Global Health Delivery: An Introspective look Global Health Delivery: How Did we Get to where we Are [Series 01]
Gathline Etienne, MD*
Corresponding Author: Gathline Etienne,
Copy Right: © 2023 Gathline Etienne, This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Received Date: May 24, 2023
Published Date: June 01, 2023
Series1: The Biosocial Roots of Mental Health Ailments
Taking a satellite view of our globe, you will find that from the beginning of time, human beings have yielded to their animalistic tendencies; fighting against each other to dominate, subjugate and even decimate. One would think that such endeavours would be a process of natural selection with the survival of the fittest. However, what has evolved are not superior human beings, but rather more sophisticated weapons, bureaucracy and political systems that mainly lead to marginalized groups, social inequalities, and racial divide. As the public experiences adversities, whether it’s being displaced from their country or family due to colonialism or war; losing their homes through disasters brought on by climate change; losing their bodies through the ravages of diseases; working endlessly for unfair wages; meeting the demands of family and friends; or acknowledging the inadequacy of the face in the mirror; such model of an unwell labour force is not sustainable. It will only result in poor productivity and economic losses; directly and indirectly. Health is indeed wealth!
Currently, global public health is at its infant stage, and health is broadly defined as social, physical, and mental wellbeing. To cope with life stressors and adversity, one must be mentally resilient. Hence, mental health is just as important as physical health, if not more important. When the mind suffers, so does the body, but it doesn’t have to be vice versa. The World Health Organization (WHO) further defines mental health as “a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.” [1] So no one is immune from mental health problems. They further state that “mental health is more than just the absence of mental disorders or disabilities” [1], which was the prior public perception. This stigma has lead to inadequate resources allocated to recognizing and treating mental health ailments.
Physicians are called upon to improve the health of others, but often sacrifice their own well-being to do so. Physician suicide is a topic of growing professional and public health concern since doctors have the highest rate of suicide of any profession and the rate is doubled (28-40 per 100,000) when compared to the general population (12.3 per 100,000) [2,3]
Doctors who die by suicide often have untreated or undertreated depression or other mental illnesses, high burnout rates and can be seen quite early during the rigorous years of medical school training. [3,2] Stoic training environments normalize stress and distress as inherent or even requisite components of physician identity. Sleep deprivation and long work hours are viewed as badges of honor. Physicians and trainees see their peers as competition, rather than collaborators, which can lead to social isolation.[4] They often practice defensively due to fear of malpractice claims.
Among other factors, such as access to lethal drugs, there are other several systemic barriers in place that discourage self-care and help seeking behaviours among physicians. The consequences of this inaction can have dire consequences, not only for the physician, but for patients and public at large.[3]
As physicians and other governing bodies become more introspective and recognize the importance of mental health, then policies and programs can be enacted as was, and is being done for physical health. The WHO summarized it quite profoundly, “Mental health is fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.” [1]
References
1. https://www.who.int/news-room/fact-sheets/detail/mental-health- strengthening-our-response
3. https://www.webmd.com/mental-health/news/20180508/doctors-suicide- rate-highest-of-any-profession
4. Kim B, Jee S, Lee J, An S, Lee SM. Relationships between social support and student burnout: A meta-analytic approach. Stress and Health. 2017;34(1)