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Bridging the gaps in mental health

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World Mental Health Day falls today on the theme, ‘Mental Health in an Unequal World’

Consultant Psychiatrist and Senior Lecturer from Kotelawala Defence Univeristy, Dr. Neil Fernando throws light on the widening treatment gap in mental health, calling for a four-pronged strategy to enable wider community access to mental health services.

by Randima Attygalle

Mekala (name changed) made history as the first young person from her village in Sevanagala to enter Medical College. All was going well for the budding doctor until she was diagnosed with Schizophrenia in her fourth year. A chronic brain disorder, Schizophrenia affects the way a person thinks, acts, expresses emotions, perceives reality and relates to others.

It took nine years for Mekala to recover and when she made an appeal to the authorities to let her complete her medical studies, she was turned down on the basis that her grace period to complete her course had expired. With her hopes shattered, Mekala had a relapse.

“Despite experts in mental health making a case for the young medical student to allow her to complete her studies, making an exception to the existing rules, the authorities rejected the case, which was very sad,” recollected Consultant Psychiatrist, Dr. Neil Fernando who was among the specialists that treated Mekala.

While that was the sad plight of a medical student here, the story of the American mathematician, John Forbes Nash Jr. was the opposite. He spent years at psychiatric hospitals being treated for Schizophrenia. When his condition improved, he was allowed to return to the Princeton University to teach. Not only was Nash welcomed by his colleagues but he also won the Nobel Prize in Economic Sciences in 1994. He opened his acceptance speech with the forthright comment, “I’m a Schizophrenia patient.” Nash’s struggles with his illness and his recovery inspired Sylvia Nasar’s biography A Beautiful Mind and later a film by the same name starring Russell Crowe as Nash.

World Mental Health Day was observed for the first time on October 10, 1992. It was started as an annual activity of the World Federation for Mental Health by the then Deputy Secretary General Richard Hunter. Hunter began his career in the mental health field during World War II when as a conscientious objector he joined the Civilian Public Service programme. Hunter, a law graduate, while serving a hospital for the mentally ill patients, was disheartened by the lack of awareness of mental health which drove him to advocate for it.

This year’s theme for World Mental Health Day- ‘Mental Health in an Unequal World’ highlights that access to mental health services remains unequal. This is compounded in a world which is becoming increasingly polarized, points out Dr. Fernando. “The gap between the haves and have-nots is widening each day and the inequality is more prominent when it comes to mental health. Lack of investment in mental health disproportionate to the overall health budget contributes to the mental health treatment gap.”

People with mental disorders experience disproportionately higher rates of disability and mortality proving that ‘there is no health without mental health.’ According to WHO, persons with major depression and schizophrenia have a 40% to 60% greater chance of dying prematurely than the general population, owing to physical health problems that are often left unattended (such as cancers, cardiovascular diseases, diabetes and HIV infection) and suicide. Suicide is the second most common cause of death among young people worldwide. Yet, health systems have not yet adequately responded to the burden of mental disorders.

As a result, the gap between the need for treatment and its provision is large all over the world, notes the WHO’s Mental Health Action Plan 2013-2030. ‘Between 76% and 85% of people with severe mental disorders receive no treatment for their disorder in low-income and middle-income countries; the corresponding range for high-income countries is also high: between 35% and 50%. A further compounding problem is the poor quality of care for those receiving treatment.’

One in every four persons develops a mental illness says Dr. Neil Fernando. “Yet the annual investment in mental health is less than US$ 2 per person. In low income countries, it is less than US$ 0.25. In 2019, WHO pointed out that for every dollar spent on mental health, there is a return of four dollars from improved health and productivity.” Although it is accepted that large hospitals are not the best of places for people with mental disorders, 67% of financial resources are allocated to mental hospitals,” notes the psychiatrist who goes onto add that mental hospitals often restrain people unnecessarily resulting in abuse, poor health outcomes and human rights violations.

The tragic story of P.P. James who was confined to the asylum in Angoda for 50 years is one of the worst violations of human rights resulting in restricted hospitalization. Arrested on a charge of killing his father late one night in 1958, James was ruled mentally ill by a judge and was committed to the asylum for the criminally insane and was forgotten for 50 years, never having stood trial. Worst, the father he was charged for having killed was actually alive and died only 23 years after James’ arrest for ‘his murder’. A half a century after his arrest, his case was dismissed and James was finally free. “Although James had recovered decades ago and the courts were informed, there was no response as his file had been lost,” recollects Dr. Fernando who was serving in the hospital’s criminal ward at that time.

