With a prevalence rate of 18.7% and a startling treatment gap of 92.4%, Bangladesh is facing a concerning increase in mental health disorders, according to the 2019 National Mental Health Statistics (National Mental Health Survey 2019). By 2030, mental health disorders are expected to account for about 15% of all diseases worldwide, up from 13% in the current estimate (United Nations, 2022).
In response to this challenge, BRAC has been working since January 2022 to ensure access to mental health services at the grassroots level as well as to initiate mental health and psychosocial support in partnership with the Directorate General of Health Services (DGHS) and the Mental Health Unit of Non-Communicable Disease Control (NCDC).
To assess the effectiveness of the intervention, two research studies have been carried out: 1) “Impact Study on Mental Health Pilot Project” by BRAC Institute of Educational Development (BIED), University of Tokyo, Kanazawa University, and Infant, Child and Family Psychiatrist, Australia; and 2) “Process Evaluation of Mental Health Pilot Project” by Professor Dr. M. Kamruzzaman Mozumder, Department of Clinical Psychology, University of Dhaka.
On 22 October, 2023, two research findings on the mental health pilot project were presented. Experts, government officials, academicians, researchers, and representatives of reputed non- governmental and international organisations related to mental health were present at the event. The focus of the event was to share important findings from the researchers and gather valuable feedback from the guests for future planning. KAM Morshed, Senior Director BRAC, facilitated the discussion.
According to the research, BRAC mental health para-professionals had little experience and confidence at first, but with supervision and training, they were able to develop their abilities. Clients felt emotionally lighter and more at ease as a result of their provision of a secure and open space in which to express their thoughts and feelings, leading to improved mental health. During sessions, clients also learned how to control their emotions and their wrath. Clients and community members saw significant behavioral changes and improved coping methods as a result of getting Psycho-social Support (PSS) from para-professionals, which improved emotional understanding and strengthened connections.
Farjana Sharmin, Programme Manager, Clinical Psychology, BRAC Health Programme, shared project details and the intervention process. She also discussed global mental health conditions, Bangladesh mental health status, and the government’s initiatives in mental health programmes. The collaboration between the government and BRAC in implementing mental health and psychosocial support at the community level was highlighted.
Prof. Dr. Tabassum Amina from BRAC Institute of Education Development prtesented the findings of the Impact Evaluation of Mental Health Pilot Projec. The project, conducted collaboratively by BIED, University of Tokyo, Kanazawa University, and Infant, Child, and Family Psychiatrist from Australia, revealed the remarkable impact of community-based mental health interventions. The project significantly raised mental health awareness, reduced distress levels, severe psychological distress, depression, and Post-traumatic Stress Disorder (PTSD), while enhancing the quality of life in areas like physical health, psychological well-being, and social relationships.
Professor Dr. M. Kamruzzaman Mozumder, the second speaker, provided a comprehensive process evaluation that highlighted the effectiveness of the training module designed for Para-professionals. Notably, the study emphasises the significance of handholding, supervision, and self-care support in building the skills and confidence of these Para-professionals.
The chief guest Prof. Dr. Mohammad Robed Amin, Line Director, DGHS, emphasised the collaboration between the government and the NGOs. He said, “This project has been highly successful at every step with powerful client satisfaction. BRAC can be part of our existing mental health initiative through the WHO special initiative. In this context, it’s important to ensure that mental health services are not limited to intellectual individuals in society but should be made accessible to the local population through Para-professional training. Mental health cannot only be addressed by the government, rather there is a need to collaborate with NGOs.”
The special guest, Hossain Ali Khondokar, Additional Secretary, Ministry of Health and Family Welfare, added, “Superstition can only be tackled through education. It is essential to remember that no health is sustainable without mental health. Thus, I believe now is the time to advocate for a partnership between the government and NGOs in detecting and providing services for mental health issues among the general population.”
Asif Saleh, Executive Director of BRAC said, “This is a significant achievement in the field of mental health, made possible by the government’s support and freedom of operation. It’s essential to emphasise the principle of ‘Do No Harm’ in mental health, as interventions can sometimes do more harm than good. Care and sensitivity are paramount. The Para-counselor model, a relatively recent concept, has the potential to become a pioneering export from Bangladesh to the global mental health arena.”
The Mental Health Pilot Project aims to make a substantial impact on the community-based mental health environment by raising awareness and highlighting the significance of developing para-professional capability. Its all-encompassing methodology enhances personal lives and guarantees psychological wellness.
The results of these two investigations provide insight into the beneficial effects of community-based mental health treatments in Bangladesh. Going forward, the intervention is still dedicated to improving mental health services, both locally and as a possible worldwide model.