Mental Health in Sri Lanka
A Summary
Evolution and Current Research Trends of Mental Health In Sri Lanka
A Summary by Hiranthi Munasinghe
Historic Statistics on Mental Health in Sri Lanka
1898: Establishment of the First Mental Hospital
In a significant historical development, the inaugural mental hospital in Sri Lanka emerged in 1898, marking a pivotal moment in the country's approach to mental health. This establishment laid the foundation for addressing mental health concerns, reflecting the evolving societal attitudes towards mental well-being during that era.
1964: Inauguration of Mental Health Research
The year 1964 witnessed a groundbreaking milestone with the publication of Sri Lanka's first mental health research. This marked a crucial step forward in advancing the understanding of mental health issues within the local context, contributing to the nascent field of mental health research in the country.
1983-2009: Impact of Civil War on Mental Health
The period spanning from 1983 to 2009 was marred by the devastating Sri Lankan civil war, leaving an indelible impact on the mental health landscape of the nation. Numerous studies conducted during this time shed light on the profound consequences of the conflict on the psychological well-being of the population.
2007: National Survey on Common Mental Disorders
In 2007, a comprehensive national survey unveiled a sobering reality, indicating a lifetime prevalence of 13.3% for common mental disorders in Sri Lanka. This survey offered crucial insights into the widespread nature of mental health challenges, prompting a deeper understanding of the scale and scope of the issue.
2010: Establishment of the National Institute of Mental Health
A significant stride in mental health infrastructure occurred in 2010 with the establishment of the National Institute of Mental Health. This institution played a pivotal role in centralizing efforts to address mental health concerns, fostering research, and advancing professional expertise in the field.
2012: Decentralization of Mental Health Services
Recognizing the need for accessibility, the Sri Lankan government launched a program in 2012 aimed at decentralizing mental health services. This strategic move sought to bring mental health support closer to communities at provincial and district levels, addressing regional disparities in service availability.
2016: Integration of Mental Health into Primary Care
In 2016, Sri Lanka took a progressive step by integrating mental health services into primary care. This strategic shift aimed to embed mental health considerations within the broader healthcare framework, ensuring a more holistic and comprehensive approach to addressing mental health challenges at the grassroots level.
2022: High Prevalence of Adolescent Mental Health Problems
Recent research in 2022 has unveiled a concerning reality, indicating that a staggering 40% of adolescents in Sri Lanka grapple with mental health problems. These issues, ranging from loneliness and anxiety to suicidal ideation, underscore the urgent need for targeted interventions and support structures to safeguard the mental well-being of the younger generation.
Key aspects of Mental Health in Sri Lanka
Prevalence of Mental Disorders
An estimated 13.3% of the population in Sri Lanka has encountered a common mental disorder, as revealed by the National Mental Health Survey conducted in 2007. This statistic underscores the substantial prevalence of mental health issues within the country, emphasizing the need for a comprehensive understanding and effective interventions to address the diverse spectrum of psychological challenges.
Common Disorders
Among the prevalent mental disorders in Sri Lanka, anxiety disorders (4.2%) and depressive disorders (3.1%) stand out as the most common, according to findings from the National Mental Health Survey in 2007. These disorders, affecting a significant portion of the population, highlight the importance of targeted mental health initiatives and support systems.
Other Disorders
In addition to anxiety and depressive disorders, post-traumatic stress disorder (PTSD), obsessive-compulsive disorder (OCD), and eating disorders contribute significantly to the mental health landscape in Sri Lanka. Various mental health studies conducted in the country have consistently identified these disorders, indicating the complexity and diversity of mental health challenges faced by the population.
Vulnerable Populations:
Certain demographic groups, such as adolescents, women, and individuals affected by conflict, emerge as particularly vulnerable to mental health problems. Research on mental health disparities in Sri Lanka has underscored the heightened susceptibility of these populations, emphasizing the importance of tailored interventions and targeted mental health support programs.
