Forum, careful analysis in a report by a Harvard group resulted in an estimate that the annual global costs of mental illness to the economy was 2.5 trillion dollars in 2010, a staggering number that was expected to rise to 6 trillion dollars by 2030.

The joint meeting, called ‘Out of the shadows, making mental health a global priority’ will be run by the World Bank and WHO, from April 13th to 15th in Washington. It will be a forum to examine how the major financial actors in global development can address this issue. These key funders and politically powerful groups can hopefully start to play their role, joining development organisations like CBM, and other groups like service user organisations and activists, so make more resources available and raise prioritisation of mental health.

CBM will be well represented at the meeting. Carmen Valle will be sharing our experiences of working in Sierra Leone with partners to build resilience and reduce the psychological impact of the Ebola epidemic. This is a part of Disaster Risk Reduction that is often not sufficiently recognised. Information about this project with our partners in Sierra Leone is here. She will also be talking about how our partners ensured that access to important public health messages, for example during an epidemic like the 2014/15 Ebola outbreak, can be accessible to all people, including people with disabilities.

I will be speaking during a panel discussion on the topic of mental health and people with sensory impairments. The main points are that

  • Mental ill health is much more common in people with sensory impairments, but is often not recognised.
  • Mental health components should be integrated into services for people with sensory impairments, for example ensuring that service users themselves, and health and education personnel, are made sensitive to these needs and are aware of how to address them
  • The barriers that people with sensory impairments face should be specifically addressed in messaging relating to mental health by paying attention to accessible formats (as in any other awareness and public health work).

Carmen and Julian will be Tweeting and Blogging from the meeting. Follow our our blog, Twitter and Facebook to get all the latest news about the WHO meetings in Washington DC (the hashtag for this event is #mentalhealthnow). You can also follow Dr. Julian Eaton and Dr. Carmen Valle on Twitter who will be tweeting live from the events.

Additional information on the Innovation Fair can be found here.


Julian Eaton

Mental Health Advisor, CBM

The fourth summit of the Movement for Global Mental Health in Mumbai

The Movement for Global Mental Health was founded in 2008 with the aim of mobilising interested actors in a call for human rights for people with psychosocial disabilities, and access to good quality and affordable treatment, especially in the poorer parts of the world.  Since then, the Movement has held a summit every 2 years (previously in Athens, Cape Town and Bangkok) where members have come together to share, celebrate, and plan.

The membership of the Movement is diverse, taking in service users, care providers of all sorts, academics, and others.  The main method of communicating and networking is through a website; www.globalmentalhealth.org ; a good route to join the Movement!

The exciting decision was taken for this year’s summit in India was to focus on service users as a unique and powerful group within the Movement’s membership.  The theme was ‘Nothing about us without us’, and the event was organised by users and their organisations (in India), and had a programme largely devoted to contributions by people with psychosocial disabilities.

Panel Discussion "Nothing About Us Without Us".

Panel Discussion “Nothing about us without us”.

One of the refreshing differences from a typical conference was that there was a larger emphasis on creativity and expression than on academic or scientific activities (though there was scientific content as well).  For two days, we were privileged to hear powerful and inspiring stories from the lives of people with psychosocial disabilities, and those who live and work with them. We watched, and often joined in with, dance, art, drama and provocative discussions.

Forum Theatre by The Banyan

Forum Theatre by The Banyan

The conference organisers The Banyan and Public Health Foundation of India did a wonderful job of welcoming us, with the student volunteers at the venue (the Tata Institute of  Social Sciences) even giving up their own rooms for delegates. There was a positive atmosphere, and a strong sense of purpose, which was translated into the decision taken at the end of the summit to form a local group affiliated to the Global Movement for activities in South Asia.

CBM is proud to have been associated with the Movement since its inception, and will continue to share its aim of providing a strong voice for people with psychosocial disabilities and others committed to realisation of human rights for all.



You have the will, you have the power

The International Day for Persons with Disabilities is celebrated on Dec 3 every year. This year the theme is Inclusion matters: access and empowerment for people of all abilities, and one of the sub-themes is – Including persons with invisible disabilities in society and development.


