February 26, 2005
by Kevin Caruso
Clinical Depression requires treatment. Period.
And untreated depression is the number one cause for suicide.
But my concerns are high that many tsunami survivors will not receive the help that they need.
The reason: There aren’t enough psychiatrists in the affected countries to treat those who are depressed.
For those who live in the United States and look in the phone book, there will be pages upon pages of listings for psychiatrists, but trying to find a psychiatrist in Sri Lanka or Indonesia is a different matter.
Let’s look at the numbers.
The population of Indonesia is about 225 million and there are about 450 psychiatrists, which equates to one psychiatrist per 500,000 residents.
The population of Sri Lanka is about 20 million and there are 30 psychiatrists, which equates to one psychiatrist per 667,000 residents.
Economic and cultural considerations are the reasons for the great disparity between the number of psychiatrists in the U.S. and those countries. And one of the cultural differences is this: “Talk” therapy with a professional is a foreign concept for many residents in Indonesia and Sri Lanka.
Thus, some officials in Indonesia and Sri Lanka believe that bringing in psychiatrists from other countries is not necessary; and that counseling of ANY kind is not necessary, and even potentially harmful.
Dr. Athula Sumathipala, chief of the Psychosocial Department in Sri Lanka, is opposed to offering counseling to those who are suffering psychologically because of the tsunami. He contends that social and religious traditions as well as close family and community ties should help carry people through their tsunami “hardships.”
But Colonel Geerhan Lantara, the military commander in Meulaboh, Indonesia, stands in strong opposition to that idea. He wants as many psychiatrists as possible to be brought into Indonesia. He has seen the residents suffer and he knows that they need professional intervention.
“Too many surgeons have been sent to us and not enough psychiatrists…we need psychiatrist,” he said emphatically.
Both countries are developing some mental health outreach programs, however, especially for children. They are using some of the foreign aid money to train teachers, doctors, nurses, and others to recognize signs of depression and to provide help when needed.
And some health professionals are taking it upon themselves to reach out to tsunami victims.
Sujeewa Amarasena, a Sri Lankan doctor, organized an outreach program to offer tsunami survivors emergency pshychological help. She is working with doctors and psychiatrists to provide counseling to those in need.
One of her objectives is to prevent as many suicides as possible.
So what do I think about all of this?
Sujeewa, and others like her, are doing the right thing.
She is a hero. She is not only intelligent and compassionate, but is using common sense and is TAKING ACTION.
I have enormous respect for her.
On the other hand, Dr. Athula Sumathipala, the chief of the Psychosocial Department in Sri Lanka, who was mentioned above as saying that tsunami survivors do not need counseling, is espousing an extremely ignorant, very outdated, and patently dangerous view.
Hopefully there will be many more Sujeewas, who understand the need for professional intervention, than there will be Sumathipalas, who will sit back, do nothing, and think that “family ties” will somehow cure clinical depression, severe anxiety, and post-traumatic stress disorder.
The reality is evident, however: Many tsunami survivors will not receive the mental health treatment that they need.
And I pray every night that they will not die by suicide.
If you or someone you know is suicidal because of the tsunami (or for any reason)
please click below for immediate help:
Prevent Suicide Now.com