The absence of mental health legislation in the country to suit the present day needs is also cited by the senior consultant as a drawback in realizing mental health from a human rights perspective. The proposed Mental Health Act has remained only a ‘draft’ for decades, he says.

Stigma and discrimination, very often within families of patients (even after recovery) compounds the unequal access to mental health care and impedes the quality of their lives. Problems of knowledge, attitude and behaviour contribute to stigma. Many people even after recovery are abandoned by their families and are often deprived of their rightful inheritance.

In our setting, the stigma is even extended to the very locality where the hospital for the mentally ill stands- commonly referred to as pissan kotuwa in derogatory terms. When posted to Angoda as a young psychiatrist in 1984, Dr. Fernando took the bus from Kandy to Fort and from there to Angoda. “As the bus approached Angoda, the conductor was shouting Pissan kotuwa bahinna- pissan kotuwa bahinna and nobody got down from the bus. At the next bus halt half the passengers got off the bus and opted to walk back,” he recollects. The hesitancy of residents from the area to be identified with a hospital, drove authorities to rename the areas as ‘Mulleriyawa New Town.’ Angoda Mental Hospital was renamed ‘National Institute of Mental Health.’

Migration of qualified psychiatric specialists to other countries is another challenge points out Dr. Fernando. Sri Lanka’s failure to deliver mental health care services to a larger population is attributed to four broad reasons by Dr. Fernando:

1. The centralized services limited to large hospitals

“We need to decentralize mental health care and take it to primary health care or to the village level and integrate it to normal health care services.”

2. Services are all hospital-based

“The majority of people who need mental health services do not come to hospitals, hence the treatment gap is further widened,” remarks the senior consultant who calls for a ‘complementary community-based’ system. “Like in the case of maternal health, we can develop a system where patients are seen at home. We already have psychiatric nurses and this cadre can be further strengthened.”

3. The treatment is largely disease-based

“Instead of looking only at the disease, we should have a patient-friendly service which looks at a person holistically addressing his/her other needs as well.”

4. Services are delivered on one-to-one basis

“When we know that one in four people will be affected by a mental health problem during his/her lifetime, one-to-one delivery will not be adequate,” says Dr. Fernando who says the involvement of patients as well as their care givers in mental health services is essential. The effort could make them active partners in the process, so that they too can be empowered to take ownership to the delivery of care, he says.



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Sections of US media looking power straight in the eye

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President Trump addressing the media at the White House.(BBC)

Some fundamental freedoms seen to be at the heart of democracy in the US – religion, speech, the press, assembly and the right to petition the government – are at risk of being undermined at present by the country’s Executive President. However, the latter is being legally challenged on this score by some sections of the US media and the citizenry of the country could take heart from this notable defense of media freedom.

In fact this is good news for the world of democracy. The push back is coming from organizations such as CNN, ABC, CBS, Fox, NBC who constitute the nucleus as it were of the US media and their solidarity no less than their resourcefulness calls for commendation.

Following a recent White House decision to suspend CNN from what was referred to as ‘participation in presidential pool coverages’, the other media organizations mentioned refused to replace it in the pool. Their position was that the public had a right to receive ‘accurate and independent information about the government.’

Earlier, the White House decided to bar MS NOW and Politico from entering its premises following the restrictions imposed on CNN. The organizations were accused of publishing “FAKE NEWS’ , ‘Fiction’ and ‘lies’ in respect of the administration. These organizations lost no time in initiating a federal lawsuit accusing the central administration of violating their rights guaranteed by the First Amendment.

However, the latter litigating organizations could now consider themselves as having been vindicated because the federal court hearing their case has ordered the Trump administration to temporarily restore White House press access to journalists from the mentioned media institutions. Notably, the court has declared that the ban is ‘likely unconstitutional’. The case is proceeding.

The mass media of the most vibrant democracies of the West ought to be no strangers to such inspirational acts of solidarity and exemplifications of independence but there are lessons here for the democracies of the South that could stand them in good stead. Minus the right of a people to be informed, the rest of fundamental rights featuring in Southern Bills of Rights and legislation of the kind are bereft of substance and meaning.

It is informed decision-making on the part of a citizenry that makes for democratic vibrancy and on this score many a Southern democracy fails. While Southern publics generally demand of their governments continuous economic well being and substantive material benefits they are not equally desirous of being informed and knowledgeable.

This lacuna in the consciousness of many Southern publics enables their governments ‘to get off the hook’, so to speak and govern, or more often misgovern, their countries with impunity. Among other factors, this species of mass ignorance makes it possible for governments to dismantle democracy and rule in perpetuity.

