We are very happy to share with you an update from our member in Cameroon, Didier Demassosso. Didier has been a strong voice for mental health and human rights in Cameroon and he has just been recently awarded a Cameroon Human Rights Fellowship for 2017!!
Reflecting on three little-big leaps in mental health development in Cameroon during 2016
The First Cameroonian days of Mental Health held from the 15th to the 17th of December 2015 organised by the Ministry of Public Health was historical. Since then a new impetus has driven the mental health sector in Cameroon. It should be said that mental health is not still a priority in Cameroon. A lot still has to be done in mental health promotion, increasing human resources in mental health, mental health financing, mental health advocacy, and mental health legislation. The larval efforts since 2015 are considerable as what used to be but the impact on the health system is still to be felt. The integration of mental healthcare in primary healthcare taking into account universal health coverage and integrated people centred healthcare services framework is still far away.
However, the role played by associations, NGOs and online communities of practice (such as the GRID, Psy du Kamer, UNIPSY all on whatsapp and Facebook) involved in mental health and clinical psychology has provided a powerful momentum for the mental health movement which can be traced back to the creation of the department of psychology in the University of Yaoundé I in the 90’s. In fact, since 2015 the mobilisation of mental health associations and health organisations (such as “UNIPSY et bien-etre”, ACAM-PSM, Soins Psy sans frontier, and HIFA) has had a considerable positive influence on the mental health sector especially in terms of increased awareness raising, increase in crisis intervention mobilisation and advocacy. Three events marked by the systematic involvement of associations merit to be highlighted and implications for Cameroon’s mental health sector could be derived.
From the 9th to the 10th of May 2016 in Douala was held the first ever International Forum for the Promotion of Psychiatric and Psychological care organised by Healthcare Information For All (HIFA), late Association of Cameroonian clinical psychologist, Soins Psy sans frontier, UNIPSY et Bien-etre, Association Yam-Mars Psy, and DIAP under the aegis of the Ministry Of Public Health. This forum gathered mental health professionals from Cameroon, France, Swiss, and Gabon to reflect on the practice of mental healthcare in Cameroon. It stemmed from the forum which was on the one hand a scientific encounter and on the other hand an exchange platform between professionals with the sub direction of the promotion of mental health and psychiatry of the Ministry of Public Health that a lot still has to be done to enable mental health to be a priority in Cameroon. In fact, no mental health promotion and mental health education strategy and plan was discussed and made so as any attempt to develop strategies and plans to integrate mental healthcare in primary health care. Even if the training and recruitment of mental health professionals to increase the mental health workforce was discussed, no concrete strategy was put forward to solve the problem of the drastic low number of mental health professionals. Human resource in mental health is one aspect of mental healthcare affecting seriously service delivery in Cameroon not to talk of quality service delivery. Nevertheless, efforts by the Ministry of Public health mental health’s department became visible when two trainings to reduce the gap of mental health care provision by building the capacities of non-mental health professionals on basic mental healthcare principles following the mhGAP 2013-2020 WHO’s framework was done .
In fact, capacity building workshop on the management of psycho-traumas, by Mercy ships and Tributaries international trainers to religious leaders, health and mental health professionals was done in Douala (from 25th to 29th April 2016) and Yaoundé (from 2th to 6th May 2016). The role that religion plays in the life of Cameroonians is important and involving faith based organisations (FBO) to promote mental health was an important thing to be done.
On the 21st of October 2016 a train derailment occurred in Eseka in the Centre region of Cameroon killing 79 people from official sources and leaving several hundred wounded. This crisis situation in itself unique in the history of accidents in Cameroon as what concerns the violence and destruction that occurred, immediately led to the mobilisation of mental health professionals by the MoH’s mental health department to provide support and mental healthcare to the affected community, to families and victims. For about a month following the accident several mental health professionals worked voluntarily in very difficult conditions to support and bring mental healthcare to families and victims of the accident. Most of the human resources for this work came from associations such as “UNIPSY et Bien-etre” which provided volunteers at all stages of the crisis intervention process. Unfortunately lack of coordination and support from the government halted the efforts.
Political will to make mental health part of Cameroon’s healthcare practices is enshrined in its 1996 constitution (art.16). More concretely, 20 years later on the 26th of October 2016, the Minister of Public Health Andre Mama Fouda validated a series of very important documents laying foundation for Cameroon’s mental health system namely; mental health policies and programmes, guidelines procedure on treatment of some mental health disorders. This other historical step in Cameroon’s mental health development gave a lot of joy to the several Cameroonian mental health professionals who have been battling and struggling for years to gain a more formal support and recognition by government. In spites of this leap a lot still needs to be done. Paramount is financing mental health, integrating mental healthcare in primary healthcare and training adequately and recruiting mental health professionals in all public healthcare services (especially clinical psychologist, counsellors, and occupational therapist).
As time goes by it is becoming clearer that the role of associations and NGOs involved in mental health, support of persons living with a mental health condition and their families will have a considerable impact in developing and constructing the mental healthcare sector. It implies therefore that government needs to support systematically the efforts of associations in areas of training and capacity building, financial motivation of mental health professionals volunteering and their supervision is also very important. Many of the mental health professionals who volunteered and worked during the Eseka railway accident were not adequately prepared to meet up the extreme challenges they experienced, they received no form of incentive for the work they did and they were not supervised at the end of their interventions. This state of things is a reflection of the state of the mental health system. The human resources in mental health in Cameroon are extremely insufficient to meet-up with the growing demands. The need to maintain these frontline mental health human resources is vital if the efforts which started in 2015 should be maintained. One strong way to do this is to integrate mental health in all policies, mental health advocacy and promote school mental health. There is a mental health component to every human endeavour and an effort to make this known in Cameroon is the struggle of a few frontline mental health associations. There is no health without mental health, no mental health development without community based actions driven by associations and communities of practices (CoP) involved in mental health in Cameroon. Supporting these associations is a sustainable way to achieve mental healthcare for all in Cameroon
Mental Health Specialist