Mental Health Disparities in South and East Asia: Research Priorities and Collaborative Strategies

Introduction

Mental health disparities in South and East Asia present a significant challenge, with high levels of unmet needs. According to global estimates, the WHO(World Health Organization)South-East Asia Region alone accounts for a substantial portion of depression and anxiety cases. In India, the National Mental Health Survey highlighted a concerning 85% treatment gap for depression. Similarly, Nepal’s first national mental health survey revealed significant prevalence rates, emphasising the urgent need for action in these regions.

Research Priorities in South and East Asia

1. Integrating Mental Health in Perinatal Care(PMH): PMH impacts parents and influences offspring long-term. The WHO stresses integrating mental health screening and treatment in routine perinatal care, especially in low and middle-income countries (LMIC). In LMICs, postnatal depression exceeds 25%, with maternal suicide remaining a leading cause of death at nearly 10%. PMH requires special focus in LMICs, especially where high rates of gender-based violence and intersecting psychological issues exist. The WHO stresses integrating mental health screening and treatment in routine perinatal care, especially in low- and middle-income countries.
2. Supporting Carers of Individuals with Disabilities: Carers play a vital role in supporting individuals with disabilities but often face neglect and high rates of physical and mental health issues. Research in LMICs, including countries in South and East Asia, highlights the urgent need for tailored support strategies for this overlooked group. For instance, in India, most carers face a lack of adequate support. In Nepal, many carers experience strained family relationships, marital difficulties, and a lower quality of life. In Pakistan, carers often suffer from depression and stigma related to their caregiving roles. A Thai longitudinal study found high psychological distress in carers, influenced by Buddhist family support beliefs, without detailing specifics. A study in Pakistan found carers of psychosis patients often attribute the illness to spiritual and social factors. This belief system, along with associated shame and stigma, affects their help-seeking behaviors and preference for non-medical interventions. The International Mental Health Development Group’s (IMHDG) meeting proposed documenting carers’ experiences, defining support needs, and training professionals, led by carers, clinicians, and researchers.
3. Utilizing Digital Health Technologies (DHT): DHTs leverage the widespread availability of personal devices to address barriers to accessing care and training, particularly in regions where mobile device ownership and internet usage are high, but face-to-face services are limited. In the Asia-Pacific region, 75% use smartphones and 45% use mobile internet, according to a 2022 report. A survey of 192 early-career psychiatrists, junior doctors, and medical students from India, Nepal, Indonesia, Thailand, Pakistan, and Japan revealed that 77% believe DHTs can be as effective and useful as face-to-face care, although most respondents lacked formal training in their use. IMHDG calls for studies on DHT use, care models, and privacy issues in mental health, involving lived experience.
4. Building Research Capacity: To grow research efforts, develop culturally-validated screening tools for mental disorders, guided by local experts and community insights. Introducing research staff and routine data collection can track outcomes and diversify regional research output. This approach is particularly useful for exploring community carer health. A positive step is the 2022 Paro Declaration, committing WHO South-East Asia members to enhance local mental health research.

Conclusion

The IMHDG’s research priorities and collaborative strategies are crucial for addressing mental health needs in South and East Asia.The IMHDG identified four priority areas, outlined evidence, gaps, and collaboration opportunities within and beyond the region. These areas are interconnected and reflect a range of intersecting challenges. Focusing on key research areas and fostering collaboration can significantly enhance mental health outcomes and inspire global change.