Risk Factors:
Multiple studies on mental health risk factors in Sri Lanka have identified a range of determinants contributing to the prevalence of mental health problems. These encompass socio-economic factors such as poverty and unemployment, social factors including isolation and discrimination, exposure to violence and trauma, experiences of childhood abuse and neglect, substance abuse, physical health issues, and limited access to mental health care. Understanding these risk factors is crucial for developing holistic approaches to mental health prevention and intervention strategies.
Limited Mental Health Services:
Mental health services in Sri Lanka face significant challenges, characterized by limitations and fragmentation. The shortage of mental health professionals, particularly in rural areas, creates barriers to access for a substantial portion of the population. The existing gaps in service provision highlight the urgent need for increased investment, resource allocation, and strategic planning to enhance mental health services across the country.
Stigma and Discrimination:
Stigma and discrimination associated with mental illness are pervasive and represent major obstacles to individuals seeking and receiving mental health care. Studies on mental health stigma in Sri Lanka reveal the detrimental impact of societal attitudes, contributing to the reluctance of individuals to disclose or seek help for mental health issues. Addressing stigma and discrimination is paramount to creating an environment conducive to open discussions, understanding, and acceptance surrounding mental health.
Cultural Aspects of Mental Health in Sri Lanka/ The Taboo of Mental Health in Sri Lanka
Mental health is a taboo subject in Sri Lanka due to a number of factors, including cultural beliefs, lack of awareness, and stigma. Culturally, there is a belief that mental illness is a sign of weakness or that it is caused by supernatural forces. This can lead to people feeling ashamed to admit that they are struggling with a mental health problem. Additionally, there is a lack of awareness about mental health problems in Sri Lanka. This means that many people may not even realize that they have a mental health problem, or they may not know where to seek help.
Moreover,, there is a lot of stigma associated with mental illness in Sri Lanka. This can make people afraid to seek help or to talk about their problems. The stigma can also lead to discrimination and social isolation. This can have a significant impact on a person's quality of life and mental health. Not to mention that the taboo surrounding mental health in Sri Lanka can have a number of negative consequences for people with mental health problems. It can make it difficult for people to seek help, which can lead to their condition worsening. It can also lead to social isolation and discrimination. This can have a significant impact on a person's quality of life and mental health.
Source- Wickramaratne, P. I. R., Gunasekara, S., & Wijesuriya, S. (2010). Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka. Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 987-996.
Mental Health Research Trends in Sri Lanka
Mental health research in Sri Lanka has increased in recent years, with a growing focus on vulnerable populations, such as adolescents, women, and conflict-affected individuals. However, there are still a number of challenges to conducting mental health research in Sri Lanka, including a shortage of mental health researchers, limited funding, and lack of access to research resources and infrastructure.
1.Post-Conflict Sri Lanka: The Lack of Mental Health Research and Resources among Affected Populations (Sritharan & Sritharan, 2014)
This study examined the available published literature on the post-conflict and tsunami disaster mental health concerns in Sri Lanka. The study found that there are significant gaps in mental health research and resources in Sri Lanka, particularly in the area of post-conflict and disaster mental health.
2. Mental health condition among adolescents is a leading cause of health‐related disability in Sri Lanka (Rajapakse et al., 2022)
This study found that mental health conditions among adolescents are a leading cause of health-related disability in Sri Lanka. The study also found that adolescents with mental health conditions are more likely to experience social and academic impairment.
3.Challenges of Research in Rural Mental Health in Sri Lanka (De Silva & De Silva, 2017)
This study identified a number of challenges to conducting mental health research in rural Sri Lanka, including:
- A shortage of mental health researchers
- Limited funding for mental health research
- Lack of access to research resources and infrastructure
- Stigma associated with mental illness, which can make it difficult to recruit participants for research studies
4.Physical and mental health issues to the neighbouring residences due to the construction projects in Sri Lanka
This study found that construction projects can have a significant negative impact on the physical and mental health of neighbouring residents. Residents may experience respiratory distress, hearing impairments, traffic congestion, lack of landscape, and flooding conditions. The study also highlights the importance of health and safety measures in project management.
