Ten years ago today, Bangladesh launched its Mental Health First Aid program. One focus was on reducing disaster impacts, further contributing to Bangladesh’s internationally renowned successes at dealing with disaster risks. Irrespective of disasters, mental health first aid helps with daily living.
Training and Awareness Across Bangladesh
Bangladesh’s government, the charity Action Contre La Faim, the Innovation for Wellbeing Foundation, and MHFA (Mental Health First Aid) England collaborated to initiate mental health first aid training and awareness for the country. They ensured that existing training was modified to be fully pertinent to Bangladesh’s context.
Together, bringing Bangladesh on board as the 24th country at the time with a mental health first aid program, they have trained thousands, including the ordinary public, leaders, teachers, and emergency service professionals. Many of these people now form the country’s cadre of mental health first aid trainers, in order to train others.
In promoting the importance of mental health first aid, they highlight that at the time, 16 percent of Bangladeshis were estimated to have a mental health and wellbeing condition. This number, as with everywhere, is likely to be an underestimate. Not everyone accepts or understands mental health and wellbeing sufficiently to seek assistance when needed. Nor do many cultures or countries admit that adverse mental health and well-being conditions can be prevented, diagnosed, and redressed.
While mental health first aid is about day-to-day living, it is also needed in Bangladesh and around the world as part of dealing with disasters. Bangladeshis experience regular floods, both from freshwater—since the country sits at the confluence of three huge rivers—and from saltwater, through cyclone-driven storm surges and variations in upstream river discharges. Meanwhile, the baking arid-lands serve up droughts as landslides cut roads built along hillsides. Coastlines await the full impacts of sea-level rise from human-caused climate change and the country already swelters through worsening heatwaves.
Due to long-term work, these situations do not always become disasters. A culture of cyclone education, warnings, and response has cut storm deaths from hundreds of thousands in tempests in 1970 and 1991 to dozens per storm in recent years. Tapping into local knowledge has helped to deal with flooding waterways and watering holes drying out. Bangladesh recently implemented a landslide early warning system.
The Future for Bangladesh
These successes, including overcoming barriers to discussing and acting on mental health and wellbeing, do not mean that all is well. Bangladesh is plagued by corruption, poor practices in planning and building infrastructure, rampant poverty, and deaths from easily preventable diseases such as dengue fever.
Extremism and political violence are ever-present. The country struggles with a huge refugee crisis, including deficient psychosocial support, as Rohingya have been forced out of their homes in Myanmar.
One mistake in warning or a few years of program neglect could mean that a cyclone again becomes a cyclone disaster, with the ensuing adverse mental health and well-being impacts. The impressive work on cyclones has not been matched for earthquakes, with the fear that the country could be the site of the first million-death earthquake in human history. Bangladeshis were shaken by the April 2015 Nepal earthquake shortly after they started the mental health first aid program, and they felt last month’s tremor in Myanmar.
The 2004 Indian Ocean disaster led to fatalities in Bangladesh. Much worse could be a failure of one of India’s dams on the border. Air pollution in Dhaka is among the worst of the world’s capital cities.
And Bangladesh’s health services remain woefully underfunded, understaffed, undertrained, and undermodernized for all aspects of mental health and well-being. A wealth of local, vernacular, and indigenous knowledge also exists throughout Bangladesh, with many aspects contributing constructively to current understandings of and actions on mental health and well-being.
Everyone and every country must begin somewhere for mental health first aid. Bangladesh now has a decade’s jump-start.
