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.