Inequalities in healthcare, barriers preventing access to information, and disparities in education and socioeconomic opportunities inevitably mean that the world’s most vulnerable communities face the greatest impact of poor mental health.  

Persons affected by neglected tropical diseases (NTDs), such as leprosy, face perhaps some of the greatest challenges in maintaining their mental health, which is widely understood to have a direct effect on physical recovery. According to a mental health and NTD study published in Leprosy Review, one in two persons diagnosed with leprosy experiences depression and/or anxiety. ¹

Over the last decade, recognizing the important role of positive mental health for persons affected by leprosy, Lepra has developed a series of operational research projects that seek to integrate components for strengthening emotional health in leprosy and lymphatic filariasis treatment program design. One such project is “Mind to Heart” in Bangladesh. 

Built on learning gained from projects such as Lepra’s “Mental Motivators,” the Mind to Heart project is community-led. With funding from the Sasakawa Health Foundation, it is implemented in partnership with the Bogura Federation, a grassroots Community-Based Organisation (CBO) supported by Lepra that brings together 101 community “self-support groups” in a network spread throughout Bangladesh’s Bogura District.  

During 2023, Phase 1 of the project aimed to support 300 persons affected by leprosy with grade 2 disability in the Bogura District. The project’s initial goals included lowering levels of anxiety and depression alongside raising awareness. Improving access to community and specialist mental health services is a key element, along with widening the capabilities of the Bogura Federation to serve as a center of holistic care. 

To reach the goals, three tiers of intervention were made available: 1) awareness raising and signposting (helping people understand, access, and navigate services that will improve their health) by Mental Motivators (community volunteers) for the lowest level of need; 2) professional structured counseling for moderate need; and 3) specialist onward referrals for the highest level of need.   

These Phase 1 activities, including mental health counseling, were well received by participants: 91% of survey participants stated that Mental Motivator support has been beneficial for their mental wellbeing and 73.7% indicated that their knowledge about mental health issues improved.  

Phase 2, due to start in spring 2024, seeks to implement improvements based on lessons learned during Phase 1. In particular, this second phase will address the need for more intensive and longer-term therapeutic interventions, and it will seek to further strengthen the Bogura Federation, better enabling them to support the community’s ongoing emotional health needs.

The Mind to Heart project demonstrates that there is no single intervention which can solve the issue of poor mental health. It is clear that a range of interventions are needed. With the interdependency of emotional, social, financial, and physical health for persons affected by leprosy clearer than ever, Mind to Heart will continue to be embedded into local healthcare structures, with the Bogura Federation leading sustainable improvements for years to come. 

¹ Jennifer Mangeard-Lourme, Guillermo Robert de Arquer, Jayaram Parasa, Rajni Kant Singh, Naveen Satle, and Radhika Mamhidi, “Depression and anxiety in people affected by leprosy and lymphatic filariasis: A cross-sectional study in four States in India,” Leprosy Review 91, no. 4 (2020): 367-382, https://doi.org/10.47276/lr.91.4.36.