In Myanmar, the overwhelming combination of political conflict, COVID-19, and economic decline has resulted in an unprecedented mental health crisis. So when Eh Wah,* a social worker who deals with vulnerable youth in Yangon, learned that The Carter Center was piloting a peer-to-peer mental health services support program, she jumped at the opportunity to participate.
During the counseling skills training, she learned of a 10-year-old girl in her community struggling with depression. “After losing her parents to COVID,” Eh Wah related, “she said she didn’t want to live in the world anymore… that it’s too unhappy of a place.”
Hearing those words come from a child shocked her: “Expanded access to mental health support is so necessary,” she said, “especially in rural communities.”
Myanmar’s growing mental health crisis — and dearth of care providers — prompted The Carter Center to launch a pilot project to train women in Myanmar to serve as mental health peer counselors.
Myanmar is home to the world’s longest continuing civil war, spanning seven decades to date.
“The inevitable toll on mental health is impossible to ignore, and recent events have only intensified the unmet need for services,” said Masa Janjusevic, the Center’s country representative for Myanmar. “Given the Carter Center’s deep expertise in mental health and the limited number of mental health workers in Myanmar, we saw an opportunity to innovate.”
In the summer of 2022, The Carter Center launched a peer-to-peer mental health support training project for women’s civil society and faith-based organizations. The pilot, implemented in partnership with the Counseling Corner — a Myanmar-based organization that provides mental health counseling, psychotherapy, and support — leverages existing community networks and expands upon relationships the Center has already built.
“Community-based and civil society organizations have long played a significant role in bridging treatment gaps,” Janjusevic said. “While they aren’t a replacement for an effective public health system, they play a vital role. This project will equip a wide range of women with the knowledge, skills, and support to increase community access to basic mental health support. If successful, it could be expanded to other civil society and community-based organizations and geographic areas in Myanmar.”
Several Myanmar Carter Center staffers participated in the training.
“It created a safe space for us where we could learn how to be vulnerable and open with others,” said Thiri, * one of those staffers. “It really relieves stress.”
It is uncommon to speak about mental health issues in Myanmar, she said: “Generally, people around you are accepting of physical illness but don’t quite understand mental health, so they ignore it.”
Thiri has already begun applying her newly learned skills to her personal life. Where she used to let work and negative news consume her, she can now better manage her emotions and has developed a better work-life balance.
The situation in Myanmar has significantly deteriorated since the military coup in February 2021.
“The current political crisis has deepened the stress levels for the people across the country,” she said. “You can easily get overwhelmed, especially with social media. There are so many unpleasant images and news items. Through this project, we are providing training to people working on the ground in affected communities so they are better able to manage their emotional response.”
Though mental health in Myanmar is a critical issue, access to care is neither easy nor cheap: “It is difficult to access mental health services. There are facilities, but they are for those with more serious health issues.”
There’s also the cultural implication of seeking out help. Historically, it has been considered taboo to openly discuss negative emotions like depression and anxiety. But that school of thought is slowly changing among the younger and more progressive Myanmar people, said Thiri.
“We are more involved in opening up about our feelings than our parents’ generation.”
For many training participants though, deep-seated fears and mistrust make it difficult to be vulnerable. To solve for that, each participant is required to write a series of self-reflective essays: “It’s more comfortable to write your thoughts rather than sharing them with strangers,” she explained.
Participants then use these essays as the basis for a practice counseling session.
“This exercise helps everyone to warm up to each other and realize they have a lot of similarities. It builds trust and creates a team environment.”
Manaw,* from Myanmar’s Kachin state, feels the positive impact of participating in these trainings every day. “I learned there are different ways to listen,” she said. “I use the active listening skill when speaking with my colleagues. I know that sometimes it’s OK to listen and not respond.”
Manaw also has learned self-acceptance and how to manage her emotions at work. She has seen great improvement in her professional relationships and gives credit to the training.
“In the past,” she said, “if I had an issue at work, I would ignore the situation and harbor the mental burden. Now, I am open to sharing my feelings and coming to a resolution.”
In Myanmar, the daily risk of violence has exacerbated mental health care needs. As Thiri put it, the case for expanding peer-to-peer mental health support to other parts of the nation is strong: “It is really important to validate your feelings and not ignore them… especially in our community. These trainings are vital to the health of the country.”
*Names in this story have been changed to protect the interviewees.
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