A closer look into Tanzania's mental health crisis

Arusha. Mental health struggles are a critical and underestimated issue in Tanzania.

Like other countries, we face a significant mental health crisis. In 2019, the World Health Organization (WHO) reported that 1 in 8 people globally suffer from a mental disorder.

Sadly, Tanzania aligns tragically with this statistic, with an alarming five out of every 100,000 people having committed suicide in the past five years due to mental health issues.

Providing mental healthcare in Tanzania presents distinct challenges.

While the Ministry of Health, Community Development, Gender, Elderly, and Children works to prioritise mental well-being, significant obstacles remain.

The World Health Organization emphasises the immense burden of mental illness here, including alarming suicide rates.

This underscores the urgent need for strengthened mental health services in Tanzania.

Background of mental health in Tanzania

To fully grasp the situation, understanding the current state of Tanzanian mental health infrastructure is essential.

WHO's Mental Health ATLAS 2020 country profile of Tanzania highlights that the country faces specific challenges in providing mental health services.

Tanzania's mental health infrastructure is restricted, with only a few specialised facilities available, such as Mirembe National Mental Health Hospital and Lutindi Mental Hospital.

The current state of Tanzania's mental health infrastructure plays a vital role in understanding the challenges it faces:

1. Limited resources: Tanzania faces limited mental health facilities like Mirembe National Mental Health Hospital.

With roughly 900 psychiatric beds nationwide, services are severely insufficient.

2. Workforce shortage: The country's total mental health workforce comprises approximately 38 psychiatrists, 495 mental health nurses, 17 psychologists, 29 social workers, and 181 other specialised mental health workers, totalling 760 professionals.

This highlights the immediate need for expanding the mental health workforce to adequately address the mental health needs of the Tanzanian population

3 Underfunding: An investigation into the funding and management of mental health resources reveals systemic issues.

Interviews with healthcare professionals and a review of government expenditure reports suggest that the misallocation of resources and bureaucratic inefficiencies contribute to chronic underfunding.

There is a pressing need for a thorough audit of how funds are spent and a strategic realignment toward mental health services within the national healthcare policy.

Drug abuse war intertwined with mental health

Tanzania's battle against drug addiction is deeply interconnected with the mental health crisis, especially among vulnerable youth.

At Arusha's methadone clinic, Dr Blandina witnesses this devastating trend saying: "Many of those seeking help are young people, though we also see middle-aged and even some elderly patients."

An interview done recently by the Daily News magazine with Dr Erasmus Mndeme, Director of the Itega Drug Dependence Treatment Center, confirms the nationwide scope of this epidemic: "Our country faces a significant drug problem, but the government and stakeholders are fighting tirelessly to address it."

Despite dedicated efforts, support infrastructure remains woefully inadequate.

Currently, 7,658 individuals receive methadone treatment across Tanzania, with a staggering 87 percent (6,682) concentrated in Dar es Salaam.

To address this imbalance, Dr Mndeme outlines plans for four satellite clinics and a facility within Segerea prison, aiming to increase accessibility and decentralise care.

Dr Mndeme highlights a critical concern linking drug addiction to HIV prevalence.

In Tanzania, about 8.8 percent of those in methadone treatment are HIV positive.

This reflects a broader national crisis where approximately 30,000 people are injecting drugs, with an alarming HIV prevalence rate of 36 percent among them.

His insights underscore the urgent need for comprehensive healthcare services that address both addiction and its health consequences.

Addressing this crisis requires a holistic approach.

Dr Mndeme emphasises that clinics offer comprehensive care, including HIV counselling and treatment, TB services, STI management, and vital psychosocial support.

This multifaceted strategy tackles both the immediate and long-term health consequences of addiction.

The way forward for mental health space in Tanzania

Despite the challenges, Tanzania's unwavering commitment to mental well-being offers hope.

A collaborative approach – uniting healthcare, policymakers, and the community – is essential.

Dr Blandina and her colleagues emphasise the urgent need for expanded resources and trained professionals to meet the rising demand.

Recent progress is encouraging.

The national mental health dialogue in 2022 underscored the crucial focus on children and adolescents, highlighting the damaging impacts of harsh parenting and bullying.

Progress demands increased government funding, community-centred support, and wider access to national health insurance.

Promising steps are being taken. Awareness campaigns and integration into primary care are combating stigma and expanding access.

International collaboration with the WHO supports Tanzania's health sector review, aiming to deeply embed mental health into national policies.

This progress demonstrates the country's commitment to a future where mental well-being is a priority for all.

If you or someone you know needs support now, call or text 116 or chat at https://www.sematanzania.org/child-helpline  to reach out to the suicide or crisis lifeline