The Irrawaddy

The Need for Mental Health Care in Myanmar

Myanmar is suffering from a hidden mental health epidemic. Years of internal conflict have led to a traumatized society and a multitude of mental health issues. This epidemic is hidden because unlike physical injuries, mental health issues cannot easily be seen. Yet, below the surface, the complications and damage done by mental health issues have ramifications not just for individuals but for the whole of society.

Mental health is vitally important and there is a strong and demonstrated link between mental health and human rights. For individuals, better mental health aids good decision-making, and allows for independence and the ability to live a life in full enjoyment of their human rights. While, for society, healing acute trauma experienced during the armed conflict and military dictatorship, enables people to move forward with their lives free from the weight of the past.

As a joint secretary of the Assistance Association for Political Prisoners (AAPP), I have been dealing with many former political prisoners and many victims of human rights abuse. I see many are suffering from trauma, depression, stress and other kinds of common mental health problems. I studied this subject and finally I translated a book called “Counseling for Torture Survivors.” That book described former political prisoners’ experiences both during interrogation and life in prison, how they are dealing with mental problems and how counselors could help to solve those problems.

Then I met with different psychiatrists from different countries and I explained my ideas for a mental health program in Myanmar. However, initially it didn’t work. Finally, I found someone from John Hopkins University (JHU) and they liked my idea and they agreed to support us technically. It was in 2010 and AAPP had the opportunity to work with JHU’s Applied Mental Health Research group to implement a novel and promising mental health treatment program called the Common Elements Treatment Approach (CETA).

AAPP’s Mental Health Assistance Program (MHAP) is the first counseling program in Myanmar in which qualified counselors offer extensive and long-term support to citizens of all backgrounds through group sessions and trainings as well as individual counseling. MHAP started in 2011 on the Thailand-Myanmar border and expanded into Myanmar in 2012. Not only does MHAP’s work raise awareness of mental health and fill the void in adequate service provision, but it also recognizes the causes and treats the symptoms of the trauma that many clients have experienced. MHAP works on reconciling the effects of past human rights abuses and empowers people to move forward.

I believe that alleviating the impact on civilians’ mental health of past wrongdoings and trauma from conflict is essential to the success of the national reconciliation process. The failure to adequately address and compensate for past abuses has been shown in other countries to lead to ongoing tensions and continued human rights violations.

Yet, despite this work being done by organizations like AAPP, there are a number of major obstacles blocking the improvement of the overall quality of mental health in Myanmar.

Firstly, government facilities are under-developed and lacking resources, and therefore, usually struggle to deal with mental health issues. There is a poor quality of, and poor access to, mental health treatment in rural areas. MHAP works in these remote areas trying to fill this gap. MHAP does this by training counselors. Counselors are trained vocationally in the best methods of treating common mental health trauma within communities. By training community members to become counselors, we can ensure that counseling is available in remote communities. While MHAP works with psychiatrists, we train counselors, as this training is shorter and more community members can offer mental health care to those who need it.

Alongside the provision of sufficient resources to address mental health issues, there is an acute need to develop a comprehensive mental health policy. Such a policy would take mental health issues into consideration and have a holistic approach to dealing with the problem. Adequate mental health service provision then, is a necessary step in recognizing the impact that the conflict has had on society, and consequently in making possible a process of collective healing.

There is also need to raise awareness. It is okay to not be okay. Mental health issues do not discriminate. They can, and do, affect anyone and everyone.  Yet for many, mental health issues are likely to be seen as a weakness. This stigma often stops people from seeking the help or treatment they vitally need.

If these issues are addressed, we will see a benefit to human rights as well as a better functioning society.

Yet in the meantime, until these long-term issues are addressed with long-term solutions by the government, programs like MHAP will continue filling in the gaps, providing counseling to those who need it most, and dealing with the country’s trauma from decades of civil war and political unrest.

Bo Kyi helped found the AAPP and currently serves as a joint secretary.