Eng 105 Research

1 The State of Mental Health Care in Bangladesh
The State of Mental Health Care System in Bangladesh:

The Need for Improvement
Sadia Zaman
Eng 105, Section 08
Ms. Nadia Kamal Al-Siraj (NKS)
August 4, 2016
Acknowledgement
I am solemnly grateful to Almighty Creator who has given me this opportunity to carry
out such an interesting research and enabled to develop a research paper as a requirement of the
completion of ENG105. I want to thank my honorable course instructor, Ms. Nadia Kamal Al-
Siraj for giving me the opportunity to prepare this paper and to provide me the necessary
information and advices from time to time. Her practical knowledge, guidelines and constant
monitoring has encouraged me in doing the best I can and thus generating this research paper
successfully.
I would want to thank Ms. Sarah Fardeen, Ms. Sabeeha Saleque, Sister Lipy Gloria
Rozario and Dr. Mohammad Tariqul Alam, for taking time out from their busy schedule for my
interview. Their sincere opinion and expertise on my topic have enabled me to develop an in
depth analysis of my research. Lastly, I would want to thank my Parents, friends and all my well-
wishers without whose support it would not have been possible.
I had a great time working on this topic and hope that you will too while reading it.
Sincerely,
Sadia Zaman
Abstract
This paper attempts to shed light on the current condition of Bangladeshs Mental Health
Care system and the need for improvement on multiple fronts. According to a research by World
Health Organization (WHO), mental illnesses pose worldwide threat to health while making low
to medium income countries like Bangladesh the greater victims. A systematic review conducted
by ICDDR found out that the overall prevalence of mental illnesses range up to 30% in
Bangladesh. Despite the alarming prevalence of mental disorders, this sector remains
unexplored with very little systematically collected data, insufficient funding and lack of
treatment facilities in primary care. At the same time the government allocated fund for the
mental health sector is very low which inhibits the system from progressing further. In order to
cater to the problem on a mass level the acknowledgement of mental disorders and their growing
occurrences in the country, is mandatory. This paper describes the current situation of mental
health care system in Bangladesh and suggests that this sector faces multiple challenges such as
lack of public mental health facilities, scarcity of mental health practitioners and inadequate
financial support.
Table of Contents
Introduction.................................................................................................................... 5
Background.................................................................................................................... 7
Research Questions.......................................................................................................... 9
Hypothesis................................................................................................................... 10
Research Methodology.................................................................................................... 13
Data Presentation and Analysis.......................................................................................... 14
Summary of Interviews................................................................................................... 23
Summary of Research Findings......................................................................................... 26
Limitations and Recommendations..................................................................................... 27
Conclusion................................................................................................................... 28
Bibliography................................................................................................................ 29
References................................................................................................................... 31
Appendix..................................................................................................................... 34
Introduction
According to WHO (World Health Organization), mental health is "a state of well-being in which
the individual realizes his or her own abilities, can cope with the normal stresses of life, can
work productively and fruitfully, and is able to make a contribution to his or her community"
(2004). WHO states that Mental health is the perfect balance of emotional and psychological
state of an individual and that it affects their abilities to function daily, make decisions, deal
with stress, behave normally and eventually affects their physical health. An online article
published by Medical News Today, states that an individual with a healthy mental state can work
productively, make healthy life choices, and easily maintain a good physical wellbeing
(Nordqvist, 2015). But, those who lack a healthy mental state or in other words have mental
illnesses and disorders are unable to function normally, and face serious challenges in thinking
and behaving. The mentally ill people usually show abnormal behavior and attitude while facing
severe difficulties in performing daily actions (Nordqvist, 2015).
WHO explains that mental health problems pose an even greater threat to medium and
low income countries such as Bangladesh since the mental health care services are severely
underfunded and issues regarding mental illnesses are easily neglected (Nordqvist, 2015). Over
15 million people suffer from a wide array of mental health issues yet there are not enough
mental health treatment institutions or service providers (Islam & Biswas 2015). In this country,
a large group of people are victims of grievous mental disorders that deprive them form having a
normal life. Photojournalist Allison Joyce, who had visited some patients affected in Pabna
Mental Hospital, concluded that the People with mental illness are severely neglected in
Bangladesh and patients are stigmatized and provided insufficient treatment (2015). The
patients need appropriate medical treatment, family care and mental health care from the medical
institutions and medical service providers. This research paper will bring into spotlight the areas
of the mental health care system that need improvement and the ways in which these needs might
be addressed, in order to provide proper treatment to the patients.
According to Rahman (2000), the mental health care services available in Bangladesh are
barely sufficient compared to the large magnitude of the number of mentally ill patients and it
has become imperative that these mental health issues are prioritized as any other chronic
diseases and the treatments provided are improved. Dr. Waizul Alam (2014) stated that in order
to cater to this problem effectively, we need professional assistance. More medical service
providers and doctors would be necessary in the mental treatment facilities to ensure sound
treatment. The more knowledge we possess on the mental health issues and illnesses, the more
awareness we will be able to spread and eventually we will be able to bring up a more sincere
nation. This paper will portray how the mental health care system is neglected in Bangladesh and
will provide an in depth knowledge about the mental health care system in Bangladesh.
Background
Mental health complexities and illnesses have been a serious concern worldwide for quite
some time now. It has been found out that mental health constitutes about 13% of the global
burden of diseases (World Health Organization, 2008). According to a literature review by BMC
psychiatry, the developing countries such as Bangladesh are more vulnerable to psychiatric
diseases than the developed countries. The developing countries with an unstable socio political
condition face more natural or man-made disasters, poverty and usually have overcrowded
communities which might account to an increase in mental illnesses. The topography of
Bangladesh is situated on a geographical plane which is more prone to floods, storms and other
natural disasters which cause great suffering and bring about more mental illnesses among the
affected people (Karim et al., 2006).
The medical sector including numerous hospitals, organizations and NGOs that work on
chronic non-communicable diseases in Bangladesh also largely ignore mental health (Biswas &
Islam, 2015). In Bangladesh, chronic diseases are meant to include diabetes, cancer and other
physical diseases only. Despite being linked with the chronic diseases, the mental illnesses do not
get significant attention (Biswas & Islam, 2015). It can be derived that the professional including
doctors and medical service providers do not acknowledge mental health issues to be a major
threat to the overall health system in this country. According to World Health Organization
(2008), almost 15 million of the population are afflicted with different kinds of mental illnesses
which basically is 10% of the current population. Yet still, the treatment facilities provided on the
primary health care level is almost negligible.

