Mental health has been selected as the main theme of World Health Day for the year 2001. This is in recognition of the increasing importance of mental health the world over. In the Eastern Mediterranean Region of the World Health Organization (WHO), mental health has always been regarded as an essential part of health.
Mental health is not restricted, as some may think, to mental disorders. It deals also with behavioural and emotional aspects of daily life, as well as relations among individuals, which can positively or negatively affect the quality of life. It is also directly linked to the development of stronger families which enjoy close bonds and are capable of raising happy and fulfilled children. It aims at the development of societies in which, members are respected for their personal capabilities as well as the assistance and support they provide for each other. It also entails reciprocal understanding of the opinion of others. Provision of positive mental health values can also greatly contribute to the art of good parenthood. Mental health encompasses, and is influenced by cultural life, traditions and religious aspirations; in short, all aspects of the emotional, intellectual and spiritual life of a population.
The countries of the Eastern Mediterranean Region of WHO are blessed with the existence of strong family ties, cohesive social institutions and the presence of spirituality and religious beliefs which positively affect the mental health of the population. However, the Region also faces a number of issues, which can adversely affect mental health. Our population is very young, and much of our youth is faced with uncertainties about its future. Waves of migration and unplanned urbanization are associated with poverty, breakdown of the families and heavy stress. We are facing a world with many cultural adversities, and there are many instances where the requirements of reconciling traditions with the new trends causes stress. A number of countries of the Region face wars and internal conflicts, and there are millions of refugees in different parts of the Region.There are also existing and emerging issues of the elderly, women and other special groups, which need attention.
As for mental and brain illnesses, the studies undertaken on "Global Burden of Disease are indicative of their importance. According to these studies five out of ten major causes of disability are related to mental disorders. At least 11.5% of the "Global Burden of Disease is directly caused by mental health problems. There are also a number of global and regional studies showing that a high percentage of all the adult population entering any health facility suffer only from a mental health problem. A very high percentage of these cases remain unrecognized and go through unnecessary tests and sometimes even surgical procedures, causing much personal suffering and extra burden on already heavily burdened general health facilities. On the other hand, epidemiological studies show that serious mental illnesses are as common in the Region as in other parts of the world. The Region is particularly faced with issues of depressive disorders, epilepsy, care of chronically ill and suicide, the risk of which inevitably increases with stressful conditions and changes in daily life and family structure. Substance abuse is also an increasingly important issue, with serious mental health, social, economic and moral consequences.
I am also pleased that the Region has many success stories in the promotion and protection of mental health. During the past 15 years initiatives have been undertaken to develop national mental health programmes in countries of the Region. The main strategy of these programmes has been integration of mental health services within primary health care. In some countries great steps have been taken to implement these programmes. Some of the programmes of this region are being regarded as major achievements.
In 1997 during the Regional Committee for the Eastern Mediterranean in Teheran, Islamic Republic of Iran, the ministers of health of the Member States of the Region or their official representatives signed a declaration committing their good offices to the cause of improving mental health. Following that event I sent a letter with 10 suggested types of programme for selection by the countries.
Since then we have had some positive responses to these programmes. However I would also like to renew that call and request all countries to initiate programmes for mental health during this year
As we look at all issues of mental health, we need to choose and adopt initiatives and activities according to our regional needs and priorities. I would like to conclude by mentioning some of these needs and priorities:
At all levels, -decision-makers, health sector officials and the general public-we need to recognize the value and importance of mental health as an existing and emerging health need and not a luxury.
We need to find ways to decrease the stigma attached to mental illnesses and their treatment by advocating the public recognition of these disorders and the fact that they can be treated.
Further integration of mental health within primary health care is a priority, as is ensuring the availability of a basic level of services for patients in all countries.
Mental health of the special groups and also emerging mental health problems, such as those related to women, children, the elderly and refugees deserve special attention.
Substance abuse is a growing problem which has the potential to cause severe public health consequences, such as the ones related to HIV/AIDS and other blood -borne diseases. Let us unite in the provision of services to combat this menace and decrease the demand for substances.
Our conscience, duty, and indeed our interest dictate that we seek to reformulate all prevailing concepts regarding mental health problems. Let us keep away from the fictitious myths that have long stigmatized mentally ill persons and make use of the scientific and humanitarian approach to solving mental health problems, noting that such solutions are available and virtually in place.
Let the slogan of World Health Day this year-Stop Exclusion, Dare to Care-be our guide to a better understanding for the whole of humanity with its diversity.
