Despite a spike in various mental health conditions after the pandemic, health services in the country remain insufficient and neglected due to a lack of expert physicians and necessary medical facilities, according to mental health professionals.
About one-third of the country's population is suffering from various types of mental health issues. But there are no mental health treatment facilities at the district and upazila levels. There is also a crisis of specialist doctors.
The Directorate General of Health Services, however, said services for mental health issues will improve with the passing of the National Mental Health Policy 2022.
According to the National Mental Health Policy, the number of mental health professionals in the country is very low compared to mental health problems.
There are only 1.17 mental health workers per 1,00,000 people in Bangladesh. Of them, 0.13 are psychiatrists, 0.01 are other specialist physicians, 0.87 are mental health nurses and 0.12 are psychologists and other professional mental health workers.
The National Institute of Mental Health (NIMH) in the capital provides outdoor and indoor services. The number of beds in this hospital is now 400. Apart from this, there is only one 500-bed mental hospital in Pabna.
Bangabandhu Sheikh Mujib Medical University (BSMMU) and some medical college hospitals provide treatment for mental disorders. The number of psychiatric beds in the country is 0.4 per 1,00,000 population. Daycare facilities for mental health have not yet been established in the country.
The budget allocated for mental health in the country is 0.50% of the total health budget, according to the health policy.
Prof Dr Mohammad Ahsanul Habib, former director of Pabna Mental Hospital, told The Business Standard (TBS), "There are 350 psychiatrists and less than 100 psychotherapists for the 16 crore
people of our country. These doctors live in Dhaka, Rajshahi and various divisional cities. At the district and upazila levels, medical care is absolutely inadequate."
"It is not possible to increase the number of specialist doctors overnight. But opening a psychiatrist's post in the district hospitals will at least increase the number of doctors. Patients will get some services at least," he said.
Dr Mohammad Ahsanul Habib, who is also head of the Department of Psychiatry at Anwer Khan Modern Medical College and Hospital, said, "Various age-dependent mental problems have risen sharply after the pandemic. Now we are getting patients that we didn't get before. The effects of coronavirus on mental health will be felt even after another 5-7 years."
"Children's internet addiction has increased significantly after being online for long periods of time for classes. They are less attentive to studies but more addicted to games. Game addiction has increased as young people go out less and many have turned to addiction out of depression," he said.
"Many middle-aged people who tested positive for Covid-19 developed depression. Domestic violence has increased a lot," Ahsanul Habib added.
The suicide rate is increasing in the country. Health experts suggest emphasising mental health to prevent suicide.
According to the National Mental Health Survey 2018-19, around 17% of adults and 14% of children in the country have some form or the other of mental disorder.
According to the survey, 24.2% of people suffering from mental disorders get treatment at
government hospitals, 5.5% from private practitioner psychiatrists, 33% from other doctors and 2.2% from homoeopathy and Unani doctors who practice Perso-Arabic traditional medicine.
Dr Fakhrul Alam, former director of the National Institute of Mental Health, said many people are not getting treatment for their mental health conditions because of the unavailability of psychiatric healthcare.
"To address the issue, psychiatric units should be built in every district and existing units at the medical colleges across the country should be upgraded accordingly," he added.
Professor Dr Robed Amin, line director of Non-Communicable Disease Control (NCDC) at DGHS, told TBS, "There is a shortage of specialist doctors in mental health in the country. However, apart from specialists, we are trying to provide services as much as possible."
"With the support of telehealth, we have a pilot project running in two upazilas to connect specialists through telemedicine and provide services to people. We will take the next step after seeing the report of those two upazilas. NCDC trains doctors every year to identify and treat mental health issues," he said.
Dr Robed Amin said the non-governmental development organisation Brac is working with the government in some districts, including Cumilla, on how to screen patients in rural areas and bring them under treatment.
"Patients are being screened at community clinics and upazila health complexes and treated there or referred if necessary. Besides, work is being done by targeting four districts under the World Health Organisation's special initiative on mental health," he said.
"Now that the mental health policy has been prepared, a strategic plan has been made, more progress will be made on mental health. Since this is a big issue in the future, there may be a separate operational plan for it," Robed Amin added.