The data regarding mental health is very limited due to the lack of research and studies.
This explains why the health care system in providing mental health care services is lacking
behind and is failing to accommodate treatment to the millions at stake. There is no specific
mental health authority in the country. Bangladesh WHO-AIMS report on the mental health
system in Bangladesh states that there are 50 outpatient mental health facilities and none of the
facilities provide follow-up care after treatments. The report also states that there are about 30
community based psychiatric inpatient facilities and about 11 community residential facilities in
the country all of which have very limited capacities and are mostly reserved for children and
women ( World Health Organization, 2006).
The only 500 bedded hospital is the government run Pabna mental hospital which again
in turn is understaffed and lacks adequate maintenance. On average it turns out to be one bed for
two hundred thousand patients in Bangladesh which is too meagre compared to any developing
country in the world. The reason for the lack of maintenance could as well be accounted to the
governments funding allocated on the mental health care sector. The amount of expenditures by
government on the mental health care services have been just a scanty amount of 5% of the
entire health care budget in the 2005 and have not increased significantly till date ( World Health
Organization, 2006). WHO-AIMS report (2006) had estimated the aggregate number of
professionals and service providers in this sector to be around 0.49 mental health practitioner per
100,000 population back in 2005, which have increased by a very little percentage.
Overall the multifaceted challenges need to be overcome on both national and community
level. More hospitals, treatment facilities, educational institutes, psychiatrists, psychologists
would need to be introduced to address the concern nationally. If no proper action is taken then
the mental health sector will remain unaddressed while the rate of mental illness would be rising.
Research Questions
Research Questions: Through my research I look forward to call to attention the lacking in
treatment facilities in the mental health care system of Bangladesh and emphasize on the
importance of adequate treatment and care for mental health issues. The questions mentioned
below would perfectly demonstrate my hypothesis and help me search for related information.
1. What encompasses mental health illness?
2. What is the prevalence of mental illness in Bangladesh?
3. What is the current state of the mental health treatment facilities or hospitals in Bangladesh?
4. How can the mental health care facilities and treatments be improved in order to provide better
treatment to mentally ill people?

