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DHAKA (BANGLADESH):
Prof. Pedro Ruiz former President of American Psychiatric Association
who is also President-elect of World Psychiatric Association delivered a
special lecture on Mental Health and Socioeconomic Determinism during
the recently held WPA Regional Conference at Dhaka, Bangladesh. This
session was chaired by Prof. Rizwan Taj from Pakistan. Prof. Pedro
pointed out that with the increase in poverty, there is an increase in
mental diseases. The deprived social class suffers more from mental
disorders. Quoting Economy Stress and Health Related outcome in 20 US
metropolis data, he further stated that 1% increase in unemployment
leads to 0.84% increase in suicides, 6.7% increase in homicides, 2.4%
increase in forcible rape, 0.76% increase in accident deaths and 5.6%
increase in death due to heart diseases besides 7.1% increase in stroke.
Poverty, stress and mental illnesses are all inter related. Talking
about poverty stress manifestation he said that poverty results in poor
housing, inferior nutrition and education besides lack of health
insurance. He wondered that how one can maintain dignity if his/her kids
are not going to school. He was of the view that we must hear to our
kids when they are two to three years old. If you don’t, their IQ will
not be good. We must convince the governments to ensure good access to
healthcare for all. Poverty also leads to poor pre, postnatal care,
unwed pregnancies, prostitution, sexual abuse, rape, HIV and AIDS as
well as family instability. Poor people, Prof. Pedro said usually have
more kids; suffer from sleep disturbances, accidents, alcoholism,
substance abuse and imprisonment. They also suffer from primary sleep
disturbances, anxiety, mood disorders, chronicity of schizophrenia,
alcohol related disorders, dementia, mental retardation and pain trauma.
Giving figures of mean financial income of Americans, Prof. Pedro said
that Asians are on top of the list with median income of US$ 51,205
followed by Whites with US$ 44,366 while Native Americans mean income is
US$ 30,784. About 10.2% of Americans live below the poverty line. About
fifty million Americans which include 33.4% Hispanics and 22.4% Blacks
have no health insurance. There are twelve million kids who are poor in
USA and out of every four, one which comes to 2.8 million do not have
health insurance. The prevalence of cardiovascular diseases, cancer,
respiratory infections, diabetes, accidents, suicide and homicides is
much higher in Blacks as compared to white male and females. We have to
recognize it as a problem and collect non-clinical data related to socio
economics. Performance measures should be stratified by socio economic
position. Efforts should be made to overcome barriers to treatment by
addressing socio economic conditions. We must promote culturally
competent services, advocate full access to health and mental
healthcare, strive for community empowerment, help abolish stigma,
prejudices and discrimination.
Continuing Prof. Pedro said that we must aim at full health services
parity, support prevention efforts, show commitment to quality care and
access to care, fair distribution of resources, scientific knowledge
besides showing commitment to resolving of conflict of interest.
Healthcare professionals must strive for patient welfare, privacy of
patients, their welfare, autonomy and social justice.
During the discussion it was pointed out that if one looks at the
situation in India, Pakistan and Bangladesh, though there is lot of
poverty, stress and mental illnesses but joint family system is a safety
net. That is why the overall burden of mental diseases is less as
compared to the affluent societies in the West. |
