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Wednesday, November 6, 2024
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Breaking the Silence: A New Era for Mental Health Care, Support in Laos

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Mental health in Laos has long been overlooked. Due to the limited educational opportunities and resources related to mental health in the country, the population is less exposed to these issues and often lacks awareness. This is especially true for older generations, who did not have access to the resources available on the internet or social media.

However, the younger generation is becoming more aware of mental health issues, driving a slow but steady rise in demand for mental health services.

One of the leading mental health support initiatives in Laos is “Gamlangchai,” a community-based (locally focused) mental health organization founded in 2020. Gamlangchai’s mission is to create safe spaces for the Lao community, with a particular focus on young people. 

The organization promotes mental health awareness in schools, providing training for non-mental health specialists (those without formal training in mental health), and organizing peer support programs. These programs help individuals share knowledge on self-care (taking steps to maintain personal health) with the wider community.

Phatsaline “Pan” Vongsaly, co-founder of Gamlangchai and a mental health advocate, observed that only a small portion of the Lao population is aware of mental health issues. However, she noted that the Covid-19 pandemic has brought greater awareness, as more people began experiencing mental health challenges, regarding them as “more common than anybody had thought.”

“When COVID-19 came, I feel like everybody, regardless of who you are, where you work, or your current mental state, all got through some mental health challenges from the pandemic,” she said. “Whether it’s quarantine, adjusting to life while working from home, or people losing their jobs, you face a lot of uncertainty.”

She added that these challenges have prompted organizations worldwide, including in Laos, to integrate mental health programs into their agendas.

Pan also highlighted several initiatives aimed at addressing mental health in Laos, such as Reach Out Laos, which introduced mental health hotline services. She further noted that organizations like the World Health Program have supported local groups, including the Lao Women’s Union and Lao Youth Union, in incorporating mental health services into their work.

Recognizing the ongoing need for support, Pan drew from her experience working with the World Health Organization to create her own safe space, Gamlangchai. 

“The insights I gained from professional work inspired me to begin my own advocacy journey,” she said.

Overcoming Stigma and Misunderstanding

Despite efforts to establish facilities that support mental health in Laos, a significant barrier remains: the fear of stigma, according to Pan.

“For example, if you have a fever or a broken arm, why would you go to the doctor right away? Because it’s visible, isn’t it? You can clearly see the problem and feel comfortable going to the clinic, getting medication, and following the doctor’s advice,” she explained, drawing a parallel between physical and mental health.

“But when it comes to mental health challenges, even though the younger generation is more aware of these issues, the stigma and discrimination they may face from their communities still prevent many from seeking the support they need,” she continued.

Pan emphasized that because mental health issues are often invisible, many people mistakenly label those experiencing symptoms as “lazy” or “crazy.”

“We use these terms so casually that we don’t realize how they might impact someone with mental health disorders,” she said, offering an example of how even basic tasks, like taking a shower, can feel overwhelming for someone with depression.

She also pointed out common misconceptions about mental health terminology. For instance, mood shifts from sadness to happiness can be inaccurately labeled by layman’s understanding as bipolar disorder due to a non-professional understanding. It’s important to note that only qualified mental health professionals can accurately diagnose mental illnesses.

“The words we use when discussing mental health disorders matter,” she said.

This issue has motivated Pan, through Gamlangchai, to focus on educating the public about the correct terminology for mental health conditions.

In addition to the stigma that discourages many from seeking help, Pan highlighted that the affordability of mental health services is another significant barrier. She pointed out that mental health challenges often arise before the age of 25, a time when many are not yet financially stable.

Addressing Life-Threatening Mental Health Crises

Facing these challenges, some individuals may feel overwhelmed by their frustration, pain, and suffering, which can tragically lead to thoughts of taking one’s own life. When asked if the current economic crisis in Laos contributes to this, Pan explained that while it can exacerbate stress, it’s not the only cause

According to Pan, individuals without a strong support system may struggle more deeply, but genetic predisposition to mental illness also plays a significant role. On the other hand, some people, despite facing similar hardships, may cope more positively if they have developed resilience, often shaped by their upbringing.

