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Tackling Mental Illness In The World's Toughest Places

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This year's World Health Day theme is Depression: Let's talk. As someone who has survived a mental illness, Megan Radford is glad the conversation is beginning -- especially for women in the world's toughest places.

Crying on the floor in my bathroom was not the end I envisioned for my journalism adventures. But two summers ago, that's where I was.

I graduated with a Master of Arts in journalism in the spring of 2011. Six months later, I left Toronto, first moving to Senegal, then to Tunisia. Over the course of a year I had worked for Al Jazeera, the CBC, and a host of other media from the UK to South Africa.

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Megan Radford in Tunisia.(Photo: Rabii Kalboussi)

When I wasn't freelancing, I spent most days writing and editing about culture for an English-language start-up with a team of other young journalists from around the world. I was living my dream.

A dark turn

But that dream had the makings of a nightmare as well. With the rise of terrorism in North Africa, the stakes for those of us reporting the news got higher.

I told stories of rape, assassination, and a second Tunisian revolution. I closed the windows of my apartment in downtown Tunis so tear gas wouldn't seep in, and I went to sleep with the echo of chants for freedom in my head.

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People gather at the funeral of an assassinated Tunisian leader. (Photo: Megan Radford)

After a year and a half in Tunisia, I moved to Egypt to teach English. The sexual harassment I experienced in Cairo set me on edge, and I began to crumble like a burned out wick.

Then a former coworker of mine, along with his friend, were reported missing in Libya. The Islamic State claimed responsibility and the news threatened to black out my usual optimism. It was time to go home.

Getting help and finding hope

That's how I ended up on the floor of a windowless room, in darkness, on a beautiful summer's day. I was home and safe in Canada, but the trauma of the three years prior had followed me.

On my way home, my colleague's face had flashed in my mind and I began to cry. In my head, a pounding refrain told me, "He's dead. He's dead. Oh my God, he's dead."

My journalism training had prepared me to recognize the symptoms of post-traumatic stress disorder, or PTSD, and I knew I had to get help.

Because of my work medical benefits, I was able to begin the counselling I needed. Biking around my new city, doing art therapy, and spending time with family contributed to my healing.

I move through my days now with an acute understanding that I am one of the lucky ones- both because I was never physically harmed by the trouble I saw, and that I had access to services and support that pulled me out of the darkness.

A devastating illness

That's not the case for most people around the world who must endure unspeakable trauma in silence and isolation. In Kenya, many women live under constant threat of gender-based violence, poverty and disease.

Being exposed to this kind of adversity leaves them at greater risk of developing severe mental health issues. But the stigma associated with being "crazy" prevents many people from seeking treatment. Even if they do, the health systems available to them often aren't equipped to cope with the demand.

Mental illness takes a significant toll on your ability to function in any job. When you're a single mom and have the added pressure of being the sole breadwinner, depression, anxiety and PTSD can cripple your ability to cope.

Which is why World Vision staff working in the slums of Nairobi, Kenya, recognized that something had to be done for the mental health of women in the community. It wasn't enough to educate women, provide primary health and develop their livelihoods: World Vision also had to help women deal with the stress of their everyday lives, and trauma that they suffered.

Community support makes all the difference

World Vision, in partnership with the Ministry of Health and the community, undertook a clinical trial of Problem Management Plus (PM+), a mental health tool created by the World Health Organization that assists adults who are exposed to adversity.

PM+ uses five sessions to help women manage problems and build social supports so they can be productive. It may not seem like a lot, but for a woman who has never had this kind of support, the relief they feel at being able to talk to someone is profound.

By training community health workers, PM+ was made accessible to the people right in their homes. It was also discreet, as neighbours didn't know what kind of illness the workers were paying a visit for.

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Community health workers in Kenya train in a PM+ workshop. (Photo: World Vision Kenya)

"There is some heaviness we ladies experience that we can't tell our relatives," one woman said. I can imagine the things she's referring to: poverty, losing children, political tension, sexual assault. But the confidentiality of the community health program allowed her to "feel at ease and share."

Taking away the devils

The study concluded that the 209 women who received PM+ had much higher improvement than the 212 who received the usual care from nurses at local clinics. They missed fewer days of work, and suffered less of the symptoms associated with their mental illness.

One woman told the health workers that before the program, she was planning to kill her son and herself with rat poisoning due to her depression. But after talking with the workers, she learned breathing exercises and other coping mechanisms that, she said, "take away the devils".

In areas like Nairobi, support like this is vital to the survival of communities and families. Of the 2313 women screened for the program, 50% had experienced sexual violence, and 75% had been physically assaulted. A full 36% of the women showed clinical levels of psychological distress and low functioning.

Helping more people, more ways

World Vision is now working with the Kenyan Ministry of Health to train healthcare staff in PM+. These professionals will pass on their knowledge to others, so the whole healthcare system will be ready to deal with the devastating effects of mental illness.

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Mental health programs help women in Kenya lead better lives. Photo: Zipporah Kageha, World Vision

I can't tell you how much hope this brings me. Coming home from "the field" meant I got a reprieve from violence and harassment. But for women and girls in the developing world, there is no escape.

No escape, except through programs like World Vision's development projects. Holistic health, economic opportunities, and education allow women and girls to take charge of their own future and find a way out of the cycle of gender-based violence. Will you participate in bringing hope to girls and their communities?

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