Mental health in a drawing
By Mackenzie Currie
This post is part of a series of opinion pieces in diverse mediums focusing on the theme “What makes you mad about global health?” These submissions are by McGill students who were part of the course PPHS 511 Fundamentals of Global Health in Fall 2021.
“Without mental health there can be no true physical health.” Dr Brock Chisholm, Director-General of the World Health Organization (WHO), 1954.
In the past few years, we have seen a significant increase in mental health advocacy and a general shift in conversations about mental illness to destigmatize conditions of which 30% of the global populations suffers annually (Ngui et al, 2010). However, mental health remains one of the most neglected health problems globally – especially in low and middle-income countries (LMICs) (Brunier, 2020). In addition to the inaccessibility of mental health resources, discrimination and stigma are major barriers for accessing mental health care among these populations. The neglect of mental health in LMICs and Global Health is a dark topic, especially when considering the colonial history of Western psychiatry and horrific notions that non-Western people were “protected from mental illnesses due to the posited absence of civilisation therein” (Whitely, 2015). Although everyone today would denounce this blatant racism, many are apt to ignore the covert ways in which these racist sentiments are perpetuated through neglectful care of mental illnesses in LMICs.
Mental and physical health are inseparable, and mental disorders are often accompanied by comorbidities such as noncommunicable diseases. For clinicians, it may be easier to focus on physical disease and completely ignore the accompanying mental disorders (or write them off as ‘side effects’ that may be cured by treating their physical ailments). In turn, individuals suffering from mental illness are at greater risk of developing physical health conditions. This leads to a vicious cycle of poor physical and mental health outcomes. The neglect of global mental health is infuriating – mental health care is a human right, not a luxury for wealthy nations. Poor mental health is a huge contributor to enforcing cycles of poverty, disease, and general human suffering. The same urgency to treat physical illness is not seen for mental illness. How are individuals expected to take their mental health seriously when the health care system neglects its existence?
My creative assignment was inspired by a quote from Dr Brock Chisholm, the first Director-General of the WHO, who said in 1954, “Without mental health there can be no true physical health” (Kolappa, 2013). I attempted to encapsulate the despair and anger I feel about the current state of Global Mental Health, especially in the context of this statement made almost 70 years ago. The headless patients being treated by doctors is my representation of the neglect and inconsideration of primary health care systems towards mental health. It also highlights the idea that good mental health is a secondary priority, and a luxury reserved for individuals of higher socio-economic status; of individuals of ‘higher consciousness’. The endless hallway is meant to represent an unending cycle of poor health outcomes if mental health continues to be neglected. I also wanted it to represent the fact that clinical care alone is not sufficient to adequately and effectively treat mental illness – the empty, windowless hallway and shadow patients representing the lack of consideration of the complex social factors that contribute to mental illness. Everyone should be concerned about Global Mental Health; mental health contributes to every aspect of a persons life, no matter their age, sex, or socioeconomic status. Awareness about mental health for all fosters empathy and connection that surpasses borders. We all share the human mind, and we are all responsible for the wellbeing of our global consciousness.
References:
Ngui EM, Khasakhala L, Ndetei D, Roberts LW. Mental disorders, health inequalities and ethics: A global perspective. Int Rev Psychiatry. 2010;22(3):235-244. doi:10.3109/09540261.2010.485273
Brunier, Allison. World Mental Health Day: an opportunity to kick-start a massive scale-up in investments in mental health. World Health Organization (WHO). 2020. https://www.who.int/news/item/27-08-2020-world-mental-health-day-an-opportunity-to-kick-start-a-massive-scale-up-in-investment-in-mental-health
Whitley R. Global Mental Health: concepts, conflicts and controversies. Epidemiol Psychiatr Sci. 2015;24(4):285-291. doi:10.1017/S2045796015000451
Kolappa K, Henderson DC, Kishore SP. No physical health without mental health: lessons unlearned?. Bull World Health Organ. 2013;91(1):3-3A. doi:10.2471/BLT.12.115063
(Digital drawing made using Adobe Fresco on iPad)
Acknowledgments:
We would like to thank Professor Madhukar Pai for setting and sharing this assignment results with us and the teaching assistants Alexandra Jaye Zimmer, Lavanya Huria and Angie Sassi for their support in coordinating the results.