by Dr Shaazneen Ali, Specialist Registrar in Central and North West London NHS Foundation Trust, London and Co-founder of Mental Health Awareness Foundation, the Maldives
The tiny island nation of the Maldives is described as a paradise on earth by many, and one may think that living in this Eden would provide immunity from depression. However, just as depression sees no socio-economic boundaries, it sees no geographical boundaries world-wide either. There is very limited research in the Maldives in the field of mental health but there appears a stark discrepancy in these figures when just conversing about it with small groups of professionals. The various professionals we have come across in the Mental Health Awareness Foundation’s (MHAF) training programmes speak about depression being a common illness in their local communities amongst various population groups and also about the immense stigma associated with mental disorders.
In 2003, Ministry of Health conducted a nation-wide survey to assess the magnitude of mental and neurological disorders[1],[2]. This survey found that more than 29.1% of the respondents reported that they had a mental health condition, with nearly 5% suffering from anxiety and depression and nearly 4% reporting somatic symptoms. Another finding of note was the increasing rate of suicide, particularly in the youth38. However, no formal research figures are available about this hugely ostracised act in the Maldives. Though not all suicides are due to depression, the link between suicide and mental disorders such as depression is well established[3].
The National Drug Use Survey 2011/2012 revealed that an estimated prevalence for the capital island of Malé and the atolls were 6.64% and 2.02% respectively[4]. However, it may be that the actual prevalence rates are higher38. The survey also showed that mental health problems were common in this population38. Data on mental health problems among the drug users implied that about 15% in Malé and 9% in the atolls had been diagnosed with a psychological disorder40. More than a third of current drug users in Malé stated that they were affected by a ‘mental problem’38. In another study, Global School Based Student Health Survey 2009, in the Maldives 35.5% of students felt ‘so sad or hopeless almost every day for two weeks or more in a row that they stopped doing their usual activities during the past 12 months’[5]. Further research is required in establishing the prevalence of depression and other mental disorders in the country.
In the Maldives, stigma appears to the biggest barrier to addressing this leading cause of global burden of disease[6]. MHAF has been able to work on its goals, with some very generous donors, volunteers and collaborators such as the Ministry of Health, Maldives. However, at the same time, our goals receive stigma from some sources. Until we address the stigma within our society, this will remain the biggest hurdle to climb in order to tackle this crippling illness. Stigma and discrimination against patients and families prevent people from seeking mental health care[7]. We hope that on this World Health Day, 7th of April 2017, the message of the World Health Organisation’s ‘Depression: Let’s talk’ campaign will help address this silent killer. MHAF in collaboration with the Health Protection Agency, Ministry of Health, Maldives, is working on a number of campaign projects for World Health Day to highlight this debilitating, but treatable global health issue and to help fight the stigma associated with this condition.
[1] Niyaz, H., Naz, A. (2003) Mental health situation in the Maldives. Male’: Ministry of Health.
[2] National Mental Health Policy 2015-2025, Draft 2014- Version 3; Available from: http://www.searo.who.int/maldives/mediacentre/ental-health-policy-2015-2025.pdf?ua=1
[3] Suicide fact sheet [Internet]. World Health Organization. World Health Organization. Available from: http://www.who.int/mediacentre/factsheets/fs398/en/
[4] United Nations Office for Drugs and Crime. (2012) National Drug Use Survey Maldives 2011/2012. Male’: United Nations Office for Drugs and Crime.
[5] World Health Organization and Centre for Disease Control and Prevention. (2009) Global School Based Student Survey, Country Report, Maldives, Ministry of Education in collaboration with Ministry of Health and Family
[6] Ferrari, A.J., Charlson, F.J., Norman, R.E., Patten, S.B., Freedman, G., Murray, C.J.L., et al. (2013) Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings from the Global Burden of Disease Study 2010. PLOS Medicine. Public Library of Science
[7] 10 facts on mental health [Internet]. WHO | 10 facts on mental health. Available from: http://www.who.int/features/factfiles/mental_health/mental_health_facts/en/index5.html
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