After thirty years working in the textile industry, Mr. Kumar found that he could work no more. Like many other people with a mental illness, he became disorientated and distressed. Living in the intense community environment of a village in India, his situation was misunderstood by many local people. He was vulnerable to abuse and neglect. Unable to perform the roles of husband and father and needing constant support from his family, Kumar struggled to fi nd his feet again.

Where services fail to reach

BasicNeeds was established in 1999 as a response to the situation in which many people fi nd themselves when affected by mental illness. According to the WHO, mental illness accounts for 12.3% of the global burden of disease and will rise to 15% by the year 2020. It is often said that mental health is the poor relation within the spectrum of health services. This is particularly apparent in many countries in Asia, where access to mental health services for a large proportion of the population is very low or non-existent. To use an expression common in many villages; ‘The government doesn’t reach this far’.

BasicNeeds is planning to extend its programs to Orissa, one of the poorest states of India, which offers a typical example of shortfalls in services. In Orissa, there are only nineteen psychiatrists for a total population of 36 million people. The internationally recommended number of psychiatrists for this population would be 367. Other professional services show similar levels of under-resourcing. In Laos, where BasicNeeds commences a community mental health program this year, there are two psychiatrists and a single mental health unit with fi fteen beds for a total population of over six million people.

In many countries (arguably in all countries) awareness of mental health issues in general society remains low. Mental illness is largely misunderstood, leading to discrimination against families that have a mentally ill member, who are largely ostracized from the community. In poor rural areas and urban shanties, food insecurity, poor physical health, migration, alcohol abuse and limited preventative health programs all have a direct impact on the vulnerability of large numbers of people to mental disorders.