Mental ill-health the latest NCD

The World Health Organisation (WHO) marked the World Mental Health Day this month with the theme being ‘young people and mental health in a changing world.’ The aim is to raise global awareness of mental health issues and to stimulate advocacy.   

According to the WHO, this theme is of vital concern because about 1 in 5 adolescents experience mental and behavioural problems in any given year. Moreover, half of all mental health problems in adulthood have their onset during or before adolescence.  

Dr. Bente Mikkelsen, WHO’s/Europe Director of the Division of Noncommunicable Diseases and Promoting Health through the Life-course states, “It is important to protect the younger generations as they are the future leaders. We need youth at every table. We need their voices to shape their future in the right way, using their creativity and energy to make change.”  

With the recent release of 2 WHO/Europe reports, “Situation of child and adolescent health in Europe” and “Adolescent alcohol-related behaviours: trends and inequalities in the WHO European Region, 2002–2014”, the health and well-being of young people is high on the regional agenda.  

Dr Mikkelsen notes that “the area of mental health is still misunderstood, but now there is momentum and the highest possible recognition of mental health”.  

At the third United Nations General Assembly high-level meeting on noncommunicable diseases (NCDs), held last month in New York, mental ill-health was endorsed as the “fifth NCD” alongside cardiovascular diseases, cancer, diabetes and respiratory diseases.  

According to the WHO, half of all mental illnesses begin by the age of 14, but most cases go undetected and untreated. In terms of the burden of the disease among adolescents, depression is the third leading cause. Suicide is the second leading cause of death among 15-29 year-olds.

Harmful use of alcohol and illicit drugs among adolescents is a major issue in many countries and can lead to risky behaviours such as unsafe sex or dangerous driving. Eating disorders are also of concern.  

In Sri Lanka, till recently, there was an imbalance in our thinking with those with known mental disorders being marginalised or even condemned as “Mulleriyawa cases.” In a derogatory manner, many also would often say someone should be “sent to Angoda” referring to the area where the public mental hospital is situated. But thinking patterns now are generally more enlightened because most of us are aware that almost all people have some form of mental disorder. This is natural because we suffer far more mental injuries than physical injuries. Each time we are hurt, sidelined or otherwise ill-treated, we suffer mental injuries.   

On Tuesday, the government took an important step to curb the possibility of mental problems among children by making non-compulsory the highly competitive Grade 5 Scholarship examination. During the past few decades— especially with subtle forms of selfishness and self-centredness growing in a competitive globalised capitalist market economic system -- many parents perhaps unknowingly pushed their children too much to get high marks in the Grade five scholarship exams. In Grades four and five, tens of thousands of children are known to have been forced to study till late and go for tuition class after class with little or no time for play or recreation. As a result many children are known to have suffered mental health problems which later manifested in more deadly forms like heroin addiction or suicidal tendencies.   

According to research done by social science lecturers M.A.S. Irfana and K. Kanesarajah, physical, mental, social and spiritual related problems have been identified among the students sitting the grade five scholarship exam. The researchers say though more students suffer from phobias like anxiety, grief, tension, stress and personality disorders, they are still forced to sit for this exam. Although they have been some positives such as outstation students getting higher marks than those in prestigious Colombo schools, the negatives are many and it would be a plus point for the society if the government totally scrap the Grade 5 Scholarship competition.