Treating Common Mental Health Disorders in Burma and the need for Comprehensive Mental Health Policies

Introduction

In 2015, two of the ten health problems that cause most disability in Burma were mental health problems: depressive and anxiety disorders (IHME 2015). Prevalence of both of these disorders is increasing (WHO 2017a). They make up what are called Common Mental Health Disorders (CMHDs). Effective therapies are available for CMHDs, however, the majority of the world’s population does not have access to these treatments. In Burma, the treatment gap for CMHDs is nearly 90% (Than Tun Sein et al. 2014). Recent political reforms in Burma create a window of opportunity for policy makers to strengthen the mental health system. The Assistance Association for Political Prisoners (AAPP) is amongst Burma’s leading implementers of, and supporters for the improvement of, mental health services. This is AAPP’s first advocacy report on mental health.

Published by AAPP 5

Introduction

In 2015, two of the ten health problems that cause most disability in Burma were mental health problems: depressive and anxiety disorders (IHME 2015). Prevalence of both of these disorders is increasing (WHO 2017a). They make up what are called Common Mental Health Disorders (CMHDs). Effective therapies are available for CMHDs, however, the majority of the world’s population does not have access to these treatments. In Burma, the treatment gap for CMHDs is nearly 90% (Than Tun Sein et al. 2014). Recent political reforms in Burma create a window of opportunity for policy makers to strengthen the mental health system. The Assistance Association for Political Prisoners (AAPP) is amongst Burma’s leading implementers of, and supporters for the improvement of, mental health services. This is AAPP’s first advocacy report on mental health.

0.1 AAPP’s Mental Health Assistance Program

For the last several years, AAPP has had the opportunity to work with Johns Hopkins University (JHU) Applied Mental Health Research group to implement a novel and promising mental health treatment program, named Common Elements Treatment Approach (CETA). CETA trainers began educating actors from the civil society to practice alongside them and extend the reach of the program. The Mental Health Assistance Program (MHAP) is now an integral part of AAPP’s work. AAPP has witnessed the life-changing effects that mental health treatment can have on people suffering from mental health disorders. But AAPP has also experienced first-hand how fragile Burma’s current mental healthcare system is. AAPP raises awareness of mental health treatment at all levels of society. AAPP collaborates with the Ministry of Health and Sports in Burma, Burmese universities, international research groups, actors of civil society, and many more. Together, AAPP works for a system where people suffering from mental illness are no longer neglected, but get the healthcare they are entitled to.

0.2 Aims

This report aims to:

– Explain the importance of providing evidence based mental health services for CMHDs, in particular to the Burmese population;

– Show examples of the successful implementation of CETA; and

 – Outline AAPP’s recommendations for strengthening the mental health system in Burma after years of experience in the field

0.3 How to use this report

This report is meant for policy makers of Burmese health policy; all medical care providers and providers of mental healthcare in particular; providers of public service, such as all health workers, prison staff, police, teachers, military, and social workers; students in all these fields; national and international academics; staff from non-governmental organizations (NGOs), international NGOs (INGOs) and civil society organizations (CSOs); and any other interested parties.

Depending on their background, readers will use this report in different ways. Chapter one through four are largely informative, and will be useful to those with less experience in mental healthcare or the Burmese context. Others who have experience in mental healthcare in Burma will be able to briefly scan through these sections. Chapter five is more narrative and illustrative, and will be interesting to those not familiar with CETA. AAPP strongly recommends all readers to read the recommendations set out in chapter six. These recommendations can give anyone an idea of what they can do to support and contribute to mental healthcare in Burma.

A list of recommended readings is included at the end. This serves to elaborate on some of the major issues this reports argues for, but that are sometimes touched upon only briefly because of space limitation.

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