According to Pamela Kanellis, program officer at Global Mental Health,
“When one thinks about health challenges in developing countries, diseases like HIV/AIDS, malaria, tuberculosis, and other tropical diseases quickly come to mind, but few think of mental health. In fact, three-quarters of those afflicted with mental disorders live in developing countries. Mental disorders are a leading cause of disability globally and represent 14 per cent of the global burden of disease. Despite the enormous health burden, it remains one of the most neglected diseases”.
I’ve had a recent experience volunteering at Clinic Esperanza, where I came into contact with a woman who had a follow-up for various lab tests and was being given another lab test to see if she had helicobacter pylori. However, what stood out to me was that she was describing symptoms of depression, such as not being able to go on with her daily routine because she could not stay awake. The med student in the clinic printed out a self-assessment quiz for depression, but in English. The woman was more comfortable with the Spanish language, so I helped translate some of the self-assessment. She was supposed to select how frequently she felt certain items on the questionnaire within the last two weeks. The assessment reviewed things such as appetite, sleep, feeling like one has failed one’s family or have let down oneself, to feelings of self-inflicted injury or suicidal thoughts. I felt a bit uncomfortable because I wanted her to answer truthfully and I did not want her to think I was judging her responses. I helped her understand how to score the test to get a result. She had fallen in the range of mild depression, but borderline moderate depression. I am not sure how the med student and doctor reviewed the results, and what they considered was severe enough for medication. I do know that the clinic carries antidepressants and I would have predicted they gave her medication since her depressive symptoms interfered with her daily life. One thing I wonder is how stigmatized are mood disorders and mental health illnesses on the island. How often do people seek help for feeling depressed? Do they seek medication? Is cognitive therapy even an option? Another thing to consider is: are these self-assessments easy to understand and are they culturally competent within the context of the island population?
