Essential care package to address mental health and stigma for persons with neglected tropical diseases
Overview
Over 1 billion people worldwide are affected by neglected tropical diseases (NTDs) and a similar number are affected by mental health conditions. These independently burdensome conditions are significantly interlinked. People affected by NTDs often experience stigma, discrimination and social exclusion. Many people report distress associated with these experiences, and there is evidence to show that mental health conditions are more common among this group, compared to the general population.
For people living with NTDs, stigma creates barriers to participation in society, leading to a decreased quality of life and resulting in delayed help-seeking and treatment. The distress associated with living with NTDs or the experience of stigma – such as worry, fears, sadness and insecurity – contribute to reduced social functioning and further isolation. People living with chronic NTDs experience higher rates of depression, anxiety and suicidal behaviours compared to the general population, or even compared to other populations with chronic conditions. WHO’s Mental health of people with neglected tropical diseases – towards a person-centred approach (2020) provides a comprehensive summary of the relationship between NTDs, stigma and mental health conditions.
Recognizing the significance of the impact of stigma and the comorbidity with mental health conditions for people living with NTDs, some civil society organizations are working to reduce stigma and promote mental health in their work. However, a whole-of-society approach and multisectoral response are required. Historically, the intersection of mental health and NTDs has been neglected, yet without its adoption the broader agenda of eliminating NTDs will be hindered.
Addressing the negative impacts of NTDs, stigma and mental health conditions therefore requires systematic actions that go beyond health service interventions. Social, psychological and socioeconomic factors should be addressed to ensure social and economic inclusion and the overall improved well-being of people affected by NTDs. A person-centred approach is essential to ensure that people’s multiple specific needs are addressed effectively. This requires multisectoral collaboration and efficient integration of work among relevant partners to address stigma, and it requires provision of accessible comprehensive services for people affected by the comorbidity of NTDs and mental health conditions.
The Essential Care Package (ECP) to address mental health and stigma for persons affected by neglected tropical diseases (hereby referred to as the ECP) includes evidence-based mental health interventions, drawn from the WHO mhGAP guidelines for mental, neurological, and substance use disorders (3), particularly those listed in the UHC Compendium. Evidencebased interventions to reduce population health-related stigma and discrimination are included in the ECP in order to address the stigma experienced both by people living with mental health conditions and by those living with NTDs.
