Multi-sectoral approach lacking for emerging mental health issues

The Ministry of Health developed a national mental healthcare framework calling for collaborative efforts from all stakeholders



Critically, inclusive multi-sectoral collaboration to mental health will allow the stakeholders to make the mental wellbeing of the people a priority beyond the mental healthcare system, yet there is a dearth of explicit and coordinated responses in meeting the growing mental health needs.

Despite many ongoing efforts from different stakeholders to support and promote mental health and wellbeing, an integrated and whole-of-society response has become even more critical with the mental health issues weighing most heavily on populations.

With so much more recent attention on the growing mental health issues in the country, the Ministry of Health (MoH) developed a national mental healthcare framework calling for collaborative efforts from all stakeholders sharing a common goal to enhance the mental well-being of the people struggling with mental health issues.

The framework provides a roadmap to ensure good mental wellbeing for all through a multi-sectoral approach and emphasizes reinforcing, reorienting, and starting new mechanisms to enhance mental health services for all.

Focusing on four major domains – leadership, governance, and mental health system, integrated and responsive mental health services, mental health promotion and prevention of mental illness, and data and information system for mental health – it expects to make meaningful links across sectors.

“These initiatives by various agencies provide opportunities to build on and re-orient our efforts to strengthen commitments to deliver timely, reliable, and effective interventions,” reads the framework document.

And such an approach that has much to teach each other also means strengthening the ongoing efforts of all stakeholders, implementing evidence-based and sustainable interventions.

This is because good performance in mental health is not limited to access to health-based care and services, but rather must include a wide range of sectors including relevant governmental and non-governmental agencies, schools and workplaces, as well as other community actors, among others.

“Determinants for mental health are multidimensional as it is influenced by social factors, economic reasons, genetic factors, working environment, health status, and family environment. Any changes in any of these factors elevate the risk of mental health issues at any point of time,” it stated.

Lack of collaboration among stakeholders

While there have been increased efforts over the last two decades when it comes to mental health, what typically are absent from these efforts are coordinated implementation for better impact and concerted effort and support for people with mental health-related issues to encourage service-seeking behavior and community-based recovery.

This is also problematic given the lack of coordination among stakeholders for advocacy and interventions and inadequate financial support for stakeholders to expand services such as treatment and rehabilitative and also effective recovery.

An integrated and responsive mental health service is also a concern. More often than not, some mental health professionals like psychologists and social workers are not incorporated in the civil service cadre for the provision of specialized services.

“Due to inadequate mental health professionals, stigma, discrimination and low mental health literacy associated with mental disorders, people requiring mental health services may not be availing services.”

Considering the emerging mental health issues and needs of vulnerable groups, it calls for a responsive and resilient system while also recommending integrating mental health services in primary healthcare centers and general hospitals.

It also touches upon the lack of rehabilitation centers for addiction and mental health-related disability for recovery and reintegration, a uniform model for treatment in rehabilitations, follow-up care services, infrastructure in the national referral hospital and schools and universities referral and follow up.

Other challenges include lack of workplace-based support for mental health, government, corporate and private sectors, school-based care and support, care for caregivers, follow-up for suicide cases, including suicide postvention services, among others.

In addition, a national-level mental health survey has not been conducted and many of the attempted suicides are not captured as they are not reported or not coming for professional help for their suicidal behaviors.

“The national-level survey would provide a more reliable prevalence of different mental illnesses for evidence-based interventions,” it stated.

Meanwhile, the groundbreaking ceremony for the construction of a 60-bedded Mental Health Center (MHC), as part of Multi-Disciplinary Super Specialty Hospital in Thimphu national referral hospital campus will take place in the coming days.

This will bring more specialized services through appropriate human resources – general psychiatrists, clinical counselors, psychiatric nurses, and other health professionals – and the required infrastructure to strengthen the integration of mental health services in health care centers.

The national mental health program was established in 1997 to promote mental health, prevent mental disorders, and enhance treatment services.