Tackling the Toughest Cases: Desperately Poor and Mentally Ill

The stigma of mental illness is global, and the charity BasicNeeds is fighting it in Africa and Asia, where devastating poverty makes their work even tougher.

Charlotte Perry Dougherty in Uganda, one of the places where BasicNeeds is providing mental healthcare. (Photo: BasicNeeds)

Shari Roan is an award-winning health writer based in Southern California.

Mental Health Innovation: BasicNeeds

Who: Charlotte Perry Dougherty, executive director of BasicNeeds U.SFounded in 1999, BasicNeeds is an international charity that provides mental health services to people in the poorest nations in the world.

Why It's Innovative: When it comes to supporting really poor countries, the vast majority of organizations focus on physical—not mental—health. To make matters worse, in many of these places mental illness is shrouded in stigma and there are almost no local services. BasicNeeds’ unique model addresses poverty as well as the illness. They might, for example, help someone find a job or develop skills. The group does all their work within the framework of each culture, so workers are careful to respect local customs, such as the work of traditional healers.

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"Our mission is to help people with mental illness and epilepsy live and work in their own community and have the opportunity to have strong and healthy lives," Dougherty says. "I think what distinguishes what we do is that it's community-based and it's holistic. Community-based means going to the people who need the services. We start in the community and talk to people. That allows us to work on the social and economic side as well as the medical side.

"One aspect of that is working with whoever may be [treating] people with mental illness. In many cases, it's traditional healers because the primary care system and the public health systems don't do mental illness. Often the cultural belief is that the person is possessed by evil spirits. Part of our outreach is talking to traditional healers about what kinds of situations they see, what their patients are experiencing, how they're treated. We believe it's perfectly logical to believe there are evil spirits in your body but that there are medical aspects of the illness that can be treated medically. A medical approach can benefit these people who are suffering. BasicNeeds is bringing medical treatment to places that have none and in places where there isn't even a recognized need for it. The innovation is raising awareness and getting people to understand the nature of mental illness."

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The Problem That Keeps Her Up at Night: "Funding is what keeps everyone up at night in this field. But that's related to the issue of stigma associated with mental illness. That's a problem everywhere, not just in the developing countries. In the places we work it's paired with a lack of understanding of mental illness, and the result can be human rights abuses. We can come a long way in addressing the lack of understanding of mental illness."

How You Can Take Action: Overcoming stigma starts with every person being open and honest about mental illness, Dougherty says. "Talk about personal stories—what experience you've had or that family members have had, things you've seen and heard. We're finding more and more that what helps is the ability to talk openly about these things and that family and community support is critical in recovery. Without that, people are isolated and feel unworthy, and that just adds to the problem."

More Encouraging News About Mental Health: "I'm beginning to see change in terms of willingness and openness to talk about mental illness. It's exciting to see that because I think that involving people who have lived the experience in the treatments of others can be really helpful. It's the peer treatment model. It's the core of what we're doing in BasicNeeds with self-help groups. We involve caregivers as well as patients so there is peer support among families. It's just very motivating for people to hear positive stories and feel like there's hope or hear negative stories and feel like they're not alone."

Do you think treatment for mental illness would improve if it was less stigmatized? 

Shari Roan is an award-winning health writer based in Southern California. She is the author of three books on health and science subjects.

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