‘স্বাস্থ্য বাজেট পর্যালোচনা: প্রস্তাব ও প্রাপ্তি, পর্ব-১’

The government of Bangladesh allocates minimal funding to mental health, with current mental health revenues accounting for only 0.44 percent of the health budget. The lack of financial commitment is exacerbated by the fact that mental health continues to be neglected in the country, as evidenced by a meagre 0.5% of the health budget allocated to mental health, leading to major challenges such as a lack of qualified mental health workers, healthcare workers and inadequate public mental health services.

67% is dedicated to mental hospitals. Less than 0.11% of the population have access to free essential psychotropic medications. Daily out-of-pocket expenses for the lowest-priced antipsychotic and antidepressant medication is 5.00 taka (US$ 0.07) and 3.00 taka (US$ 0.04) respectively. Health insurance is a rarity and, in any case, typically does not cover drugs for mental illness. There are even fewer psychiatrists (0.16 per 100,000 population). The majority of these professionals work in the urban areas of the country, namely the capital city of Dhaka. Types of mental healthcare providers in Bangladesh include psychiatrists, nurses, psychologists, social workers, occupational therapists and general mental health workers. Approximately half the psychiatrists (54%) in Bangladesh work in government mental health facilities or private sector clinics; 46% work for NGOs, for-profit mental health facilities or in private practice.5 Psychiatrists working in government facilities are allowed to concurrently work in the private sector as well. Around 62% of psychosocial professionals, including clinical psychologists, social workers, nurses and occupational therapists, work for government-administered mental health facilities, 26% work for NGOs or in private practice, and 12% work for both the public and the private sectors. The distribution of human resources between urban and rural areas is grossly disproportionate, with a heavy concentration in urban areas. The density of psychiatrists and psychiatric nurses in or around the largest city, the capital Dhaka, is five times greater than the density of these professionals in the rest of the country. Bangladesh’s available workforce in mental healthcare is scarce and skewed in distribution, an immense barrier to improving mental healthcare in the country.

Despite the passage of a new mental health law in 2018 to ensure the provision of health services and general well-being for people with mental illness, a lack of public support and the prevailing stigma surrounding mental illness in Bangladesh often discourage policymakers from allocating adequate resources, financial resources, funds for mental health services.

So we see that lacking the right amount of resources for mental health in the budget allocation leads to lack of Mental Health provision for the greater society. There cannot be under-utilisation of the budget as well.

WHO framed the health budget execution into three phases – 1) budget formulation, 2) budget execution, and 3) budget monitoring.

By following these steps budgeting can ensure better resource a location for mental health in Bangladesh. Bangladesh has allocated 5.19 percent of the proposed national budget—Tk 41,407 crore—to the health sector in FY2024-25. The share of the health sector has been more or less five percent of the budget for more than a decade. We can conclude that increases in the budget for mental health and the overall budget can help Bangladeshi people in the long run.