Hypothesis
World health organization (WHO) describes mental health illness as a disease of the
brain which leads to unstable emotional and mental state of mind eventually leading to
disturbances in cognitive, mood and behavioral processes (World Health Organization,
2005). Mental health disorders such as depression, anxiety and addiction are readily found in
patients of all ages while some of the more critical mental disorders include: clinical depression,
bipolar disorder, dementia, schizophrenia, anxiety disorders and neurosis (Nordqvist, 2015). The
patients show a variety of differing responses to everyday activities, often exhibiting erratic
behavior and irrational thinking. According to the NIMH (National Institute of Mental Health),
the usual symptoms may include drastic changes in mood, personality, personal habits, social
withdrawal, inability to differentiate between reality and fantasy and lack of control over own
actions. Factors that might trigger mental health illnesses include biological disorders, genetic
factors, traumatic life experience, family history of mentally ill ancestors, a reaction to
environmental stresses, biochemical imbalances, or a combination of these (World Health
Organization, 2005).
A report by National Institute of Mental Health found there are 14.5 million adults with
mental disorders in the country and nearly 20% of children aged 12-17 have a mental illness
(2011). Another systematic review led by an international health research institute in Dhaka,
ICDDR, found that the overall prevalence of mental disorders in Bangladesh is between 6.5 to
31% among adults and is estimated to be between 13.4 to 22.9% among children (2015). The
study had indicated that prevalence of mental disorders were more prominent in overcrowded
urban areas than the rural ones. It also indicated that women and children were more
susceptible to mental disorders and that children from poor families showed an increased
symptoms of mental illness. However due to lack of knowledge, superstitious beliefs and social
stigma, individuals with mental illness refrain from seeking out professional help, explained
Omar Rahman, a psychiatrist in Bangladesh (2011). There is a high chance that the prevalence of
mental illness in Bangladesh is underestimated due to all the social barriers associated with it
(ICDDR, 2015). In order to overcome the misconceptions, more research in this sector, more
qualified mental health professionals at the treatment facilities and mass awareness raising
campaigns are required; educating the mass accurately about mental illnesses will help alleviate
the effect of social stigmas.
Despite the vast population of mentally ill patients, the current mental health care system
remains highly neglected, mistreated and stigmatized in Bangladesh (ICDDR, 2015). To begin
with, the only organizations directly dealing with mental health are Pabna Mental Hospital and
the National Institute of Mental Health (Saif, 2016). The Pabna Mental Hospital is the first and
the only mental hospital of the country and yet, the treatment facilities here lack proper
maintenance, sufficient mental health service providers and is largely underfinanced as well.
Allison Joyce, who had visited the hospital last year concluded that the hospital is severely
underfunded- it was poorly maintained, had few specialists, the patients had not received
adequate attention. Pabna hospital has a capacity of merely 500 beds, with about 30
professionals and practitioners which is clearly not enough to serve the 15 million people
affected (Joyce, 2015). The Bangladesh WHO Aims report (2007) mentions that only 0.5% of
the entire government health budget is allocated to mental health expenditures and that
0.11% of the population can freely access some psychotropic medicines while other patients
have to pay out of their own pocket.

In order to establish the significance of improvement in mental health care system in
Bangladesh, government and the people will need to work together on various fronts and
minimize the barriers. The government should address the shortcomings and increase the funding
for this sector, establish more treatment institutions and close the gap of the major shortage of
mental health service providers and practitioners in order to improve the mental health services.
A government regulatory body along with formal educational institutions should constantly
supervise the professionals and institutions to maintain the quality of mental health services
provided, said Professor Shaheen Islam, in a discussion for the rights perspective of the
Bangladesh Mental Health Act (2014). She also emphasized that mental health service
providers, along with social and community workers should be moderately trained on mental
health issues in order to ensure mental health service and awareness at all levels. By creating a
social movement about mental health protection, awareness and necessary knowledge on the
mental health issues and their symptoms can be spread out among both the urban and rural
population (Islam, 2014). The necessity of addressing the mental health care issues is vital and
should be given utmost precedence in the improvement of the mental health treatment sector of
Bangladesh (ICDDR, 2015).

Research Methodology
For my primary research I have conducted 4 direct, in depth interviews of 2 faculty
members, 1 psychiatrist and 1 student counsellor. I have asked them questions regarding the
mental health care state in Bangladesh and the necessity to improve the current system. I have
mainly collected and related to their opinions and experiences that they have shared throughout
discussion in the interviews. For understanding and incorporating common publics perspectives
I have developed and conducted an online survey using a questionnaire. I have distributed my
questionnaires among a specific sample of 30 people who have sufficient knowledge in this
sector and have come across mentally ill patients at any point of their lives. I have used the data
derived from the questionnaires in the data analysis and to summarize my research findings. I
have also quoted and summarized the interviews in the Summary of Interviews section.
For my Secondary Research I have utilized the university database for online journals
and articles. Apart from that, I have also searched the internet to look at past research papers,
articles, web portals, blogs, newspapers, journals etc. addressing my proposed topic. I have
browsed the internet from my university which has an educational domain for better results. I
have also used the standard Google search engine, Yahoo search engine and Google Scholar to
find all the data relatable.

Data Presentation and Analysis
1. What is mental health according to you? Responses Responses (%)

The mental stability (calmness, temperament) of 14 46.67%
an individual
The physical, mental and social well being of an 11 36.67%
individual
It is the ability of a person to behave normally. 3 10%
It is the same as physical health 2 6.67%
For my primary research I have conducted a survey by distributing questionnaires among
a specific group of 30 people. Since the topic I chose was not very much familiar with the
general people, I had to choose only those who had minimal knowledge regarding this and
understood my concept. My questionnaire contained 9 questions. I will be explaining 7 of the
important ones in different graphical and chart forms.
The column chart below shows different opinions given by the survey respondents when
asked for their opinions regarding mental health. 46.7% think that it is the mental stability
(calmness, temperament) of an individual. 36.67% responded that it is the physical, mental and
social wellbeing of an individual. 10% said it is the ability of a person to behave normally while
only 6.67% responded saying that it is the same as physical health.

