For Dr Maniphone Vongphathep, a health worker at Hadsayfong district hospital in Vientiane, capital of the People’s Democratic Republic of Lao (Lao PDR), mental health is essential to overall health and well-being. She has noticed an increasing trend of distressed and stressed people in the community as a result of the socio-economic impacts of the COVID-19 pandemic.
“I think it is important that we provide mental health care to people in the community. Many people in our community or even worldwide are going through the same difficulties,” she says.
Dr Vongphathep and other staff at the hospital have now received training from the Department of Hygiene and Health Promotion of the Ministry of Health. The initiative, which aimed to strengthen mental health and psychosocial support skills for people with mental health conditions and community members, was supported by WHO, through the Universal Health Coverage Partnership (UHC Partnership).
Rising mental health conditions due to COVID-19
Mental health conditions can be just as serious–and just as deadly–as physical illness. They account for 14% of the total global burden of disease and constitute one of the leading causes of premature death, disability and human misery around the world.
In most countries, there is still a lot of shame and stigma associated with mental health problems. As a result, many people with mental health conditions do not seek help. In addition, such conditions disproportionately affect poor and marginalized people who often have inadequate access to the health system, so again, the true extent of the problem is hidden.
In Lao PDR, the COVID-19 pandemic is increasingly affecting the mental health of the population with a rising number of people suffering from distress; either directly due to illness from COVID-19 or due to the economic hardships they experienced as a result. An estimated 75% of people live in rural areas with no access to mental health care services.
Mental health care at the primary level
The Ministry of Health identified primary health care (PHC) as an ideal platform to improve mental well-being and promotion at village level. WHO is supporting the Government to deliver long-term mental health services at the PHC level, and to implement tools, guidelines and recommendations on mental health and psychosocial support.
WHO’s Mental Health Gap Action Programme (mhGAP) gives countries a practical framework for scaling up mental health services. It is particularly designed for low- and middle-income countries, and can be adapted according to local contexts and systems for training of health workers.
“We have a need for broad-based mental health services. These should be available in every province in Lao PDR. Our core strategy is to enhance the capacity of the existing health workforce to deliver mental health services,” said Dr Bounfeng Phoummalaysith, Minister of Health.
Reaching out to the community and supporting people at primary health care level will provide a lifeline to many, especially those who are vulnerable. The country is now taking major steps to deliver mental health care nationwide as part of a long-term national effort.
Lao PDR is among the 115 countries and areas to which the UHC Partnership helps deliver WHO support and technical expertise in advancing UHC with a PHC approach. The Partnership is one of WHO’s largest initiatives on international cooperation for UHC and PHC. It is funded by the European Union (EU), the Grand Duchy of Luxembourg, Irish Aid, the Government of Japan, the French Ministry for Europe and Foreign Affairs, the United Kingdom – Foreign, Commonwealth & Development Office, Belgium, Canada and Germany.
COVID-19 mental health and psychosocial support homecare kit training for district health officers. Vientiane, June 2021. @WHO/Vannaseng Insal