Two years after South Sudan gained independence, Dr. Inka Weissbecker toured the young country's only mental health facility.
The hospital looked more like a prison ward. Patients were sedated, living in their own filth; a traumatized young girl wandered the hallways unattended; people with schizophrenia had no medication. Weissbecker, global mental health and psychosocial advisor for the International Medical Corps, brought the tragedy to potential donors, imploring them to fund better mental health services.
Her plea fell on deaf ears.
"They thought, 'South Sudan is not ready for mental health. The country has bigger problems,'" she recalls with frustration.
Mental health disorders affect one in four people around the world and even more in low-and-middle- income countries riven by strife. Still, the problem is often overlooked in light of other pressing development priorities.
It wasn't until civil war broke out in South Sudan that mental health funding poured in, as the world's attention turned to children with post-traumatic stress disorder and traumatized civilians.
Money for mental health only follows bombs, bullets and trauma, says Weissbecker, while a growing mental health crisis remains ignored.
For many, the logic is inescapable. In the hierarchy of needs, lifting people out of poverty and ensuring they are fed comes before mental health treatment.
But this thinking crumbles when you look at the massive ripple effect of untreated mental health disorders.
Studies show a relationship between mental health conditions and unhealthy lifestyles, leading to higher rates of cardiovascular disease, diabetes and obesity, as well as drug and alcohol abuse. Health-care systems in developing or crisis-plagued regions cannot handle the strain. Low-income countries average one psychiatrist for every two million people and spend less than one per cent of their health budgets on mental health.
Typically, when developing countries do invest in mental health, the money doesn't go to outreach and prevention but to mental hospitals. Institutions are much more disruptive to patient's lives, and carry a greater stigma in areas where education and awareness are lacking.
Donors and international organizations are often no better, explains Weissbecker. "When conflict breaks out, that's when people start paying attention."
The international community has made tremendous strides delivering medicines, containing outbreaks and fighting disease around the world.
Now it must do the same for mental health.
The United Nations Sustainable Development Goals include mental health alongside other focuses of development. This inclusion recognizes mental health treatment as a human right, one that's key to empowering growth and prosperity in all countries.
We need to do more. We need to fund and train more psychiatrists and doctors, build community-based mental health services, and help break the cultural stigma associated with treatment. These are the types of solutions that were on the table at the World Health Organization annual meeting on mental health earlier this month.
Closer to home we can do more as well. While studies show a decline in American’s mental health in recent years, we’ve started to recognize the social and economic benefits of investing in mental health. It’s time we applied the same standards around the world. And we don’t have to wait for the trauma of conflict.