1. What is mental health according to you?
The mental stability (calmness, temperament) of an individual
6.67
The physical, mental and social well being of an individual
10.00
Responses
It is the ability of a person to behave normally.
36.67
46.67
It is the same as physical health
0.00 5.00 10.00 15.00 20.00 25.00 30.00 35.00 40.00 45.00 50.00
2. How would you describe mental illness? Responses Responses (%)

Mental and emotional instability brought about by 5 16.67
physical ill health.

It is not an actual illness, it is just a misconception 5 16.67
within an individual's mind.

It is a brain disease, which brings about unusual 7 23.33
behavior in an individual.
The inability of an individual to function normally. 12 40.00
Mental and emotional instability for any reason 1 3.33
2. How would you describe mental illness?

Mental and emotional instability brought about by physical ill health.
3%
17%
It is not an actual illness, it is just a misconcept within an individual's mind.
It is a brain disease, which brings about unusual behavior in an individual.

40%
17%
The inability of an individual to function normally.
Mental and emotional instability for any23%

reason
The doughnut chart shows that out of 30 people 12 (40%) people had answered that
mental illness is the inability of an individual to function normally. 7 of them have acknowledged
that it is a brain disease, which brings about unusual behavior in an individual, which accounts to
23%. 5 of them have answered that it is the inability of an individual to function normally while
another 5 have said that it is not an actual illness, just a misconception within ones mind which
makes 17% each. Only one person put in their own comment that it is the mental and emotional
instability for any reason. From this question I got to know that a majority of the respondents are
aware about the existence of mental illness while about 17% of them are not even
acknowledging it as a disease.
3. How widespread do you think mental illness is in Response Responses
Bangladesh? s (%)
1(not widespread at all) 1 3.33
2(Barely widespread) 7 23.33
3(somewhat widespread) 12 40
4(quite widespread) 9 30
5(very widespread) 1 3.33
How widespread do you think mental illness is in Bangladesh?

45
40 40
35
30 30
25
23.33
20
Percentage 15 Responses
10
5
3.33 3.33
0
Widespreadness
The graph here shows that 40% of the respondents said that mental illness is somewhat
widespread in Bangladesh. Surprisingly, 30% acknowledged that mental illness is quite
widespread and have marked 4 on a scale of 1 to 5. Another 23.33% have said that they think it is
barely widespread. Only 3.33% of the respondents said it is not widespread at all and another
3.33% said it is very widespread.
4. Do you think that Bangladesh needs more Responses Responses
Government run mental health hospitals? (%)

Yes, absolutely, every district should have one. 63.33 19
Yes, maybe 1 or 2 more. 26.67 8
Prefer not to answer 3.33 1
Every city should have one, however small it is. 3.33 1
Depends on percentage of mental sick people 3.33 1
The pie chart below illustrates that among the 30 people surveyed, 19 of them responded
saying that they think every district should have a government run mental hospital, which makes
it a good 63.3%. 8 (26.7%) of them said that maybe 1 or 2 more hospitals countrywide would be
helpful. 1 person preferred not to answer while two others commented their own opinions saying,
every city should have one, however small it is and that it depends on percentage of mental sick
people. Each of them accounted for 3.33%.

4. Do you think that Bangladesh needs more Government run Mental Health Hospitals?
Yes, absolutely, eve ry district should have one.
3% 3%
3%
Yes, maybe 1 or 2 more.
27%
Prefer not to answer
63%
Every city should have one, however small it is.
Depends on pe rcentage of mental sick people
5. Do you think there is a need for more mental health care Responses Responses
practitioners and providers in Bangladesh? (%)

Yes, it is vital that more professionals are available for treatments. 80 24
Maybe, a few more practitioners will be helpful. 13.33 4
Improve quality, not quantity. 3.33 1
No, there is no need for more professionals. 3.33 1
To this question a big 80% (20 out of 30 people) of the respondents answered that they
agree that more professionals are required for treatments. 13.33% (4 out of 30 people) of the
respondents replied that a few more practitioners would definitely be helpful. Only 1 person
commented that quality should be improved and not quantity. Another 1 person had disagreed
saying there is no need for more professionals.

Do you think there is a need for more mental health care practitioners and providers in Bangladesh?
No, there is no need for more professionals. 3.33
Improve quality, not quantity. 3.33

Responses
Maybe, a few more practitioners will be helpful. 13.33
Yes, it is vital that more professionals are available for treatments. 80
0 10 20 30 40 50 60 70 80 90
6. Do you agree that the Mental Health care system in Responses Responses
Bangladesh is in need for improvement in various sectors?