Discussing the factors behind thoughts of ending one’s life, Pan emphasized the complexity of the issue, noting that it often involves an interplay of biological, psychological, and social elements. The reasons for such thoughts can vary greatly depending on individual circumstances, including pre-existing mental health conditions, experiences of bereavement, and past traumas.

To help identify whether someone is struggling, Pan suggested that loved ones should observe any changes in behavior and look out for signs like a person no longer participating in activities they usually enjoy.

“You don’t go to exercise anymore. You don’t really love the job that you are passionate about. These are signs that a person can intervene,” Pan said, emphasizing that early intervention is key. “You don’t need to wait until someone harms themselves.”

Building on this, Pan stressed that individuals going through tough times often just need someone to listen. When people feel supported and have a safe space to share their struggles, they are more likely to open up.

She emphasized the need for those offering support to be prepared for potentially difficult discussions. It’s essential to approach these conversations thoughtfully, she noted, suggesting that individuals ask questions like, “Are you okay? What’s happening? I’m genuinely concerned about you,” to convey their care and willingness to help.

Nevertheless, Pan recognized that everyone experiences mental health challenges with varying levels of severity. While some may find comfort in talking to loved ones, others might need professional help, such as therapy sessions, to properly address their needs.

Building Support Networks: Peer Support and Mental Health Care in Laos

A positive aspect of Lao culture is its strong emphasis on collectivism, where people frequently support one another in daily life. This sense of community creates a solid foundation for the psychological well-being of the population. Ketsada Soysouvanh, known as Nicky, who serves as a School Counsellor and Group Safeguarding Lead at Panyathip British International School in Vientiane and is a co-founder of Gamlangchai, highlights this beneficial aspect.

As a teacher, Nicky also emphasized that teachers and educators play a crucial role as mental health gatekeepers for young people. However, many schools in the Lao community are not adequately equipped with the knowledge and skills necessary to meet these expectations.

Building on this, and recognizing the limited mental health support facilities available, she together with the Gamlangchai team introduced in Vientiane, Laos a method called “peer support.” This approach guides individuals within a community to develop basic compassionate communication and listening skills, fostering mutual understanding and care.

“Just like physical first aid is a basic skill, mental health requires its own form of first aid,” Nicky noted. The aim of peer support programs is to connect individuals facing similar mental health challenges, helping them feel heard, validated, and hopeful in their recovery journey. This approach fosters a sense of community, reassuring participants that they are not alone and that support is available to help them navigate life’s difficulties.

Nicky explained that providing community based mental health promotion and prevention programs is the mission of Gamlangchai, particularly through peer support programs to address the lack of specialized mental health services in Laos. Echoing Pan’s earlier statement, she stressed that those offering support must recognize their own limits. Listening to others’ problems can take a toll on the listener’s mental health as well.

“Once you start to feel overwhelmed, it’s okay to take a break and let someone else take over,” Nicky advised, comparing the practice to the safety instructions on an airplane: “You should put on your own oxygen mask before assisting others.”

While the peer support method proved to be beneficial, Laos also  offers assistance facilities run by the government to help those in need. 

According to Nicky,  mental health consultations can be accessed at both 103 Hospital and Mahosot Hospital in Vientiane Capital.

However, for individuals in other provinces, particularly in rural areas with limited mental health support, she recommended contacting several hotlines. These include the Lao Women’s Union hotline at 1362, which operates 24/7, as well as the Counseling and Protection Center for Women and Children at 021 771 302 03.

Additionally, the Lao Youth Union hotline at 1554 and the Vientiane Youth Clinic can be reached at 1361 for females and 137 for males.

While access to professional care remains limited, particularly in rural areas, efforts are being made to provide services and hotlines to those in need. Ultimately, tackling mental health issues in Laos requires a collective effort from individuals, communities, policymakers, and organizations to create a more supportive environment for those struggling with mental health challenges.

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