According to the WHO, mental health can be described as the ability to cope with the everyday stresses of life, work productively, and essentially contribute to your community and includes your emotional, psychological, and social wellbeing. The 2023 Universal Health Coverage Goal for Mental Health considers that you can not achieve global health or sustainable development without mental health. It is hardly surprising that 75 percent of all mental illness cases can be found in low-income countries. These countries fail to provide proper access to quality mental health care. As a result, those affected are vulnerable to suffering, human rights abuses, stigma, discrimination, and premature mortality. Even in regions where infectious diseases are overwhelmingly high, at least 9% of the overall burden of disease is due to mental disorders. Globally, 50% of people with psychosis do not receive proper treatment, but this number may well be over 90% in countries like Ethiopia, presenting an unacceptably high treatment gap.

One of the many drivers in these low-income countries that result in mental health issues is food insecurity, which is the quantity and quality of available food. More than 870 million people worldwide consume less than the efficient amount of daily calories, leading to disabling physical and psychological health outcomes. Food insecurity has become a political and health focus in low-income countries, particularly in Sub-Saharan Africa, and is supported within the Sustainable Development Goal 2, “Zero Hunger.” Unfortunately, the Covid Pandemic worsened global circumstances, and an additional 70-161 million people are likely to have experienced hunger during 2020. An article in the Hindawi Psychiatry Journal has taken a deep dive into the relation of food insecurity and mental distress and its impact on mothers in Ethiopia. The report claims that even though all household members suffer from the effects of food insecurity, women and children are the ones affected the most. Mothers who are malnourished and lack the capacity to provide adequate care subsequently contribute to child malnutrition, which is the cause for one-third of under-five deaths in developing countries. Malnourished mothers and young children are also vulnerable to some non-communicable diseases later in life.

Additionally, having a child struggling to flourish physically and grow strong and healthy can undermine a mother’s wellbeing through the mental distress caused by the extra effort and attention required to take care of the child. In other words, the consequences of maternal food insecurity and mental distress are transgenerational. Also, mothers tend to be the primary caregivers within households and carry the burden of providing practical help, personal care, and emotional support to their ill family members while also suffering from challenging external factors like food insecurity. This ultimately causes a spiral of problems prominently for mental distress like anxiety, depression, insomnia, and somatic disorder, leading to physiologic changes and impaired health habits that can result in illness and likely death.

Among women of reproductive age, mental distress was found to be the leading cause of morbidity, with an increasingly more significant burden in Sub-Saharan Africa, especially where the political and socioeconomic circumstances are often volatile. Furthermore, there is a 60% increased mortality rate for people with a physical medical condition while simultaneously suffering from mental distress. Although the many impacts of food insecurity on physical health have been determined, few studies have been available regarding the association between food insecurity and mental distress among mothers, particularly in Ethiopia. 

The study in the Hindawi Psychiatry Journal has found a direct relation of maternal food insecurity to mental distress. Food insecurity is significantly linked with meeting the assessments for major depressive disorders. The cross-sectional study was conducted on 2,992 mothers in Ethiopia’s Tigray and Southern Nations, Nationalities, and Peoples’ regions. It found that over 57.9% of mothers are in households facing food insecurity with a substantial prevalence (39%) of mental distress among these mothers. The study confirmed that without a doubt, food insecurity brings substantial public mental distress, and the impact is potentially changeable. The remaining issue is using this study to be able to design, monitor, and evaluate food security and mental health programs to assist in forming a body of knowledge that could essentially influence public health policy in Ethiopia.

Mental illness in Ethiopia may not be as recognized as infectious diseases but it can impact overall general health and the ability to provide for one’s family. Global institutions should deliver accurate data to demonstrate the mental health treatment gap and produce a contextualized framework or approach to help reduce it. Moreover, national-level policy support and coordination are necessary for any actual development in mental health treatment coverage. Although the Ethiopian government is committed to developing mental health care, efforts have been hindered due to low financing with implementation and scale-up of mental health care. Ethiopia’s commitment to pooled risk protection through public health insurance is the most promising approach for adequate, fair, and sustainable funding. 

 

References:

1. Birhanu, T., Tadesse, A. (2019). ‘Food Insecurity and Mental Distress among Mothers in Rural Tigray and SNNP Regions, Ethiopia’, Hindawi Psychiatry Journal, Vol. 2019 [online]. Available at: https://www.hindawi.com/journals/psychiatry/2019/7458341/. (Accessed 2 October 2021).
2. Bukhman, Gene, et al., (2020). ‘The Lancet NCDI Poverty Commission: bridging a gap in universal health coverage for the poorest billion’, The Lancet, Vol. 396 [online]. Available at: https://www-sciencedirect-com.ezproxy.is.ed.ac.uk/science/article/pii/S0140673620319073. (Accessed 3 October 2021).
3. Delle, S. (2017) There is no shame in taking care of your mental health. May. Available at: https://www.ted.com/talks/sangu_delle_there_s_no_shame_in_taking_care_of_your_mental_health?language=en (Accessed 31 September 2021). 
4. Fekadu, A., Thornicroft, G. (2014). ‘Global mental health: Perspectives from Ethiopia’, Global Health Action, Vol.7(25447) [online]. Available at: https://doi.org/10.3402/gha.v7.25447. (Accessed October 2 2021)
5. Hanlon, C., et al. (2019). ’Moving towards universal health coverage for mental disorders in Ethiopia’, International Journal of Mental Health Systems, Vol. 13(11) [online]. Available at: https://doi.org/10.1186/s13033-019-0268-9. (Accessed 2 October 2021). 
6. Negesse, A., et al. (2020). ’The impact of being of the female gender for household head on the prevalence of food insecurity in Ethiopia: a systematic-review and meta-analysis’, Public Health Reviews, Vol. 41(15) [online]. Available at: https://doi.org/10.1186/s40985-020-00131-8. (Accessed 2 October 2021).
7. Sintayehu, M., et al. (2015). ’Prevalence of mental distress and associated factors T caregivers of patients with severe mental illness in the outpatient unit of Amanuel Hospital, Addis Ababa, Ethiopia, 2013: Cross-sectional study, Journal of Molecular Psychiatry, Vol. 3(9)  [online]. Available at: https://jmolecularpsychiatry.biomedcentral.com/articles/10.1186/s40303-015-0014-4 (Accessed 2 October 2021).
8. United Nations. (2021). The Sustainable Development Goals Report. Available at: https://unstats.un.org/sdgs/report/2021/The-Sustainable-Development-Goals-Report-2021.pdf.(Accessed 2 October 2021).
9. World Health Organization. (2019). The WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health. Available at: https://www.who.int/publications/i/item/special-initiative-for-mental-health-(2019-2023). (Accessed 31 September 2021). 

10. Photo:  World Health Organization. 2014. Ethiopia Scales up Mental Health Services into Primary Health Care, Ethiopia.

11. Photo: Aljazeera. 2021. No Food for Days: Starvation Stalks Tigray As War Drags On. Ethiopia.

Aug 8, 2018