Mental health services have made headlines in the UK due to lack of resources. The King’s Fund states that while mental health accounts for 23 percent of the total burden of disease in the UK, only 11 percent of total NHS funding goes to mental health services. 3 out of 4 people with mental health problems receive little to no treatment.
These are frightening statistics, as evidence grows supporting the idea that mental and physical health are intimately intertwined. Poor physical health increases the chance of poor mental health. People with serious mental health conditions are at risk for developing chronic physical illnesses. The links go on.
The World Health Organization defines health like this:
A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
It further states, There is no health without mental health. If this is indeed the case, and mental well-being is intwined in the very definition of good health, why is mental health an area so grossly overlooked?
The situation is far worse in Malawi.
Mental Health Services in Malawi
The NYASA Times states that only 4 percent of the total ministry of health budget goes to mental health service provision in Malawi. Even more staggeringly, there are only 4 psychiatrists for a population estimated at 19 million.
Malawians in rural areas make up more than 80 percent of the population, but those who suffer from severe mental health illnesses have little access to services and may be hidden by their families due to stigma. There are limited treatments for disorders. There is little provision of community services.
While mental health treatment is currently free for the patient (funded by the government or private donors), transportation to clinics where treatment is administered is not, meaning many patients struggle to access treatment as often as required.
There is only one government-run psychiatric hospital, which is located in the southern region in Zomba. It has about 150 beds and treats all ages and diagnoses. There are two small inpatient mental health units, one in Lilongwe and one in Mzuzu. These are operated by St John of God (SJOG) hospitaller service.
Dr. Kazione Kulisewa, the head of the department of psychiatry at Kamuzu Central Hospital in Lilongwe states, “Mental health conditions, despite their high disease burden, go under the radar in Malawi. Hopefully, we can increase the level of awareness of these conditions. I would also like to see reform of mental health services in the country, with more of an emphasis on community care and less on institutional care.”
The St John of God Hospitaller Service in Malawi
The Saint John of God Hospitaller Service (SJOG) in Malawi is part of the global SJOG organisation, which is a Roman Catholic Order founded in 1572.
The Brothers of SJOG Ireland arrived in Malawi in 1993, at the invitation of the Diocese of Mzuzu, to establish a community-based mental health service in conjunction with the primary health care department of St John’s mission hospital in Mzuzu.
Since its establishment it has developed to include residential care for people with acute mental illness, rehabilitation and reintegration services, education for children with special needs, and skills-based training.
Saint John of God College
The Saint John of God College (SJOG) started in 2003 as part of the wider SJOG Hospitaller Service in Malawi. Students are admitted to the college based on merit, regardless of their religious affiliation and tribe, and are recruited from all regions of the country. There are currently 259 students and it offers the following 4 programmes:
- Certificate/Diploma in Psychosocial Counselling
- BSc in Mental Health (Psychiatric Nursing)
- Diploma in Nursing (Mental Health)
- BSc Clinical Medicine (Mental Health)
A New Partnership with Medic to Medic
Medic to Medic was approached by SJOG student Solomon Phiri, who was studying psychiatric nursing in 2016. Solomon was struggling to finance this 2-year bachelors degree after completing a 3-year nursing diploma.
We were impressed by Solomon’s clear motivation, enthusiasm and passion for mental health. We sponsored him as a pilot while working to establish new processes and build a partnership with the faculty at the college. We were able to sponsor a cohort of 4 students in 2017, and 6 more in 2018/2019.
Medic to Medic is the first organization to provide scholarships to students at SJOG college.
This partnership allows us to increase support to underfunded trainee mental health workers, thereby helping to build psychiatric services in Malawi.
One trainee at a time.
SOURCES and FURTHER READING
Global Echoes: Mental Health in Malawi. A reflective essay about volunteering in mental facilities in Malawi.
Malawi’s Mental Health Service. An interesting historical look at the origins of Malawi’s mental health services.
For more information about Medic to Medic and how to support students like Solomon please visit our website at www.medictomedic.org.uk