17 October 2011
AMMAN - The Ministry of Health is preparing an evaluation to assess its experience in integrating mental health services into primary healthcare, a ministry official said on Sunday.

Bassam Hijjawi, director of the health ministry's primary healthcare directorate, told The Jordan Times that the evaluation will take six months.

"We have trained 15 general practitioners on how to diagnose and refer patients with mental health symptoms," he said, noting that the ministry will review the performance of these doctors and the cases they have diagnosed.

"If the results and performance turn out as planned, we will train more doctors in our primary health centres and the first group of doctors will become trainers," Hijjawi explained, noting that integrating mental health services into primary healthcare is "challenging".

The ministry has been implementing the World Health Organisation (WHO) Mental Health Gap Action Programme since 2008, under which 15 centres were accredited in Amman, Irbid and Zarqa to merge mental health and primary healthcare services.

Hijjawi stressed, however, that the ministry will focus not only on expanding mental health services but also on raising awareness about mental health and illness.

"We want to reach a point where people are not ashamed of seeing psychiatrists," he said, adding that patients should realise that the earlier they visit doctors, the better the results of their treatment will be.

No accurate figures are available on the number of Jordanians with mental health issues, although the health ministry estimates that between 10 and 25 per cent of the population suffers from some type of psychological malady.

According to WHO, between 35.5 and 50.3 per cent of people with mental health issues cannot reach psychological treatment in developed countries, compared to 76.3 to 85.4 per cent in less developed countries.

A total of 450 million people worldwide suffer from mental issues, acting WHO representative in Jordan Ahmad Yousfi said in a previous statement, while one in four people will develop some form of mental health issue during their lifetime.

Mental health is defined as a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community, according to the WHO website.

The positive dimension of mental health is stressed in WHO's definition of health as contained in its constitution: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." 

10 facts on mental health

  • About half of mental disorders begin before the age of 14. Around 20 per cent of the world's children and adolescents are estimated to have mental disorders or problems, with similar types of disorders being reported across cultures.

  • Depression is characterised by sustained sadness and loss of interest along with psychological, behavioural and physical symptoms. It is ranked as the leading cause of disability worldwide.

  • On average about 800,000 people commit suicide every year, 86 per cent of them in low- and middle-income countries. More than half of the people who kill themselves are aged between 15 and 44. Mental disorders are one of the most prominent and treatable causes of suicide.

  • War and other major disaster have a large impact on the mental health and psychosocial well-being. Rates of mental disorder tend to double after emergencies.

  • Mental disorders are among the risk factors for communicable and non-communicable diseases. They can also contribute to unintentional and intentional injury.

  • Stigma about mental disorders and discrimination against patients and families prevent people from seeking mental health care. Contrary to expectations, levels of stigma were higher in urban areas and among people with higher levels of education.

  • Human rights violations of psychiatric patients are routinely reported in most countries. These include physical restraint, seclusion and denial of basic needs and privacy.

  • There is huge inequity in the distribution of skilled human resources for mental health across the world. Shortages of psychiatrists, psychiatric nurses, psychologists and social workers are among the main barriers to providing treatment and care in low- and middle-income countries.

  • In order to increase the availability of mental health services, there are five key barriers that need to be overcome: the absence of mental health from the public health agenda and the implications for funding; the current organisation of mental health services; lack of integration within primary care; inadequate human resources for mental health; and lack of public mental health leadership.

  • Governments, donors and groups representing mental health workers, patients and their families need to work together to increase mental health services, especially in low- and middle-income countries. The financial resources needed are relatively modest: $2 per person per year in low-income countries and $3-4 in lower middle-income countries.

    • © Jordan Times 2011