Does society’s ignorance, stigma deprive many of treatment?

World Mental Health Day

(Photo: Jordan News)
Humanity marks World Mental Health Day on October 10 each year. Most would agree the day has added poignancy in these challenging times we are living through, from global pandemic to global warming and the resultant economic and political fallout of both. A spotlight on mental health has never been more needed.اضافة اعلان

The WHO defines mental health as “a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.” 

What progress has Jordan made in mental health reform and what can still be done to better improve conditions for those afflicted.

Scope of the problem

Unfortunately, little data regarding those suffering from mental health conditions in Jordan exists. One study in 1997 found that the prevalence of patients receiving care in primary health care centers for psychiatric disorders was 61 percent, which was higher than the 47 percent reported in neighboring countries. 

Similarly, in 2008 the Jordanian Psychiatrics Association estimated that between 15 to 20 percent of Jordanians have some form of mental illness, which is higher than the accepted global estimate of 13 percent. 

More concerning is the gap between prevalence and treatment of mental health conditions in the Kingdom. In 2013, the WHO estimates that a little over half a million Jordanians suffer from some form of mental illness, of those 23 percent were estimated to have severe mental disorders while 77 percent suffered moderate to mild mental disorders. Based on 2010 data for treatment provided, only 26.2 percent of people with severe mental health problem were treated resulting in a 73.8 percent gap between treatment and prevalence. 

Early days of mental health reform

Starting in 2008, the WHO, the Ministry of Health, and the Jordanian Nursing Council (JNC) partnered together under the royal patronage and support of HRH Princess Muna Al-Hussein to reform the mental health system in Jordan. The National Steering Committee for Mental Health was developed as a result. Their goal was to develop a national mental health policy and plan among other tasks. 

By 2010, the WHO recognized that Jordan needed intensive support to strengthen its mental health care system. The Kingdom was selected as the first country to implement the WHO Mental Health GAP Action Program (mhGAP). The goal was to integrate mental health into primary health care. 

The focus of mhGAP was on increasing services for mental, neurological, and substance abuse disorders, while also providing treatment options for the more prevalent mental health conditions such as depression, schizophrenia, and epilepsy in primary health care facilities. In 2011, Jordan launched the National Steering Committee’s National Mental Health Policy and Plan in preparation for the implementation of mhGAP. The pilot run of mhGAP was launched the same year, and by 2012 Jordan had made great strides in reform.

The problem today

A 2020 study published in the Journal of the Royal Medical Services, assessed the negative implications of stigma that mental health patients experience. In their report they found that approximately 20 percent of Jordan’s population suffers from mental illness and of all patients being treated in Jordan, patients with a confirmed diagnosis for mental illness account for 6.6 percent. 

The report examined a sample pool of mentally ill patients who either delayed or stopped treatment, showed noncompliance with treatment regimens, and experienced delayed improvement of their condition. Of these individuals, it was found that 41 percent attributed reluctance to proceed or continue with treatment, to stigma relating to their condition. Based on these findings, it was clear that despite improvements in how mental illness is treated or managed in the Kingdom, public perception of mental health issues hasn’t, but should change.

A separate study aimed to investigate the cause of the stigma society attaches to mental health issues and disorders. The study focused on people’s perception of schizophrenia, depression, and anxiety. The results were rather concerning, and likely the result of poor education and lack of proper awareness of mental health issues. 

Participants in the study had a decidedly negative viewpoint on schizophrenia sufferers in particular, as 61 percent agreed with the statement that schizophrenics are a “danger to others,” while 27 percent agreed that they “have only themselves to blame for their condition,” and 22 percent agreed with the statement that they “could pull themselves together if they wanted to.”
This study as well as others have suggested that the reason behind this general attitude is derived from cultural factors, especially those associated with personal relationships within Jordanian families. Furthermore, as a result of the social stigma the family burden on sufferers is believed to be exacerbated due to the reduced likelihood they would seek treatment. 

Read more about Health