80 percent of the mentally ill live in low or middle-income nations. So why aren’t we doing anything about them?

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The sun is scorching hot, and the two leafless trees provide little refuge in the way of shade. The village dwellers barely notice. Especially one young boy, probably 8 years old.

His face lacks the youthful exuberance you would expect and is replaced with grave concern, sewn deep into the fabric of his soul. Diagnosis: Hatred from the gods. At least that’s what he’s been told since he started acting strangely a few years ago. What else could cause the paranoia and compulsions he’s tried so hard to hide?
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In reality, the small African child is victim of a severe case of obsessive compulsive disorder (OCD) and depression. But how would anyone in his small village possess that knowledge? Only in the last few generations have wealthy nations with available research monies begun to form an understanding of the inner workings of the mind and its applicable abnormalities.

Prior to this new understanding, those suffering from mental illnesses were largely treated as criminals, often grouped together in the same cells and shackles, beaten and left unclothed. Dorothea Dix, well-known reformer in the 1840s, reported this type of activity—in Massachusetts. Her eyewitness report went as far as to include the story of one patient, kept in a “close stall” for 17 years. Sadly, this activity carried on for several generations.
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In the late 1800s, New York World reporter Nellie Bly went undercover as a mental health patient in New York’s infamous Blackwell Island Insane Asylum. The resulting work, Ten Days in a Mad-House, went “viral” and helped to reform the inexcusable injustices in government-run mental health facilities.

Bly called the asylum on Blackwell Island “a human rat-trap. It is easy to get in, but once there it is impossible to get out.” Bly personally experienced ice-baths and forced isolation. She also described the choking and beatings that other inmates experienced. Possibly the most damning conviction was the fact that foreign women, incapable of communicating in effective English terms, were hauled off to Blackwell—in spite of being perfectly sane.

Thankfully, there are no “Blackwell’s” in today’s United States, even though injustices still exist; see Juliann Garey’s recent article in The New York Times. But as a whole, the research dedicated to mental health and the services available are worlds apart from the early 1900s.

If the West is just advancing from mental health’s Dark Ages, then most developing nations are still firmly planted in its Ice Age.
Unfortunately, these great strides haven’t made the leap over poorer nations’ borders. Not even close. If the West is just advancing from mental health’s Dark Ages, then most developing nations are still firmly planted in its Ice Age.

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According to the World Health Organization (WHO), more than 80 percent of people suffering from mental disorders live in low- or middle-income nations. The vast majority of this group has no access to mental health care. Furthermore, though mental illnesses account for approximately 13 percent of the Global Burden of Disease, they are beneficiaries of only 2 percent of world health expenditure.

Take Ghana for example, 2.2 million of the 22 million-member population suffer from mental illnesses or epilepsy. Far too many patients for the 12 active psychiatrists and three public psychiatric hospitals in the country.

Chris Underhill, founder of Basic Needs, a mental health advocacy pioneer, became painfully aware of the crisis when traveling overseas several years ago. “(I)n rural areas of Africa and Asia, it is common to chain people in shackles and put them in cages to ensure their control. It was therefore clear to me that mental health is a hugely neglected area,” he wrote in an article on Takepart.com. Cases like this are the reason the WHO has declared mental health “a global human rights emergency.”

In an era completely invested in social justice and charitable campaigns, most of us are unaware that a need of this magnitude even exists. How do we account for such a discrepancy? And it’s not solely on a personal level. The mental health community at-large seems to lack a real plan to tackle the growing issue.

If any organization should champion the cause of those in mental darkness, it’s the Church.
In his 2010 article titled, “Mental illness and the developing world,” author Andrew Chambers argues that the overwhelming need for funds and organizations devoted to mental health may be due to a lack of empathy. Compared to more “visible” diseases (i.e. AIDS, malaria, etc.). “It is much more difficult to generate that empathy: there are no externally apparent symptoms to create a good snapshot image, and indeed it is very difficult to understand what living with schizophrenia or bipolar disorder would actually be like,” he writes.

Despite the difficulty in assessing these needs, we can rely on our own nation’s dark past and the testimonies of friends and family who suffer from similar disorders to foster the compassion we need to take action. This starts with addressing mental illness as actual illness. Failure to understand and empathize with those suffering within our own borders will certainly keep us from seeing the bigger picture, and prevent us from donating our time and money to those who desperately need it and unknowingly beg for it.

If any organization should champion the cause of those in mental darkness, it’s the Church. Dorothea Dix proclaimed this in her 1843 Memorial to the Legislature of Massachusetts: “Could we in fancy place ourselves in the situation of some of these poor wretches, bereft of reason, deserted of friends, hopeless; troubles without, and more dreary troubles within, overwhelming the wreck of the mind as ‘a wide breaking in of the waters,’—how should we, as the terrible illusion was cast off, not only offer the thank-offering of prayer, that so mighty a destruction had not overwhelmed our mental nature, but as an offering more acceptable devote ourselves to alleviate that state from which we are so mercifully spared…”

This “devoting of ourselves” as the Church should be through prayer, through action and maybe even through financial means. Organizations such as Basic Needs, who are devoted solely to issues of mental illness abroad, are perfect places to start.

Maybe then, if we start to do our job, the young boy can breathe a sigh of relief.

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