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Overcoming Obstacles to Accessing Mental Health Services in Ethiopia

“What do you see as one major obstacle to people seeking treatment that may be needed, and what advice or suggestion do you have to help overcome that obstacle, whether for the person, family member, or practitioner?”

That was the main question posed to panelists at the Ethiopian Global Initiative’s Ethiopia Public Health Forum, the focus of which was “Beyond the Stigma of Mental Health and Substance Abuse.” On June 1, I attended this forum as a representative of IntraHealth International.

As in many places around the world, diagnosing and caring for people with mental illness in Ethiopia is complicated by stigma surrounding these diseases. The keynote speech was provided by His Excellency Dr. Kesetebirhan Admasu, minister of health, and focused on the need for increased access to mental health programs in the country, highlighting the recent release of the National Mental Health Strategy 2012–2015. Following his speech, four Ethiopian mental health experts discussed clinical and societal aspects of mental health in Ethiopia and the Ethiopian diaspora. I was asked to provide a summary of the discussions with my perspective from work with USAID as a donor, as well as ways to engage family, community, and the diaspora.

Participating in the forum allowed me to present an overview of IntraHealth’s current and past work in Ethiopia and the important role of human resources for health (HRH) interventions to improve provision of mental health screening and services. Ethiopia adopted its first mental health policy in 2006 based on the results of a WHO assessment of the country’s mental health systems. That assessment provided data on the limited human resources available to staff the six inpatient and 53 outpatient facilities in the country. With just 1.2 mental health professionals per 100,000 people, and most of these workers based in the capital city, it is clear how the mental health system in Ethiopia could be improved through efforts to attract, train, and retain greater numbers of mental health workers in areas where they are needed most.

Taking the audience beyond the medical and cross-cultural models, I also highlighted the significant role of the community as part of a larger support network of under-recognized health and social service professionals involved in providing access to mental health services such as teachers, social workers, lawyers, and police officers. I also spoke to the role of family members and the importance of building capacity for self-care in mental health. For some of my remarks, I was able to draw on past experience with the Ethiopian diaspora contributing to programs in their home country through the Millennium Social Bond and the Renaissance Dam Social Bond. In addition to the social bonds, according to the World Bank, the diaspora remits about $1.5 billion annually to Ethiopia with significant increases expected in the coming years.

From my standpoint as a non-Ethiopian international development professional, it seems as though there are resources currently available to address stigma surrounding mental health in Ethiopia, such as current work being done by IntraHealth to strengthen communities and raise the profile of under-recognized cadres of HRH professionals in Ethiopia and the brimming social and economic capital embodied in the Ethiopian diaspora. I tried to shed light on these existing strengths in my contributions to the forum and emphasize that there are approaches we can take to develop the mental health workforce and confront obstacles to improving the system overall.

A webcast and photos of the forum are posted on the event website.

—Malik Jaffer
Deputy Director, HRH and Health Systems Strengthening