Often when we think about ‘inclusion’, persons with physical and sensory disabilities come to mind.  We think about making buildings physically accessible for persons who use wheelchairs and printing books in Braille for children with visual impairments.
‘Inclusion matters: access and empowerment for people of all abilities’ is the theme for the 2015 International Day of Persons with Disabilities.  On this day, December 3, we will be called to remember that true inclusion will never occur unless persons with invisible disabilities are included in society and development. But what do we mean by ‘persons with invisible disabilities’?

Mr Kaikai and other service users in a group discussion on the issue of dignity, at the EAMH office in Freetown

Mr Kaikai and other service users in a group discussion on the issue of dignity, at the EAMH office in Freetown

Persons with invisible disabilities include those whose disabilities are not immediately obvious.  It is estimated that worldwide, 1 in 4 persons will experience a mental health condition at some point in their lives.  Despite being extremely common, mental health conditions are some of the most untreated and most stigmatized around the world.  People with psychosocial disabilities are amongst those forgotten and misunderstood because of the ‘invisible’ nature of mental illness, leading to human rights abuses.
As an example, in Sierra Leone, people with psychosocial disabilities have historically been under prioritized, forgotten and abused.  In the national health budget, less than 1% of the budget goes to the Sierra Leone Psychiatric Hospital, and 0% is allocated to other mental health services.  The mental health legislation of Sierra Leone, ‘the Lunacy Act,’ was written in 1902 and is yet to be rewritten or updated.  In addition, a shocking number of human rights abuses take place around the country on a daily basis, including the routine chaining of people with psychosocial disabilities.
Mr Kaikai is the secretary of the Sierra Leone Association of Service Users and Family Support Group, explains: “Thousands of people with mental health conditions around the world are deprived of their human rights. They are not only discriminated against, stigmatised and marginalised, but are also subject to emotional and physical abuse in both mental health facilities and within their communities.”


But things in Sierra Leone are slowly changing.  5 years ago, the Enabling Access to Mental Health programme began with the support of CBM and Global Initiative of Psychiatry (GIP) and funded by the European Union.  The aim of the programme was to do exactly what the name suggests: to improve access to mental health care.  A large focus of the programme revolves around mental health advocacy and it was for this reason that the Mental Health Coalition – Sierra Leone was born.

The coalition brought together a broad range of stakeholders: health care providers, teachers, religious leaders, local and international non-government organizations, and many other members interested in mental health.  The Coalition was successful at pushing for changes in mental health in Sierra Leone including launching the National Mental Health Policy and ensuring that patients received food and water during a strike at the psychiatric hospital.  However, until recently, there were very few people with psychosocial disabilities in the Coalition.  Despite having a safe and welcoming environment for people psychosocial disabilities, the Coalition continued to speak on their behalf rather than giving them opportunities to speak for themselves.


In 2014, however, a new committee within the Coalition was formed: the Sierra Leone Association of Service Users and Family Support Group. The group has 27 members: mental health service users and their family members. The group meets on a monthly basis with the aim of empowering service users to advocate with their own voice for better medical facilities, medication, social inclusion and respect for the dignity and human right of people with mental disability.

Mr Kaikai, Secretary of the Service Users and Family Members Association, at the beach in Freetown

Mr Kaikai, Secretary of the Service Users and Family Members Association, at the beach in Freetown

Mr. Kaikai highlights the importance of including family members in the group: “Something we will never forget is how much our families have suffered and how positive it was for them to get support from other families in similar situations. And also, even more important, we couldn’t have recovered if the family hadn’t been there with us, helping, understanding, encouraging. Our families own our lives.”

This group was established with 6 goals

  • To know each other better
  • To share views and experiences
  • To mobilise for action
  • To provide a platform for awareness raising on those issues that are crucial to  mental health
  • To minimise the stress and stigma attached to mental illness
  • To express the needs of service users to government and other service providers.

The group is working towards their goals by focussing their meetings on topics that members have decided are important, including: stress management, sharing experiences to offer each other support and group counselling from a qualified counsellor.
As the group continues to grow in empowerment, they continue to set new goals and ambitions.  They hope that group will expand in numbers so that more service users can benefit from their activities and experience an increase in confidence through the peer support that the group offers.

