The mental health void: A silent emergency

Over the decades, Bangladesh has made significant progress in many areas of public health. Life expectancy has increased, maternal mortality has declined, and access to primary healthcare has expanded considerably. However, one area remains notably neglected: mental health. It is not a luxury; rather, it is a foundation of human wellbeing. And nowadays, that foundation is cracking.

According to the National Mental Health Survey 2024, nearly 28 million youths in Bangladesh live with mental health issues. Among children and adolescents, the prevalence is 13.6%.

Depression and anxiety remain the most prevalent conditions, affecting about 4.4% of the population. Despite this, more than 90% of people with mental health issues receive no treatment.

The treatment gap is one of the largest in the world. This is more than a gap; it has become an emergency. Therefore, the magnitude of the crisis is now too large to ignore, as the consequences of procrastination are becoming increasingly visible across society.

Bangladesh faces a profound shortage of mental health professionals and infrastructure. The country has only 350 certified psychiatrists, meaning one psychiatrist for nearly half a million people. The World Health Organization (WHO) recommends at least one psychiatrist per 100,000 people, while Bangladesh has only a fifth of that ratio.

This shortage is intensified by geographic concentration. The majority of psychologists and psychiatrists are concentrated in Dhaka. As a result, other regions, particularly rural areas, are left with very limited access to specialised mental healthcare.

The country's only government-run mental hospital has merely 500 beds, which is woefully inadequate. While mental healthcare facilities in the private sector have increased in recent years, they remain unaffordable for the vast majority of people.

In addition, the social stigma associated with mental health remains a significant constraint. It continues to shape how mental health issues are perceived and addressed in society. When asked about the reasons for avoiding treatment, most people mention 'shame' as the primary factor.

In rural areas, misconceptions such as beliefs in spiritual possession remain prevalent. Therefore, almost half of those with mental health issues seek assistance from traditional healers first. This often delays proper medical intervention.

Denial of mental health issues is also a pervasive barrier. Many parents dismiss symptoms, insisting that a child is 'fine' or merely 'stressed', despite clear signs of a mental health concern. Employees conceal their suffering, fearing it may be perceived as weakness and jeopardise their jobs. Students ignore warning signs, worried that admitting mental difficulties may affect their academic performance and future career prospects.

Another barrier is the enduring social discouragement that prevents individuals from seeking formal healthcare. Parents often delay taking their children for treatment for fear of social shame associated with a diagnosis. Women, in particular, forgo treatment due to concerns about harsh societal judgment. This widespread denial leaves countless individuals suffering in silence. And this silence is not just harmful – it is noxious.

Despite these grim realities, there are reasons for cautious hope. The government of Bangladesh has taken important steps, including the Mental Health Act 2018 and the National Mental Health Strategic Plan 2020–2030. These initiatives aim to reduce the treatment gap to around 50% and integrate mental healthcare into primary healthcare services.

However, progress remains slow, mainly due to limited funding. Only 0.44% of the national health budget is allocated to mental healthcare, far below the global average of 2.1%. Besides increasing funding, integrating mental healthcare into primary healthcare, strengthening community-based support in rural areas, launching nationwide anti-stigma campaigns, and implementing digital mental health tools are all essential.

In the past, the people of Bangladesh have shown remarkable resilience in the face of countless crises. Yet resilience should not mean silent suffering. A nation cannot truly flourish when millions of its people are struggling alone.

Md Limon Bhuiyan is a graduate student in Department of Sociology, Anthropology and Social Work at Texas Tech University.

Disclaimer: The views and opinions expressed in this article are those of the authors and do not necessarily reflect the opinions and views of The Business Standard.