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The Royal College of Psychiatrists Improving the lives of people with mental illness
   
World Mental Health Day


World Mental Health Day

2016

 


The theme for this year's World Mental Health Day (WMHD, 10 October 2016), set by the World Federation for Mental Health, is Psychological and Mental Health First Aid and the support people can provide to those in distress.  The World Health Organization recognises WMHD as an opportunity to raise "awareness of mental health issues around the world and mobilise efforts in support of mental health".

The Royal College of Psychiatrists is highly engaged in the promotion and support of mental health globally. Further reading below:

 


Dr Mandip Jheeta, Somaliland


Case study - SOMALILAND

Dr Mandip Jheeta, ST5, General Adult Psychiatry,

SIAS (Solihull Integrated, Addiction Services),

The Bridge, Chelmsley Wood, Solihull

Contact: mandipjheeta@gmail.com



In the Autumn of 2013 I visited Somaliland, a self-declared independent state located on the northern edge of the horn of Africa. It is a post-conflict area, after the civil war ended in 1991, with a significantly underdeveloped healthcare system. Mental health is a particularly neglected area. I spent two weeks teaching psychiatry as part of the King’s THET Somaliland Partnership (KTSP) charitable project. The project works alongside local partners to ensure that medical and nursing students have access to an international education that is both culturally sensitive and relevant to Somaliland.

Alongside Lauren Gavaghan, another UK-based psychiatry trainee, and a team of Somali co-tutors and staff, we taught and examined 68 university students how to recognise and manage common mental health problems. In additon to learning a lot myself and skills I could apply in my own practice, it was immensely gratifying to see the students, some of whom had their own apprehensions and misunderstanings of mental illness, transform into a group enthusiastic about and comfortable with people with mental illness.

The training was based on the WHO Mental Health Gap Action Programme (mhGAP) manual, which is designed to train non-specialists how to recognise and manage most mental health problems, especially where there is no psychiatrist.







Africa Inland Mission, Chad


Case Study – CHAD

Dr Noel McCune
Retired Consultant Child Psychiatrist, Newry, Co Down.

Contact: noelmcc@doctors.org.uk

 

In the Autumn of 2014 I visited Chad, a country in which there is only one psychiatrist for a population of 11 million. I had received a request from Dr Ann Fursdon of Africa Inland Mission for a psychiatrist to come and teach primary care nurses about mental health disorders. She felt there was a lack of understanding of how to treat them and that the WHO mhGAP programme would be appropriate as a means to train up nurses.

The teaching lasted five days, during which time I found the greatest interest to be in the treatment of psychotic and bipolar disorders as well as alcoholism. Over the next three weeks the teaching was followed up by visits to health centres with the goal of supervising nine of the nurses putting their training into practice.

During my time in Chad I saw a range of mental disorders and indeed 'treatments'. The nurses gained good experience providing psycho-education.  Hopefully  the training will have helped ensure that people who have often been physically restrained will receive a proper diagnosis and treatment, and that the nurses will be more able to talk directly to patients  where previously they would have let other people speak on their behalf.










Training in Dohuk



Case study – IRAQ

Dr Peter Hughes is a consultant psychiatrist based at Springfield University Hospital, London.
Peter is the RCPsych Blog Editor and Chair of VIPSIG 

Contact details: Peter.Hughes@swlstg-tr.nhs.uk



In early 2015 I was given the opportunity to go to Iraq on a training mission to support mental health care provision in the refugee and internally displaced person’s camps that have sprung up as a result of the Syrian and Northern Iraqi crises. It was a complex mission involving different UN organisations and health departments in and around the region.

The arrival of Daesh has completely transformed the humanitarian landscape, and the need for mental health care in a region with very few psychiatrists is acute. Capacity is stretched and provision is insufficient for the large amount of cases of depression, anxiety and stress to be found in the community.

Psychotropic medicine is limited, and only trained doctors are allowed to prescribe psychotropic drugs; this includes antidepressants. Some of the issues I encountered included young men feeling isolated and listless and women of all ages experiencing sexual violence. I also found that many children were having nightmares after witnessing family members being killed and as a result displayed aggressive tendencies.

What I found particularly striking was the different concept of mental illness, reflected in its treatment. Religious observance, familial closeness and even a toy workshop where mothers could make toys for their children by way of therapeutic activity were seen as ways of treating mental illness. In these types of humanitarian circumstances, listening to people’s grief and pain is as important as CBT. Even something as simple as requesting a washing machine to help alleviate the stress of mothers dealing with children who wet the bed out of their own stress was employed as a tactic.

Despite the emotional strain, it was a good experience and so too was the feeling that I had been able to help train people in some new skills in mental health and psychosocial support.






Myanmar Medical Centre
Case study - MYANMAR
Dr Bradley Hillier
Specialist Registrar in Forensic Psychiatry in South London.
Contact: bradley.hillier@gmail.com

In 2015, I travelled with six other UK psychiatrists to Myanmar (formerly Burma), a country whose modern history has been characterized by persistent human rights violations, ethnic conflicts and widespread poverty.

In conjunction with the UK-based charity “Mind to Mind” set up by Myanmar native Dr New Thein, we were to train primary care doctors in how to use mhGAP. Our “trainees” were 60 GPs working as private practitioners in the community. In addition to mhGAP training we also decided to incorporate some easily accessible psychosocial and practical approaches which we thought would be of great immediate use within the context of busy GP clinics where time pressure is high, and where patients may be under financial difficulties. We even had the opportunity to teach and practice through role play simple family interventions and psychological first aid.


As a primarily Buddhist country, meditation and mindfulness are well established culturally integrated practices. It was possible to readily translate and demonstrate how these could be used as relaxation techniques for distressed, anxious or depressed patients, and this was a source of some extremely interesting discussion about their use in Western countries. I found myself increasingly wondering whether it is possible for us as Westerners to learn in our approach to mental health care as opposed to naturally adopting the role of teacher.

 

 

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