Yes, improvement in treatment, facilities and hospitals is needed. 86.67 26
Only improvement in the facilities provided is needed. 3.33 1
Only improvement in treatment is needed. 6.67 2
More awareness among the Bangladeshi people is required besides 3.33 1
improvement in all aspects.

This was the last question of my questionnaire and it was prepared to find out how people
think improvement should be brought to the mental health care system. Majority of the
respondents, a vast 86.67% said that they think improvement in treatment and facilities provided
is needed. 6.67%, (2 out of 30 people) said only improvement in treatment is required. Only
3.33% (1 person) chose the option that only improvement of facilities is required. Another 3.33%
(1 person) commented that more awareness among the Bangladeshi people is required besides
improvement in all aspects.
6. Do you agree that the Mental Health care system in Bangladesh needs improvement in various sectors?
Yes, improvement in treatment, facilities and hospitals is needed.

3%
7%
3%
Only improvement in the facilities provided is needed.
Only improvement in treatment is needed.
More awareness among the Bangladeshi people is required besides improvement in all aspects.
87%
Summary of Interviews
I took 4 face to face direct interviews for my primary data about my topic of the research
paper. Two of my interviewees were faculties of North South University Faculty members. I
have also interviewed the counseling psychologist of the student counseling center of North
South University. At the same time I have taken an interview from a resident psychiatrist at the
National Institute of Mental Health. The interviews were more like discussion as I was seeking
their opinions on the topics rather than strict answers. Only 1 faculty member allowed me to
record the conversation while the others hesitated and insisted me on taking notes. The
interviewees were all very cooperative and frankly shared their perspective, experiences and
expertise.
The interviewees were:
1. Ms. Sarah Fardeen - Lecturer MA, University of London, UK B.A. (Hons), Carleton
University, Canada (Department of History and Philosophy)
2. Dr. Mohammad Tariqul Alam - Resident Psychiatrist, Assistant Professor, National Institute of
Mental Health
3. Ms. Sabeeha Saleque - Lecturer, Department of English and modern languages
4. Ms. Lipy Gloria- Counseling Psychologist, Student Counseling Center, North South
University
When I asked Ms. Sarahs opinion, she told me that the root of the problem lies in the fact
that people are not well aware of the existence of both mental diseases and their treatment
facilities. Ms. Sarah explained that Government funding and support is required but there should
be more patients seeking professional help. She said, If we talk in terms of economics, then
perhaps a supply and demand situation would be more comparable. When there is more and
more demand
for a product or a service, the suppliers are bound to increase the supply to meet the demands.
She later elaborated that if awareness and acknowledgement among all the social and economic
classes are not increased, then there will not be any use of increasing the institutions or medical
practitioners. At the same time she added that social stigma and the social beliefs that prevents
people from availing medical treatment should be gotten rid of to begin with. She also included,
Acknowledgement of the mental illnesses should start within ourselves, lets stop calling people
by names such as retards or mental to begin with, perhaps it will help those afflicted with
mental illnesses feel less stigmatized.
Ms. Sabeeha had served as a social worker for many years while she had lived abroad. So
she could really share some insightful thoughts during my interview. She told me that the most
vulnerable to psychological or mental illnesses are age groups of young adults and the older
people. The young adults, especially during their teenage are the most susceptible to common
mental illnesses such as depression and develop unhealthy addictions. The reason they develop
such illnesses is usually because they stay lonely and cannot open up to people more frequently.
When you are frustrated or disturbed about an issue, it is imperative that you talk openly to
someone about it, keeping it to yourself causes the frustration to fester and express itself in
unhealthy ways, she said. She said that, as a country Bangladesh is not doing enough to prevent
or cure mental illnesses. She said that, if parents look out for their children, ensure they are
maintaining a healthy psychological state and if the children do the same for their old-aged
parents, then we will be able to cultivate a more healthy mental state among ourselves.
According to Ms. Lipy Gloria, when a person becomes mentally ill, that person alone is
not affected, in fact all the people around him including his family and friends get affected as
well. So everyone should take the responsibility up on their shoulders of helping the patient
overcome their hesitations and avail treatment. She said, I meet several patients, who come to
me and still feel hesitated to share their problems frankly. Most of the times when I recommend
them to another psychiatrist or to another mental health institute, they do not listen and they drop
out of my counselling sessions as well. I think the fear of being judged by others makes them so
scared. She said that both metal health practitioners and counsellors should try their level best
to help their patients out of their hesitations. Lastly, she also added that more support from
government and medical professionals are required to help enhance the quality of treatment
provided.
Mr. Tariq told me that there are several designations of a particular mental health
practitioner. There are Psychiatrist, who actively practice treatments for the mentally ill; there are
the psychologists who mostly provide verbal or cognitive therapy and there are the social
workers who work in order to bring forth communal development in the mental health care
sector. He said that it is necessary for the various types of mental health practitioners to have a
sort of collaboration between them. Only treatment without therapy or only therapy without
treatment cannot single handedly solve the mental illness of a patient. Mental health doctors
should provide proper medication and should refer to psychologists if therapy seems necessary
for patients and vice versa. Mentally ill patients need a bit more attention than the normal
patients we see at medical centers. It is a sensitive issue itself, and the social misconceptions just
make it more sensitive to them, so it is necessary to handle the patients with utmost care, to
recommend therapy if required, he explained.
Summary of Research Findings
Through my research I found out that the prevalence of mental illness in this country is
very high and the treatment system is barely capable of providing service to the majority of
them. My research showed that majority of the people do know about mental illness and about
40% agree that mental illness is somewhat widespread in our country. A majority of 80% people
among my survey respondents agree that more mental health practitioners are required. An even
larger proportion of them think that the mental health care system needs multi-faceted
improvements, that is more improvement in facilities provided, in the treatments offered and
better hospitals are required. My interviewees also agreed that the government should increase
the funding for this sector and provide better privileges for the patients. But the interviewees
stressed more or personal and societal awareness movements. The mentally ill patients would
need help and support from both, the doctors, psychologists and their friends and family. If more
knowledge is not spread about the prevalence of mental illnesses, their symptoms, their
treatments etc. the root of the problem will remain unsolved. Among my surveyed respondents,
17 % have responded that they do not think that mental illness is a disease rather it is a
misconception these thoughts would need to be changed by properly educating the mass. In
order to help improve the mental health care system, the social stigmas would need to be
removed and at the same time more expert practitioners, hospitals and financial support is
required.
Limitations and Recommendations
While working for this research paper, I have come across some limitations that have slightly
affected my research work. Perhaps without these constraints my work would have been easier
and a bit more thorough. Limitations that I have come across are:
1. In ability to perform a survey on a random mass of people. Since a lot of people are
unacquainted with the topic itself, I could not randomly distribute my survey
questionnaire among people.