Accordingly, an educated and constantly informed public is an essential precondition for the flourishing of democracy and independent media are integral to this process. Minus an independent mass media sector that meets the knowledge needs of the people responsibly, democracy is as good as dead.

Needless to say, those sections of the US media that are currently taking the Trump administration to task over its media curbs are acutely aware of the cruciality of these fundamental knowledge requirements.

The hope of democratic opinion worldwide and locally is likely to be that media independence would thrive in the manner in which it is flourishing in the most vibrant and accountable democracies of the West.

Southern countries such as Sri Lanka that lay claim to democratic credentials, but are democracy-deficient in many ways, need to be particularly cognizant of these requirements. The publics of these countries need to go the extra mile to ensure the thriving of an independent but responsible mass media sector.

In fact it is veritably a matter of life and death. It is only an independent media sector that could, while ensuring the existence of an informed public, impress on the latter the need to protect and perpetuate its fundamental rights. In the absence of these campaigns, such publics could be eventually having on their hands governments that boast of ruling in perpetuity.

Taking a leaf from the sections of the US media referred to independent media organizations in Southern states need to act in solidarity as well. They would need to act on the basis of the principle that acts of victimization suffered by members in their fold at the hands of governments, for instance, are in fact inimical acts directed at their collectivity and which call for united remedial action. In short, no independent mass media institution could see itself as ‘an island’.

Besides some general guidance on the importance of media independence and solidarity, the message coming from the US with regard to media praxis is that power must be stood-up to unblinkingly. The mentioned sections of the US media are primarily in a struggle to ward off encroachments on their independence in the areas of policy and practice by the political executive, that is the President.

The latter would ride rough-shod over the media in the absence of robust opposition by the media itself to inimical executive action of this kind.

While media independence needs to be seen as crucial to democratic development, an obligation is cast on the media to ensure that it uses such independence responsibly and constructively.

The worst that could afflict a media sector is for it to fall prey to the clichetic ‘freedom of the wild ass’. In fact recurring irresponsibility on the part of the media could lend credence to the perception that a tightly regulated media is best for a country. It is a short step from this misguided view to the position that political authoritarianism is best for a state. That turn of events would be of course catastrophic for a democracy.

The issues discussed thus far point to the need for a broad discourse among Southern democracies in particular on what is best for them in this connection. Given the risks underscored earlier for Southern countries in particular a broad discussion on the matters at hand, which includes the public, emerges as a must for Sri Lanka. Besides, media solidarity within democratic countries and internationally is a must.

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What lessons can be learned to improve quality of Sri Lanka’s Grade 6 syllabus

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Prime Minister Dr. Harini Amarasuriya

by Prof. M. W. Amarasiri de Silva

Following public controversy over an inappropriate web link found in an English study module, the Sri Lankan government formally deferred the full rollout of the Grade 6 curriculum reforms to January 2027. In the interim, state schools will maintain the existing syllabus, reverting to standard eight-period daily timetables and previous textbooks to ensure uninterrupted instruction. Prime Minister and Minister of Education Dr. Harini Amarasuriya emphasized that this temporary pause allows the Education Ministry to thoroughly review all instructional materials, fix editorial flaws, and conduct scientific impact assessments across pilot schools prior to nation-wide implementation.

To address the oversight, an expert committee evaluated the flawed materials, completed necessary amendments, and finalised discussions to resubmit corrected modules for printing. Beyond revising written texts, the Ministry established a broader preparation roadmap—allocating funds for extensive teacher training programs set to begin mid-year, alongside scheduled informational briefings for parents, teachers, and students. Prime Minister Amarasuriya reaffirmed that none of the valid first-term modules were completely discarded or scrapped, preserving state resources while systematically rebuilding public trust and strengthening quality assurance protocols.

In this respect, this article reviews the current grade 6 syllabus comparing it with similar syllabi of India and the USA, with a view to make recommendations for the upcoming grade 6 syllabus revision.

Architecture of nation’s future

Education is the quiet architecture of a nation’s future. It is the unseen scaffolding upon which generations build their character, their intellect, and their capacity to contribute meaningfully to society. In Sri Lanka, the Grade 6 syllabus occupies a particularly important place in this architecture. It is the bridge between primary learning and the more demanding intellectual terrain of secondary education. It is the moment when children begin to move from learning basic facts to understanding concepts, from memorising information to applying knowledge, and from passive reception to active engagement. Yet, despite its importance, the Grade 6 curriculum in Sri Lanka has long struggled with issues of breadth, depth, relevance, and pedagogy. As global education systems evolve, Sri Lanka must examine what lessons can be learned from international models—particularly India and the United States—to strengthen its own curriculum and prepare students for a rapidly changing world.

