Except for a few countries, global funding for mental health research is still quite low. Health researchers and funding bodies have been urged to assess current funding patterns in order to ensure that research is distributed equitably around the world.
Every year, a sizable portion of Batswana struggle with a mental health issues of some kind. But these people encounter significant patient access barriers that prevent them from accessing the mental healthcare setting, as opposed to going to the doctor like they might for a leg injury. In Botswana, there is a distinct lack of study on mental health. Few nations, including South Africa, have a disproportionately large influence on the sub-mental region’s health. Although there is substantial evidence that mental health research is essential for enhancing health and health equity in low- and middle-income countries (LMICs), Botswana has not made the crucial step to investigate and produce the degree of mental health research required to guide policy.
According to a World Health Organization (WHO) report, the global prevalence of anxiety and depression increased by 25% in just the first year of the pandemic. Covid-19 has also had disastrous consequences in Botswana. A working paper entitled: Mental health research in Botswana: a semi-systematic scoping review prepared by Philip R. Opondo, Anthony A. Olashore, Keneilwe Molebatsi, Caleb J. Othieno and James O. Ayugi notes that Botswana has “comparatively limited research output on mental health”.
Furthermore, they discovered that there “were only 58 articles over a 27-year period. A systematic review of psychiatric research in South Africa, an upper middle-income country neighbouring Botswana, identified 908 articles over a 31-year period (1966 to 1997). Our finding that research in Botswana is limited is consistent with other studies that have identified a paucity of mental health research in LMICs,” states part of the paper. The research also states that if this issue is not addressed, it might contribute to the neglect of mental health issues in countries such as Botswana.
Despite a decrease in the number of Covid-19 cases in Botswana, the country is not yet out of the woods. The pandemic is still very much alive, and experts warn that if more Covid waves hit the country, it should prioritize mental health in a post-pandemic world.
Some mental health experts say despite a surge in patient interest over the past two years, courtesy of the Covid-19 pandemic which upended peoples’ lives, access to mental healthcare in Botswana is left wanting due to limited clinician availability and cultural stigma.
“There is critical need for mental healthcare access across all patient populations in Botswana. This is an all-encompassing issue that deserves the kind of attention other chronic diseases often receive,” says one expert, adding that “Limited health insurance access keeps a lot of people from visiting mental healthcare professionals. And even in situations where someone can find affordable healthcare providers, clinician shortages, fragmented care, and societal stigma are getting in the way of adequate care access”.
One of the primary causes for limited mental healthcare access in Botswana is the absence of adequate qualified mental health professionals to meet demand. Data shows that only about 26% of Botswana’s mental health provisions are fulfilled, a figure basically estimated by dividing the number of available psychiatrists by the number Botswana needs to have filled its clinician shortage.
Mental health data collection in Botswana is patchy since almost two thirds of people with a known mental disorder never seek help from a health professional. This is worsened by the fact that Botswana has generally turned a blind eye to mental health since less funds have been directed to treatment and reversing societal stigmas toward those suffering from mental health.
Studies conducted the last few years show that Botswana lacks access to high-quality mental health services, struggles with stigma and has a fragmented service delivery models. It is also reported that suicides are likely to significantly go up. With a suicide mortality rate of 16.1 per 100, 000 population, Botswana has the third highest rate of suicide in comes in third in the Southern African Development Community (SADC) region.
The Mental Health Atlas 2020 which tracks progress in implementing World Health Organisation (WHO) Comprehensive Mental Health Action Plan 2013–2020 notes that there still exists inequalities in the availability of mental health resources.
“Despite steady progress seen in the adoption of policies, plans and laws, as well as improvements in capacity to report regularly across years on a set of core mental health indicators, the Mental Health Atlas 2020 shows massive inequalities in the availability of mental health resources and their allocation between high- and low-income countries and across regions,” notes the report.
Dévora Kestel, Director of the Department of Mental Health and Substance Use at World Health Organisation (WHO) says “The new data from the Mental Health Atlas shows us that we still have a very long way to go in making sure that everyone, everywhere, has access to quality mental health care”.
In Botswana, social stigma of mental health conditions stops people from accessing treatment. Among other things, discrimination in social and professional circles is still a major problem. There are even reports of some parents hiding their children because they fear people will blame them for bad parenting which creates negative perceptions.
As recommendations, the Mental health research in Botswana: a semi-systematic scoping report suggests the need “to strengthen the research capacity of individuals working in the mental health field. There is a need to develop a national database of research on mental health in Botswana and to set out research priorities. This would help to guide the mental health research agenda”.