2. The lack of knowledge among the public regarding this topic. The public possess a lot of
misconceptions regarding this topic which altered some of the data that I wanted to derive
through survey.
3. The mental health sector of Bangladesh is not very researched so I could not avail a lot of
useful information online. The few online journals or articles that I could avail, discusses
more or less the same aspects.

4. The time constraint during interviews. Some of my interviewees were very busy and
could not allocate more than 10 minutes.
I would like to provide some recommendations to help eliminate such hurdles. Schools, colleges
and universities should start educating their students on the mental health issues and the
symptoms and cures of it. A more educated nation would surely stir more awareness and help act
towards improving the system. Further in depth researches are required so that more practical
data regarding Bangladesh can be found and be studied on. More professionals, psychologists
should speak up so that the mentally ill people know who to go for medication and can get a
better treatment.
Conclusion
In the process of completing my research paper, I have acquired a great deal of valuable
knowledge on the mental health care system of Bangladesh. I learned that the number of patients
suffering is significantly higher than the treatment facilities provided. I also learned that the poor
funding and research had stifled the progress of this sector. I could acknowledge that since the
social awareness regarding mental health and illnesses is missing, the funding or research alone
will not help alleviate the problem. The social barriers, especially in the rural, suburban
overcrowded areas need to be eliminated besides educating the public about the illnesses. I have
witnessed that majority of people agree that improvement is required on multiple aspects in order
to ensure proper treatment at the mental treatment institutions. Although it might be very
difficult, yet if proper awareness is raised and more people help overcome the stigmas and
misconceptions, change can be implemented. Overall, if the government, society and the general
public all work together on community and national level, soon the mental health care system
will be improved and better treatment will be ensured.

Bibliography
1. The state of mental health care in Bangladesh - in pictures. (2015). the Guardian.
Retrieved 4 August 2016, from https://www.theguardian.com/global-
development-professionals-network/gallery/2015/oct/10/neglected-mental-health-
in-bangladesh-pabna-mental-hospital-in-pictures
This article had been the reason I have picked up this topic at the first place.
Photojournalist Allison Joyce, depicted the current meagre situation at the Pabna hospital.
The article included some pictures as well which helped me get a grasp on the topic as a
whole. Overall, this article contained very helpful content that I could easily incorporate
in my research paper to enrich the quality of information. This was a helpful source in
providing me a good overview of the mental health care system.
2. Draft Bangladesh Mental Health Act, 2014: Rights Perspective. (2014). The Daily Star.
Retrieved 4 August 2016, from http://www.thedailystar.net/draft-bangladesh-
mental-health-act-2014-rights-perspective-51534
The daily star publication on the draft of the Bangladesh Mental Health Act, 2014 has
helped me get an in depth knowledge on the current scenario of the mental health system
in Bangladesh. Various types of service providers, civil society organizations and media
and policy makers shared their perspective on how the mental health act can be made
better in order to ensure proper mental health treatment. The suggestions mainly revolved
around creating social movements and practices for mental health care to be easily
available to people which provided a great deal of insight on my research topic.

