Mental health and suicide: when the alarm bells are faced with deaf ears

This article was exclusively written for The European Sting by Ms. Imane Oujaa, a third-year medical student in the Faculty of Medicine and Pharmacy of Marrakesh, Morocco. She is affiliated to the International Federation of Medical Students Associations (IFMSA), cordial partner of The Sting. The opinions expressed in this piece belong strictly to the writer and do not necessarily reflect IFMSA’s view on the topic, nor The European Sting’s one.

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The sound of alarm bells demanding us to take action on the compounding issue of mental health are as distressing as they can get, yet the silence with which they are met remains as deafening as ever. With a total spending on mental health ranging from 5,1% of the total health spending in high-income countries to 0,5% in low-income ones, saying that mental health is under budgeted would be an understatement. Very low value is placed on the populations’ mental, psychological and emotional well-being, and the pressing issue of mental disorders is relegated to the background. The light approach adopted towards this matter strikingly contrasts with the always-growing rates of suicide and mental illness worldwide. According to WHO, close to 800 000 people die due to suicide every year, which is one person every 40 seconds, and there are indications that for each adult who died by suicide, there may have been more than 20 others attempting suicide. Furthermore, one in four people in the world will be affected by mental or neurological disorders at some point in their lives. Around 450 million people currently suffer from such conditions, and even though treatments are available, nearly two-thirds of people with a known mental disorder never seek help from a health professional. “Stigma, discrimination and neglect prevent care and treatment from reaching people with mental disorders,” says WHO. “Where there is neglect, there is little or no understanding. Where there is no understanding, there is neglect.” This statement seems to be the rule in vigour, and Morocco is no exception to that rule. According to WHO’s Mental Health Atlas 2017, the Moroccan mental health workforce per 100.000 population is as follows: 0.84 psychiatrists, 0.14 child psychiatrists, 0.57 psychologists, and 0.65 social workers. Strategies for suicide prevention and child/adolescent mental health remain inexistent, in a time when Morocco shows 3.6 female suicide deaths per 100,000 people (WHO’s suicide report), making the kingdom’s rate the highest female suicide rate in North Africa. In addition, a Moroccan national study on prevalence of mental disorders shows that, among 5498 subjects interviewed, 40.1% had at least one current mental disorder. Current major depressive disorder was the most common (26.5%), and at least one anxiety disorder was found in 37% of the sample. The data is alarming and requires a plan of action to promote mental health and prevent suicide in Morocco both nationally and locally. However, this article will only cover actions that can be taken on the local scale. Promoting mental health and suicide awareness can be progressively achieved, and fighting stigma would be the first step towards that aim. Addressing this matter and removing the taboo veil over it is vital, and can be done through sensibilisation campaigns in schools and workplaces, social media campaigns, short movies and plays, open debates, round-tables, banners and flyers displayed in schools, hospitals, and administrations, the ultimate goal being putting the subject on the table and getting people to express their opinions about it. Encouraging people to talk about mental health and explaining to them that mental illnesses are as normal as other physical illnesses will help ease the stigma around mental disorders and the patients who suffer from them. Once this goal is achieved and people feel more comfortable talking about mental health and suicide, the second step would be educating them and raising awareness by explaining what mental health is, showing its importance, its impact on the personal, familial, social and economic aspects of life by sharing rates of mental illnesses and suicide, the influence they have on the subject’s family, friends and community, the cost they engender… This could be achieved by many means, including but not limited to workshops, educational videos, short articles on local newspapers, digital flyers shared on social media, advertisements on the television and radio, seminars and many more. By applying this, people should be aware of the importance of mental health and start being its advocates, taking it upon themselves to educate their families and friends and share their knowledge with them. The next thing to do would be to gather information on the local state of mental health and access to mental health services. This requires conducting studies on the need of mental health services compared to the use of them –as a great number of people who need professional help don’t often seek it-, gathering data on the prevalence of mental illness and suicide in the community, the risks and the protective factors. Visiting the centers that provide health services and conducting studies on their state would also be necessary to evaluate the services’ quality and improve the lacking areas. Building more facilities, forming mental health professionals, establishing mental health awareness and suicide prevention programs and hotlines, and controlling alcohol and substance use in the area are also effective ways to achieve that purpose. Promoting mental health and preventing suicide is a must that we can no longer get around. It is not only our governments’ responsibility, but also ours as citizens and members of our societies. Reaching a higher level of awareness can only be achieved through a combination of efforts of the governments, medias, individuals and NGOs to face an issue that had only been ignored for long. About the author Imane Oujaa is a third-year medical student in the Faculty of Medicine and Pharmacy of Marrakesh, Morocco, and a member of the International Federation of Medical Students of Morocco. A fervent advocate of mental health promotion and suicide prevention, she believes that fighting the stigma around mental illnesses is the first and most important stepping stone towards understanding them better, and thus treating them better, and hopes to help her country achieve that aim.