Mental health services in Zambia; past, present and future

Abstract

The history of the development of mental health services in Zambia stretches back to the time before Zambia became independent. The history falls into four phases: the pre-colonial phase where care was under the traditional and spiritual healers, the rise of asylums mainly for custodial confinement, followed by establishment of mental hospitals during and soon after the colonial period and most recently the decentralisation of mental health into primary health care. Fifty two years after independence, there have been notable developments in the mental health care provision. One of the notable development is that, the Zambian government recognises mental health as a serious public and development concern and the government has included mental health in the Basic Health care package. A number of reforms have been implemented aimed at strengthening the country’s mental health system. A mental health policy is in its final stage of drafting and it will soon be implemented. While the mental health services have improved in some ways, in many ways they have not lived up to the expectations. The difficulties are anchored in the deterioration in economic stagnation and the social conditions witnessed after many years of cooper price decline and overall economic stagnation. This has reduced funding to mental health services. The human resources is not adequate to meet the growing public health burden of mental illnesses. The Human Immuno-deficiency Virus (HIV) pandemic has impacted negatively on families resulting in many people developing mental illnesses. In order to address the afore mentioned challenges, there is need to integrate mental health into routine clinical practice, provide treatment in primary care units, develop a health management system, provide training relevant to mental health care and provide adequate funding. In addition essential drugs must be made available, involve communities, families and consumers in the care of the patients.