The first lesson Sri Lanka can learn is the value of conceptual clarity. India’s NCERT curriculum, especially in Mathematics and Science, is globally respected for its logical progression and conceptual depth. Indian students are introduced early to the idea that mathematics is not merely a set of procedures but a language of reasoning. They learn why a ratio works, not just how to compute one. They understand the structure of an equation, not merely the steps to solve it. In Science, they explore the properties of materials, the structure of plants, and the principles of motion with a clarity that encourages curiosity rather than rote memorisation.

Sri Lanka’s Grade 6 syllabus, while competency-based, often leans heavily toward content coverage. Students are expected to learn many topics, but the time allocated for each is limited, and the teaching culture often emphasizes memorisation over understanding. If Sri Lanka wishes to improve the quality of its syllabus, it must embrace the idea that fewer topics taught well are better than many topics taught superficially. Conceptual mastery builds confidence, and confidence builds lifelong learners.

Lesson from the US

A second lesson comes from the United States, where the curriculum is built around skills rather than content. American students in Grade 6 are expected to read complex texts, analyse arguments, write essays supported by evidence, conduct experiments, and engage in collaborative projects. The emphasis is not on how much they know but on what they can do with what they know. This skills-based approach encourages critical thinking, creativity, and independence—qualities essential for success in the modern world.

Sri Lanka’s syllabus, by contrast, often rewards students for reproducing information rather than interpreting it. The exam culture reinforces this tendency, as students are assessed primarily through written tests that measure recall. To improve the syllabus, Sri Lanka must integrate more opportunities for students to think, question, debate, and create. The classroom should become a space where students learn to solve problems, not just memorize solutions.

Another important lesson comes from the breadth of Sri Lanka’s own curriculum. One of the strengths of the Sri Lankan system is its inclusion of cultural and religious education. Subjects such as Buddhism, Hinduism, Islam, and Christianity provide moral grounding and cultural identity. Art, Music, Drama, and Health contribute to holistic development. These subjects remind students that education is not merely about academic achievement but about becoming a balanced human being. However, breadth without depth can become burdensome. Grade 6 students in Sri Lanka often juggle more than ten subjects, each with its own textbook, competencies, and assessments. This creates pressure not only for students but also for teachers, who must rush through content to meet syllabus requirements. The lesson here is not to reduce cultural subjects but to integrate them more meaningfully. Religious education can be taught through ethical discussions, community projects, and reflective writing. Art and Music can be connected to history, literature, and social studies. Health can be linked to science and physical education. Integration reduces overload while enriching learning.

Another lesson from India

India offers another valuable lesson in the form of standardised textbooks. NCERT books are used across the country, ensuring consistency in quality and content. They are written by subject experts, reviewed rigorously, and updated periodically. Sri Lanka’s textbooks, while generally well-structured, vary in quality and often lag behind modern pedagogical standards. Some are dense, text-heavy, and lacking in visual aids or real-world examples. To improve the syllabus, Sri Lanka must invest in high-quality textbooks that are engaging, accessible, and aligned with contemporary educational research. Textbooks should not merely transmit information; they should inspire curiosity. They should include stories, diagrams, experiments, and activities that make learning enjoyable and meaningful.

The United States provides a lesson in inquiry-based science education. American students conduct experiments, build models, observe natural phenomena, and engage in engineering design challenges. They learn science not as a set of facts but as a process of discovery. Sri Lanka’s science curriculum includes experiments, but many schools lack the resources, laboratory facilities, or teacher training to implement them effectively. Improving the syllabus requires improving the ecosystem around it. Schools need laboratories, equipment, and teacher development programs that empower educators to teach science through inquiry. A syllabus is only as strong as the environment in which it is taught. ***

International models

Another area where Sri Lanka can learn from international models is language education. In India, students often learn three languages—English, Hindi, and Sanskrit or Urdu. This heavy language load has its challenges, but it also produces students with strong linguistic skills. In the United States, English Language Arts emphasises reading complex texts, writing arguments, and analysing literature. Sri Lanka’s English curriculum, while improving, still struggles with uneven implementation across schools. Many students reach secondary school without adequate proficiency in English, limiting their access to global knowledge. To improve the syllabus, Sri Lanka must strengthen English instruction through better teacher training, more reading opportunities, and a shift from grammar-heavy teaching to communication-focused learning. At the same time, Sinhala and Tamil instruction should be modernised to include creative writing, literature appreciation, and critical reading.