3. World Health Organization. (2007). WHO-Aims report on the Mental Health System of
Bangladesh. Dhaka, Bangladesh: WHO and the Ministry of Health and Family
Welfare Bangladesh.
The report of World Health Organization AIMS report had provided all the fundamental
information about the mental health care system in Bangladesh. The research was done in
2005 and contained integrated analysis about this sector. I have found the information
very helpful and have incorporated some data in my research paper.
4. icddr,b - News. (2015). Icddrb.org. Retrieved 4 August 2016, from
http://www.icddrb.org/news-and-events/news?id=710&task=view
The ICDDR is an international health research institute based on Dhaka, Bangladesh. The
article above has contributed to most of my understanding regarding the existence and the
prevalence of mental illnesses. The article summarizes the findings of a systematic
review that they had conducted some months ago.
5. What is mental health? What is mental disorder?. (2015). Medical News Today.
Retrieved 4 August 2016, from
http://www.medicalnewstoday.com/articles/154543.php
I have used this article for better understanding how the mental health and mental illness
differ, and have constantly referred to this paper time and time again. The article mainly
differentiates mental health and illness and then provides the signs, symptoms of certain
mental illnesses. The data provided was well certified and immensely helpful while
preparing my research paper.
References
1. Anwar Islam, Tuhin Biswas. Mental Health and the Health System in Bangladesh:
Situation Analysis of a Neglected Domain. American Journal of Psychiatry and
Neuroscience. Vol. 3, No. 4, 2015, pp. 57-62. doi: 10.11648/j.ajpn.20150304.11

2. Desmarais, S., Van Dorn, R., Johnson, K., Grimm, K., Douglas, K., & Swartz, M. (2014).
Community Violence Perpetration and Victimization among Adults with Mental
Illnesses. Am J Public Health, 104(12), 2342-2349.
http://dx.doi.org/10.2105/ajph.2013.301680
3. Draft Bangladesh Mental Health Act, 2014: Rights Perspective. (2014). The Daily Star.
Retrieved 4 August 2016, from http://www.thedailystar.net/draft-bangladesh-
mental-health-act-2014-rights-perspective-51534
4. World Health Organization. (2007). WHO-Aims report on the Mental Health System of
Bangladesh. Dhaka, Bangladesh: WHO and the Ministry of Health and Family
Welfare Bangladesh.
5. Fahmida, A., Wahab, M., & Rahman, M. (2009). Pattern of psychiatric morbidity among
the patients admitted in a private psychiatric clinic. Bangladesh Journal of
Medical Science, 8(1-2), 23-28.

6. Hossain, M., Ahmed, H., Chowdhury, W., Niessen, L., & Alam, D. (2014). Mental
disorders in Bangladesh: a systematic review. BMC Psychiatry, 14(1).
http://dx.doi.org/10.1186/s12888-014-0216-9
7. icddr,b - News. (2015). Icddrb.org. Retrieved 4 August 2016, from
http://www.icddrb.org/news-and-events/news?id=710&task=view
8. Karim, E., Alam, M., Hussain, A., Uddin, M., Firoz, A., & Rahman, A. (2006).
Prevalence of Mental Illness in the Community. The Journal of Teachers
Association RMC, Rajshahi, 19(1), 18-23.
9. Leadership for Mental Health System Development - Dhaka, Bangladesh | Movement for
Global Mental Health. (2016). Globalmentalhealth.org. Retrieved 4 August 2016,

from http://www.globalmentalhealth.org/leadership-mental-health-system-
development-0
10. Mental Illness and the Family: Recognizing Warning Signs and How to Cope. (2016).
Mental Health America. Retrieved 4 August 2016, from
http://www.mentalhealthamerica.net/recognizing-warning-signs
11. Mental Hospital - Banglapedia. (2015). En.banglapedia.org. Retrieved 4 August 2016,
from http://en.banglapedia.org/index.php?title=Mental_Hospital
12. State of mental health in Bangladesh. (2016). State of mental health in Bangladesh |
theindependentbd.com. Retrieved 4 August 2016, from
http://www.theindependentbd.com/printversion/details/18865
13. The state of mental health care in Bangladesh - in pictures. (2015). the Guardian.
Retrieved 4 August 2016, from https://www.theguardian.com/global-
development-professionals-network/gallery/2015/oct/10/neglected-mental-health-
in-bangladesh-pabna-mental-hospital-in-pictures
14. The Importance of Mental Health | DPC Education Center. (2013). Dpcedcenter.org.
Retrieved 4 August 2016, from http://dpcedcenter.org/classroom/importance-
mental-health
15. Treatment gap for mental health problems. (2011). IRIN. Retrieved 4 August 2016, from
http://www.irinnews.org/report/93357/bangladesh-treatment-gap-mental-health-
problems
16. WHO | Mental health: a state of well-being. (2014). Who.int. Retrieved 4 August 2016,
from http://www.who.int/features/factfiles/mental_health/en/
17. What is mental health? What is mental disorder?. (2015). Medical News Today.
Retrieved 4 August 2016, from
http://www.medicalnewstoday.com/articles/154543.php
Appendix
Gender
Age
13%
Gender 37% Male Female
63%
87%
Age 15-24 25-34

