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Improving mental health in Afghanistan

U of C medicine professors promote mental health care and decrease stigma

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University of Calgary professors have been given a grant to improve mental health care in Afghanistan. The funding was provided through Grand Challenges Canada, an organization that funds research and innovative projects in the developing world.


Faculty of medicine professors Richard Scott, Scott Patten and Mone Palacios will be leading the project. The research will use e-health, a method of incorporating technology to increase knowledge of mental illnesses in developing countries, mainly using cellphones and telecommunication. The initiative will also be training health-care workers in the northeastern province of Badakhshan, Afghanistan.


According to the World Health Organization, about 75 per cent of people with mental health disorders live in developing countries and 85 per cent of those affected do not receive treatment. 


Afghanistan does not have a regular budget allocated for mental health and less than one per cent of all health expenditures in 2004 were directed towards mental health. 


“Mental health disorders are a leading cause of suffering and disability everywhere, but the problem is especially acute in the developing world,” said chief executive officer of Grand Challenges Canada Peter A. Singer in a 
U of C press release. “There is very little funding for mental health innovations in low- and middle-income countries, where mental illness is the most neglected of many neglected diseases. It’s a terrible denial of human 
potential.”


The U of C will be collaborating with the Aga Khan University, an international university based in Pakistan, as well as with local psychiatrists in Afghanistan.


“The project is fairly complex and it involves several components. Part of it involves doing some surveys and trying to understand the level of awareness and knowledge about depression as well as looking at stigma,” said Patten, who will be working with the team as an epidemiologist and psychiatrist. 


Stigma is one of the major roadblocks to mental health alleviation and may lead to work place discrimination. According to the WHO, many people perceive those affected by mental illness to be dangerous and aggressive. This is a misconception that may lead to social isolation.


“The local people in Afghanistan and the specialists at Aga Khan believe that a good place to start is with knowledge,” said 
Patten.


Part of the project will involve local community health workers to act as the first point of contact for many patients. Distance technologies such as cellphones will be used to increase communication, especially to establish consultative links between health workers and specialists. The final part of the project is to improve information and record keeping, said Patten.


“It is at a planning stage, so we are holding weekly teleconferences and so far what has been accomplished is consultation with local professionals in Afghanistan and a selection of districts to be included,” he said. 


Patten said that there will be follow-up consultations, interventions and repeat survey work to see if there is improvement of mental health care in the region. 


“It is a key part of the Grand Challenges grant that everything be evaluated. The proposal does not include specific targets, but it does include fairly specific goals and part of it is looking for higher levels of knowledge and lower levels of stigma,” said Patten. 


He said that, in addition to survey work, there will be consultation with community and religious leaders to best decide how to carry out education sessions.

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