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Women Leaders Put Mental Health on World Agenda

By Rosalynn Carter

Mrs. Carter's op-ed will run in the publications listed below during May, which is Mental Health Month. Scripps Howard News Service will also distribute the op-ed to 380 newspapers nationwide.

  • APA Monitor
  • Claiming Children
  • Compeer News
  • Journal of the American Psychiatric Nurses Association
  • Journal of Psychosocial Nursing
  • Mental Health Weekly
  • Psychiatric News
  • Psychiatric Times
  • Renaissance Center News
  • The Bell (National Mental Health Association)

Seven days a week, 24 hours a day, a group of 100 psychologists answers five phone lines at the Red Cross in Mexico City. Together, the rotating staff makes up the National System of Psychological Support by Telephone (SAPTEL), handling nearly 4,000 calls a month. Established in 1985 to help people cope with the physical and emotional devastation caused by two earthquakes, SAPTEL, which is free to callers, remains the only accessible means of mental health care for many of the city's 15 million residents. While a valuable service, it is clearly not enough.

Many developing nations lack adequate mental health care resources and facilities. Worldwide, nearly 500 million people suffer from some type of mental illness, ranging from mild depression to chronic schizophrenia.

A report released by the Department of Social Medicine at Harvard Medical School, "World Mental Health: Problems and Priorities in Low-Income Countries," tells us that "while basic physical health has improved worldwide, mental health has remained stagnant or has deteriorated....An increase in the incidences of clinical depression, schizophrenia, dementia, and other forms of chronic illness has accompanied increases in life-span because more people live to the age of risk." We need a global model of what can - and must - be done to help those who cannot help themselves.

I chair the World Federation for Mental Health's International Committee of Women Leaders for Mental Health. Established in 1992, the committee provides first ladies and others with an opportunity to review unfortunate trends and consider steps they can take to promote extensive studies of mental health issues and to devote more resources to resolving them. Recently, The Carter Center and the Federation convened a meeting in Washington, D.C., of first ladies, ministers of health, and health experts from more than 20 Western Hemisphere nations.

These leaders readily adopted improving world mental health as their personal mission, in part because women and children suffer disproportionately from indirect yet tragic links to mental illness. For instance, in several poor nations, where the mental health status of populations is worst, many women head single-parent households. Often these women are not well educated or skilled and are unable to adequately support themselves and their children. Stress from such situations can trigger serious and extensive states of anxiety and depression, among other conditions.

Being unable to afford necessities such as food and medical care compounds the problem. According to the Harvard study, certain mental conditions can be aggravated by malnutrition, which is common to the least affluent nations and evident even in wealthier societies. Moreover, women and children often suffer due to a husband's or father's mental illness or abuse of alcohol or other drugs. Rates of domestic violence in certain low income countries vary from a "low" of 20 percent to a high of 75 percent.

But these problems are not limited to developing nations. Together, depressive and anxiety disorders are responsible for between one quarter and one third of all primary health care visits in developed countries.

Numbers alone do not reflect the suffering, frustration, violence, and humiliation that many people must bear because society fails to deal effectively - and compassionately - with mental health issues. Sadly, in some countries, it is still common for mentally ill persons to be shunned to the point of near isolation. We cannot afford to ignore such pain. Again, I cite the Harvard report: "Mental health represents one of the last frontiers in the improvement of the human condition. In the face of widespread stigma and inattention, mental health must now be placed on the international agenda."

To support this effort, first ladies attending the International Women Leaders for Mental Health meeting signed a joint statement before leaving Washington. They pledged to:

  • promote at least one activity in each of their countries to improve the mental health of citizens;
  • assist in establishing international mental health programs;
  • support nongovernmental organizations involved in fostering mental health;
  • promote inclusion of mental health on the agenda of the 7th Conference of First Ladies and Wives of Heads of State to be held in Panama in 1997;
  • call upon governments that have not done so to ratify the Inter-American Convention for the Prevention, Punishment, and Eradication of Violence Against Women and request that signatory countries implement and enforce its provisions;
  • ask international financial and technical organizations to assist with efforts to promote mental health in the Western Hemisphere

In the United States, Congress has made progress in the battle for greater equity in treatment of mental illness. By prohibiting health insurance companies from placing greater restrictions on coverage for mental illness than for physical ailments, it has shown that compassionate, effective policy can be crafted to help people in need.

The commitments of the committee of women leaders and innovative, community outreach programs such as SAPTEL, serve as models of how the status of mental health can be improved worldwide. It is imperative that all nations support and emulate such efforts - keeping mental health at the top of our international agenda.

Former First Lady Rosalynn Carter is speaking out during Mental Health Month in May to call attention to the need to place mental health issues high on our international agenda. Chair of The Carter Center's Mental Health Task Force in Atlanta, Mrs. Carter also served as honorary chair of the President's Commission on Mental Health in the late 1970s. To highlight the need for countries to prioritize mental health issues, The Carter Center and the World Federation for Mental Health will convene a meeting of the International Committee of Women Leaders for Mental Health in Helsinki, Finland this July, with Mrs. Carter serving as Chair.

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