35-44 45 or above
Are you aware of the mental health treatment institutions present in Bangladesh?
46.70%
50.00%
45.00% 46.70%
40.00%
35.00%
30.00%
25.00%
20.00%
15.00%
10.00%
5.00% 6.70% Responses
0.00% 0.00%
Have you or your friends or relatives even been diagnosed with mental illness?
Yes, I have been I have encountered people with mental illnesses One of my friends or relatives have been
20% 13%
33%
Prefer not to answer.
33%
Should the funding for the Mental treatment Sector be increased by the Government?
Maybe, slight increase will be helpful. 23.33
Yes, it is absolutely necessary. 76.67
0 10 20 30 40 50 60 70 80 90

Eng 105 Research

Загружено:

Сведения о документе

Авторское право

Доступные форматы

Поделиться этим документом

Поделиться или встроить документ

Параметры публикации

Этот документ был вам полезен?

Это неприемлемый материал?

Авторское право:

Доступные форматы

Eng 105 Research

Загружено:

Авторское право:

Доступные форматы

1 The State of Mental Health Care in Bangladesh

The State of Mental Health Care System in Bangladesh:

wishers without whose support it would not have been possible.

Data Presentation and Analysis.......................................................................................... 14

Summary of Research Findings......................................................................................... 26

Limitations and Recommendations..................................................................................... 27

severe difficulties in performing daily actions (Nordqvist, 2015).

be addressed, in order to provide proper treatment to the patients.

communities which might account to an increase in mental illnesses. The topography of

affected people (Karim et al., 2006).

primary health care level is almost negligible.

women ( World Health Organization, 2006).

level. More hospitals, treatment facilities, educational institutes, psychiatrists, psychologists

1. What encompasses mental health illness?

2. What is the prevalence of mental illness in Bangladesh?

treatment to mentally ill people?

disturbances in cognitive, mood and behavioral processes (World Health Organization,

environmental stresses, biochemical imbalances, or a combination of these (World Health

the effect of social stigmas.

have to pay out of their own pocket.

In order to establish the significance of improvement in mental health care system in

Bangladesh (ICDDR, 2015).

For my primary research I have conducted 4 direct, in depth interviews of 2 faculty

find all the data relatable.

Data Presentation and Analysis

1. What is mental health according to you? Responses Responses (%)

understood my concept. My questionnaire contained 9 questions. I will be explaining 7 of the

important ones in different graphical and chart forms.

only 6.67% responded saying that it is the same as physical health.

1. What is mental health according to you?

The mental stability (calmness, temperament) of an individual

The physical, mental and social well being of an individual

2. How would you describe mental illness? Responses Responses (%)

physical ill health.

within an individual's mind.

2. How would you describe mental illness?

It is a brain disease, which brings about unusual behavior in an individual.

The inability of an individual to function normally.

Mental and emotional instability for any23%

3. How widespread do you think mental illness is in Response Responses

How widespread do you think mental illness is in Bangladesh?

widespread in Bangladesh. Surprisingly, 30% acknowledged that mental illness is quite

3.33% said it is very widespread.

4. Do you think that Bangladesh needs more Responses Responses

Government run mental health hospitals? (%)

people. Each of them accounted for 3.33%.

Yes, maybe 1 or 2 more.

Every city should have one, however small it is.

Depends on pe rcentage of mental sick people

practitioners and providers in Bangladesh? (%)

saying there is no need for more professionals.

No, there is no need for more professionals. 3.33

Improve quality, not quantity. 3.33

Maybe, a few more practitioners will be helpful. 13.33

Yes, it is vital that more professionals are available for treatments. 80

Bangladesh is in need for improvement in various sectors?

improvement in all aspects.

improvement in all aspects.

Yes, improvement in treatment, facilities and hospitals is needed.

Only improvement in the facilities provided is needed.

Only improvement in treatment is needed.

The interviewees were:

University, Canada (Department of History and Philosophy)

3. Ms. Sabeeha Saleque - Lecturer, Department of English and modern languages