Reflecting on four leaps in mental health development in Cameroon
By Didier Demassosso - Mental health advocate, MHIN-Africa Knowledge Exchange assistant, HIFA Country Representative Coordinator Afro Region
Profound changes in mental health development have occurred within the six past years in Cameroon. The First Cameroonian Days of Mental Health, held from the 15th - 17th of December 2015 and organised by the Ministry of Public Health, was historical and set the pace to what is now a real mental health revolution. Albeit increasing political will and interest, mental health is not still a priority in Cameroon. A lot still has to be done in mental health promotion, human resources, infrastructure, human rights, mental health financing, mental health advocacy, and mental health legislation. The integration of mental healthcare into primary healthcare, taking into account universal health coverage and integrated people centred healthcare services framework, is still far away. The Covid-19 outbreak in March 2020 enabled mental health to be more visible and better accepted at all levels of the health system as an important contributor to population health and mental health.
However, it is the role played by local and international associations (professional, lay service user), and online communities of practices (such as the forum, the GRID) involved in mental health, clinical psychology, health that has provided a powerful leverage for the mental health movement. This 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 psychology, and mental health associations (such as “UNIPSY et bien-etre”, Hope for the abuse and battered, ACAM-PSM, SoinsPsySansFrontier, …), and INGOs health organisations (HIFA, MHIN-AFRICA, etc ) has had a considerable positive influence on the mental health sector especially in terms of increased awareness raising, increase in crisis intervention mobilisation, service provision delivery and advocacy. Four events have been marked by the systematic involvement of associations, which merit being highlighted and for which implications for Cameroon’s mental health sector could be derived.
From the 9th to the 10th of May 2016 the first ever International Forum for the Promotion of Psychiatric and Psychological care was held in Douala, dorganised 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. One way to reduce the gap in the workforce shortage is to build capacity.
A capacity building workshop on the management of psycho-traumas, was organized by Mercy ships and Tributaries International for religious leaders, health, and mental health professionals in Douala (from 25th to 29th April 2016) and Yaoundé (from 2nd to 6th May 2016) respectively.
Yaoundé trainee of the mercy ships and tributary international psychotrauma capacity training; the presence of late secretary of state Alima Hayatou gave the event its official importance.
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 was unique in the history of public accidents in Cameroon, and 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 communities, to families and victims. For about a month following the accident several mental health professionals worked as volunteers 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 a lack support from the government halted the efforts.
From top to bottom, on the site of the Eseka train incident with the sub directorate of mental health of the Ministry of Public Health and UNIPSY et bien-etre president Joel Djache
Political commitment 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 Ministry of Public health headed by Andre Mama Fouda validated a series of very important documents laying systematically foundation for Cameroon’s mental health system namely; a mental health policy, a mental health plan and a programme, guidelines procedure on treatment of some mental health disorders.
The mental health movement that started in Cameroon in 2015 has completely changed how mental health is perceived and practiced. Many more organisations have now emerged since then, working at various community levels and even in humanitarian settings. Despite the lack of structural and financial resources, the engagement of a community of mental health organisations and individuals is deep, mental health leadership is under construction. The institutional support of the sub-directorate of mental health of the Ministry of Public Health is extremely empowering. A favourable climate is present; the need to invest in mental health, supporting local initiatives is becoming pressing as never before. I dream of a mental healthcare system in Cameroon that will be for all and everywhere.