Social Studies is another area ripe for improvement. Sri Lanka’s curriculum includes History, Geography, and Civics, but the teaching often emphasises memorization of dates, definitions, and facts. India’s Social Science curriculum, while also content-heavy, provides clearer conceptual frameworks. The United States, however, excels in teaching civics and citizenship. American students learn how governments function, how laws are made, how communities solve problems, and how citizens participate in democracy. Sri Lanka can strengthen its Civics curriculum by incorporating more discussions on governance, rights, responsibilities, and community engagement. Students should learn not only the structure of government but also the values that sustain it—justice, equality, and participation.

One of the most important lessons Sri Lanka can learn is the value of reducing exam pressure. In both India and Sri Lanka, exams dominate the educational landscape. Students are judged primarily by their ability to perform on written tests. The United States, while not free from assessment challenges, uses a wider range of evaluation methods—projects, presentations, portfolios, and continuous assessment. These methods allow students to demonstrate learning in diverse ways. Sri Lanka should consider adopting a more balanced assessment system that values creativity, collaboration, and practical skills alongside academic knowledge.

Technology integration is another area where Sri Lanka can improve. The United States incorporates digital literacy, coding, online research, and digital citizenship into the curriculum. Sri Lanka’s ICT syllabus is well-structured, but implementation varies widely. Many schools lack computers, internet access, or trained ICT teachers. Improving the syllabus requires improving infrastructure. Students must learn to navigate the digital world safely and effectively. They must learn coding not as a luxury but as a basic skill. They must learn to evaluate online information critically, a skill essential in an era of misinformation.

Teacher training

Teacher training is perhaps the most critical lesson of all. A syllabus is only as effective as the teachers who deliver it. India invests heavily in teacher training through national programs, workshops, and online platforms. The United States emphasises professional development, peer collaboration, and instructional coaching. Sri Lanka must strengthen its teacher training programmes, ensuring that educators understand not only what to teach but how to teach it. Teachers should be trained in inquiry-based learning, differentiated instruction, formative assessment, and classroom management. They should be empowered to adapt the syllabus to the needs of their students rather than follow it mechanically.

Sri Lanka must learn the lesson of relevance. A syllabus must prepare students not only for exams but for life. It must teach them how to think, how to communicate, how to solve problems, and how to work with others. It must prepare them for a world where knowledge is abundant, but wisdom is scarce. It must help them navigate a future shaped by technology, globalisation, environmental challenges, and social change. To improve the syllabus, Sri Lanka must ask: What kind of citizens do we want to produce? What kind of thinkers? What kind of leaders? The answers to these questions should shape the curriculum.

Lastly, improving the quality of Sri Lanka’s Grade 6 syllabus requires learning from both international models and local strengths. From India, Sri Lanka can learn the value of conceptual clarity and standardised textbooks. From the United States, it can learn the importance of skills, inquiry, and creativity. From its own traditions, it can preserve cultural education, moral development, and holistic learning. The goal is not to copy another country’s system but to build a uniquely Sri Lankan curriculum that is modern, relevant, and empowering. A curriculum that honours the past while preparing students for the future. A curriculum that nurtures thinkers, creators, and compassionate citizens. A curriculum worthy of a nation with immense potential and a proud educational heritage. If Sri Lanka embraces these lessons, the Grade 6 syllabus can become not just a bridge to secondary education but a foundation for national progress.

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Three magical nights at Colombo Fashion Week

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Melloney Dassanayaka is certainly a familiar name here, and abroad, as well, having represented Sri Lanka at the Miss Universe 2024 pageant, held in Mexico.

A former National Basketball player, she is also involved in several projects, beneficial to the community, including financial literacy for single women-headed families in the country.

A banker by profession, Melloney hold a Bachelor’s Degree in Business Administration.

Melloney with Asanka de Mel of Lovi Sri Lanka

This extremely talented old girl of Holy Family Convent, Bambalapitiya, was in the limelight, once more, when she was seen on the ramp at Colombo Fashion Week.

It was her very first experience, at this prestigious event, and she loved every minute of it, she said, and, what’s more, she was featured on three consecutive days.

According to the itinerary, on day 01 she walked for Lovi Sri Lanka; day 02 Rizwan Beyg (Pakistan designer), Arsath Furkhan (Indian designer), Haoyi Yan (Chinese designer) and Samant Chauhan (Indian designer); and on day 03 Vaishali Shandangule (Indian designer).

In today’s edition of The Island SceneAround, we spotlight Melloney, on the ramp, at Colombo Fashion Week.

Melloney will also participate at Miss Grand All Stars to be held later in the year, in Thailand, as Miss Universe Sri Lanka 2024.

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