GENEVA – For two years, the family of a soldier in the DRC army could not trace him until they discovered that he had been imprisoned – not for doing anything wrong but because he had a mental illness.

“When we speak of disorders, we forget these affect human beings. People who need to be in hospital should not end up in prison,” said the soldier’s brother, Dr Jean Kaseya, the executive director of Africa Centres for Disease Control and Prevention (Africa CDC).

Kaseya spoke at the launch of an African mental health leadership programme to establish a cohort of mental health advocates across the continent, held on the sidelines of the World Health Assembly in Geneva this week. Supported by Wellcome Trust, the goal of the initiative is to train leaders in the health sector to understand and address mental health “through a public health and human rights lens”.

Although the program cannot help Kaseya’s brother, who died soon after his family found him in 2020, it hopes to benefit some of the estimated 120 million Africans struggling with mental health.

Mental health is the stepchild of health programmes on the African continent, receiving just 2% of health budgets. This neglect is reflected in the significantly lower annual outpatient mental health visits in Africa, with only 14 per 100,000 people, compared to the global average of 1,051 per 100,000.

The result of this lack of investment is a vast shortage of mental health workers – 1.4 for every 100,000 people compared to the global average of 9 per 100,000.

Burkina Faso, for example, has only 12 psychologists.

Outdated policies

“Mental health policies in Africa are mostly outdated and poorly implemented,” Kaseya told the launch, attended by several African health ministers including those from Burkina Faso, Burundi and Cabo Verde.

“This programme will create a cohort of leaders who understand and can advocate for context-specific, evidence-based approaches to mental health in their countries,” said Wellcome Trust CEO John-Arne Røttingen.

Wellcome’s mental health programme, which has funded numerous African mental health research projects and initiatives, concentrates on anxiety, depression, and psychosis. Røttingen stressed that an integrated approach, with scientists working hand-in-hand with policymakers, is essential to ensure research addresses the right questions and breakthroughs are implemented when tackling these conditions.

“That’s why we are so excited to be working with Africa CDC on this programme,” Røttingen said. 

Cross-sectoral, human rights approach

The World Health Organization’s (WHO) Mark van Ommeren told the launch that effectively addressing mental health required cross-sectoral collaboration across different departments.

Addressing suicide, he explained, means engaging with the Department of Justice for gun control and Agriculture to restrict access to hazardous pesticides that are banned in many countries but still available on the continent, and education to ensure young people have life skills to cope with life challenges.

David Bainbridge, the executive director of CBM Global, an international organisation that advocates for the involvement of people with disabilities, said the programme could “make a significant impact not only on the wide treatment gap in access to mental health services but also to apply good public health practice to reduce the drivers of mental health conditions and the negative impact on well being.”

“We underscore the need to take a human rights approach to mental health which means that, in addition to the personal suffering that results from experience of mental health symptoms, we’re particularly concerned about the experiences of stigma, social exclusion and abuse experienced by people affected. You’re often denied access to basic rights like family life, livelihoods, even personal autonomy and freedom,” explained Bainbridge.

Michael Njenga, the Africa co-ordinator for CBM Global, said the inclusion of people with lived experience of mental illness in policy making was critical for successful implementation.

Some countries barred those with mental illness from voting or standing for office, while Kenya classified a suicide attempt as a “misdemeanour”, added Njenga.