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If you have a mental health problem, where you live in the world makes a big difference to the care you receive. In many lower and middle income countries, three-quarters of people with mental health problems don’t have access to mainstream mental health services. Even in wealthier, developed countries, the figure is close to 50%.

Claudia Hammond investigates some of the alternatives that occupy this ‘treatment gap’.

Psychiatrist Dr Monique Mutheru is one of just 25 psychiatrists in Kenya. In the absence of services to meet the mental health needs of Kenyans, traditional healers and witchdoctors play a crucial role in diagnosing and treating them. Claudia examines a programme which brings health workers and traditional healers together. It provides training for traditional healers to refer their severely ill patients to the clinic and avoid harmful practices that some healers carry out, such as lobotomy and bloodletting.

Even in developed countries like the United Kingdom, where mental health services are freely available, some people with mental health problems feel that the treatments do not help. The Hearing Voices Network provides support to ‘voice hearers’, through support groups, helping them to manage and engage with the voices that trouble them.