By Dr. Arvind Mathur, WHO Representative to Timor-Leste
Dili: One billion people globally, or one in every eight people live with a mental health condition. Depression ranks among the leading causes of disability, and suicide is the fourth leading cause of death among 15-29-year-olds. Despite these concerning statistics, mental health has often been a neglected aspect of healthcare worldwide, especially in the developing nations.
On this World Mental Health Day, we are reminded of the profound truth that there is no health without mental health. The World Health Organization (WHO) has aptly defined mental health as "a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community." This definition emphasizes that mental health is a fundamental human right that must be upheld for all, and this year’s Mental Health Day theme- 'mental health is a universal human right' - acts as a timely reminder for us.
In Timor-Leste, the burden of mental health conditions is likely substantial, though robust, comprehensive data is lacking. The COVID-19 pandemic has only exacerbated this burden. Preliminary data from the psychiatric department of the HNGV hospital in Dili in 2020 paints a concerning picture, with significant percentages of patients presenting with schizophrenia (29%), depression (18%), and suicidal tendencies (18%). Similar trends are observed nationally. Past surveys conducted in schools have also found high prevalence of suicidal ideation among children, which is extremely concerning. These figures only scratch the surface of the true extent of mental health challenges in the country.
The WHO is committed to supporting the Ministry of Health and collaborating with other partners to provide comprehensive and quality mental health and psychosocial services to the Timorese people. Frontline staff, including doctors and nurses, have been trained in Mental Health and Psychosocial Support, playing a vital role in identifying signs of mental distress. Awareness materials have been developed and adapted to the Tetum language to promote mental health awareness within communities.
Despite these efforts, several challenges remain. The lack of data, resources, and comprehensive mental health plans that comply with human rights principles hinder progress. Timor-Leste, with only two psychiatrists for the entire country, urgently needs capacity building and human resource development to improve service delivery.
But there is hope. In September 2022, Health Ministers from WHO Southeast Asia Region Member States, including Timor-Leste, signed the Paro Declaration, affirming their commitment to universal access to people-centered mental health care and services.
As we move forward, it is important to review the mental health strategic plan, set realistic goals, and prioritize data collection to better understand the burden of mental health conditions. Capacity building and resource allocation must continue, and awareness about mental health should remain a top priority.
Often, our families, friends and colleagues suffer in silence due to the stigma and discrimination attached to mental health issues. Our homes must become safe spaces that allow conversations around mental health. Workplaces must strive to create a supportive and inclusive environment where such conversations and nurtured and encouraged. This can happen only with awareness. I therefore call upon everyone to join hands in normalizing conversations around mental health and breaking the silence.
Mental health is a universal human right, and it is our collective responsibility to ensure that everyone can access the care and support they need. Let us work together to achieve the goal of health for all and mental health for all, not just on World Mental Health Day but every day.