5.Cultivating capacities in community-based researchers in low-resource settings: Lessons from a participatory study on violence and mental health in Sri Lanka
This study drew on the experiences of community-based researchers who supported a study on violence and mental health in Sri Lanka. It identified rewards, challenges, and recommendations for supporting their wellbeing and development. The study highlighted the importance of intentional choices around communication, training, human and consumable resources, project design, and navigating unstable research conditions.
6.Exploring challenges in mental health service provisions for school-going adolescents in Sri Lanka
This study explored the challenges experienced in mental health service provision for school-going adolescents in Sri Lanka from the perspective of school counsellors. Three main themes emerged from the data: negative perceptions of mental health and counselling, the unwillingness to invest in mental health services, and the challenges inherent in the system itself. The study suggested grassroots level initiatives that can be implemented within schools to reduce the barriers to service provision.
7.Impact of Social Media on Mental Health: A Review of Cases
This paper discussed how the use of social media can have both positive and negative impacts on the mental health of patients who attend psychotherapy. It observed how social media can precipitate, perpetuate, and protect against mental illness.
8.Mental health condition among adolescents is a leading cause of health‐related disability in Sri Lanka
This study found that mental health conditions among adolescents are a leading cause of health-related disability in Sri Lanka. The study also found that adolescents with mental health conditions are more likely to experience social and academic impairment.
9.Challenges of Research in Rural Mental Health in Sri Lanka
This study identified a number of challenges to conducting mental health research in rural Sri Lanka, including:
- A shortage of mental health researchers
- Limited funding for mental health research
- Lack of access to research resources and infrastructure
- Stigma associated with mental illness, which can make it difficult to recruit participants for research studies
10.Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka
This study found that exposure to family violence, war, and natural disasters is associated with an increased risk of mental health problems in children. The study also found that the impact of these stressors on children's mental health is mediated by a number of factors, including social support and coping skills.
References
- Rajapakse, J. C., Weerasinghe, V., & Wickramarachchi, T. (2022). Mental health condition among adolescents is a leading cause of health‐related disability in Sri Lanka. The Medical Journal of Australia, 216(9), 397-403.
- De Silva, V., & De Silva, D. (2017). Challenges of Research in Rural Mental Health in Sri Lanka. Indian Journal of Psychological Medicine, 39(2), 102-106.
- Wickramaratne, P. I. R., Gunasekara, S., & Wijesuriya, S. (2010). Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka. Journal of the American Academy of Child and Adolescent Psychiatry, 49(10), 987-996.
- Williams, S. S., Hewage, S. N., & Karandawala, I. R. (2011). Mental health research trends in Sri Lanka. Ceylon Medical Journal, 56(2), 61-65.
- Sritharan, J., & Sritharan, A. (2014). Post-Conflict Sri Lanka: The Lack of Mental Health Research and Resources among Affected Populations. Journal of Immigrant and Minority Health, 16(2), 328-335.
- Jenkins, R., Mendis, J., Cooray, S., & Cooray, M. (2016). Integration of mental health into primary care in Sri Lanka. BMC health services research, 16(1), 1-9.
- Liyanage, K., & Jayasinghe, D. (2019). Exploring challenges in mental health service provisions for school-going adolescents in Sri Lanka. BMC Health Services Research, 19(1), 1-12.
- Palfreyman, A., Riyaz, S., Rizwan, Z., Vijayaraj, K., Chathuranga, I. P. R., Daluwatte, R., et al. (2022). Cultivating capacities in community-based researchers in low-resource settings: Lessons from a participatory study on violence and mental health in Sri Lanka. PLOS Global Public Health, 2(11), e0000899.