Mr. Kaikai says:  My advice to other service-users would be, don’t ever think you are just mentally ill people with no strength to achieve something great. You might also want to know that there is dignity in mental health, as there is no health without mental health.

In a country where persons with psychosocial disabilities were invisible, service users and their families are learning to take a stand in a united front, to speak loudly and to be seen.

“You have the will, you have the power.
Dignity in mental health.
You own the future.
Long live the Service Users and Family Support Group.”
-Mr. Kaikai, Secretary of the Sierra Leone Association of Service Users and Family Support Group

Sierra Leone celebrates Dignity!

This post is written by Carmen Valle – a Mental Health Specialist based in Sierra Leone.


Once more, we’ve celebrated World Mental Health Day in Sierra Leone.

This year felt special, as during October 2014 we couldn’t truly celebrate with as many activities as we wanted to. Ebola had made it impossible.

We were all in high spirit and fully supportive during Saturday’s events. I played my little role. And while seating there, surrounded by champions of Mental Health in the country I couldn’t stop thinking…. “We’ve done so much!”

Many of the special moments that were lived on Saturday could have not been a reality if it hadn’t been for Enabling Access to Mental Health (EAMH) and the other programmes in mental health that CBM has supported in Sierra Leone.

Members of the high table. Right to left: Director of Child Protection at MSWGCA; Secretary of Association of Service Users; CBM’s Mental Health Specialist; Chairman of the MH Coalition; Focal Person for MH at MoHS; Chief Nursing Officer; Deputy Minister of Health and Sanitation; Chairman of National Commission for Persons with Disability

Members of the high table. Right to left: Director of Child Protection at MSWGCA; Secretary of Association of Service Users; CBM’s Mental Health Specialist; Chairman of the MH Coalition; Focal Person for MH at MoHS; Chief Nursing Officer; Deputy Minister of Health and Sanitation; Chairman of National Commission for Persons with Disability

One of those special moments was the recognition of the 20 Mental Health Nurses deployed all across the country in the first ever decentralization of mental health services by the Ministry of Health and Sanitation. These are the nurses that for the past 4 years EAMH has trained and supervised, providing continuous support and capacity building. In one of the most emotive moments of the event, five of those nurses received from the Ministry of Health and Sanitation certificates of merit in recognition of their outstanding performance during 2015. CBM has also contributed to the creation of these District Mental Health Units.

The 20 Mental Health Nurses with some of the members of the high table

The 20 Mental Health Nurses with some of the members of the high table

Another very special moment was the speech of Mr Kakay, secretary of the first ever Association of Service Users of Sierra Leone, created by members of the Mental Health Coalition, which is an outcome of EAMH itself. In an event that has the theme of Dignity in Mental Health, Mr Kaikai raised his voice and eloquently expressed what Persons with Psychosocial Disabilities in Sierra Leone want and how they think dignity can be secured. He got a very deserved ovation.

The Deputy Minister of Health and Sanitation also showed his gratitude. He paused in his speech, put the papers down and removed his glasses: “Now, let me tell you something”. He’s not reading any more, he’s speaking out his heart. “ We have to thank Enabling Access to Mental Health so much. They have transformed mental health in Sierra Leone. I want to acknowledge all of them now and express my gratitude”.

The Focal Person for Mental Health at the MoHS, the Chief Nursing Officer, the representative of the Ministry of Social Welfare, the Chairman of the National Commission for Persons with Disability and the Chief Community Health Officer also contributed with statements full of passion, acknowledgement of the work done and commitment to continue doing what still needs to be done. One of those urgent things, as stated by the Deputy Minister, is the review of the Lunacy Act of 1902. The commitment of the Government of Sierra Leone to develop an updated Mental Health Legislation was well established during the event.

The Coordinator of EAMH at the MH Coalition and the Mental Health Specialist, happy to celebrate

The Coordinator of EAMH at the MH Coalition and the Mental Health Specialist, happy to celebrate

By the end of the celebration all attendees committed to dignity. Not as a theme for the day, but as a personal vow that everyone should continuously remember, in every interaction, at all moments.

Happy World Mental Health Day!!