Mental Health and the Health System in Bangladesh: Situation Analysis of a Neglected Domain

Abstract

Mental Health constitutes a major public health challenge undermining the social and economic development throughout much of the developing world. It is estimated that mental disorders account for 13% of the global burden of disease (WHO 2008). However, in most developing countries mental health remains utterly neglected by the health system. In Bangladesh, for example, a meager 0.5% of the total health budget is allocated to mental health. On the other hand, as more than 65% of the total expenditure on health is out-of-pocket expenses, mental illness takes a heavy toll on the poor and the disadvantaged Based on a review of secondary data, the paper assesses the current situation of mental health in Bangladesh. The paper suggests that mental health care system in Bangladesh faces multifaceted challenges such as lack of public mental health facilities, scarcity of skilled workforce, inadequate financial resource allocation and social stigma. Bangladesh still does not have a comprehensive mental health policy to strengthen the entire health system. Clearly, the most crucial challenge is the absence of a dynamic and proactive stewardship able to design and enforce policies to further strengthen and enhance the overall mental health care. Such strong leadership could bring about meaningful and effective health sector reform, which will work more efficiently for the betterment of the health and social and emotional wellbeing of the people of Bangladesh, and would be built upon the values of equity and accountability.