Mauritius is a country with an approximate area of 2 thousand sq. km. (UNO, 2001). Its population is 1.233 million, and the sex ratio (men per hundred women) is 99 (UNO, 2004). The proportion of population under the age of 15 years is 25% (UNO, 2004), and the proportion of population above the age of 60 years is 9% (WHO, 2004). The literacy rate is 88.2% for men and 80.5% for women (UNESCO/MoH, 2004).
The country is a higher middle income group country (based on World Bank 2004 criteria). The proportion of health budget to GDP is 3.4%. The per capita total expenditure on health is 323 international $, and the per capita government expenditure on health is +192 international $ (WHO, 2004).
The main language(s) used in the country is (are) English, French and Creole Patois. The largest ethnic group(s) is (are) Indo-Mauritian, and the other ethnic group(s) are (is) Creole. The largest religious group(s) is (are) Hindu (more than half), and the other religious group(s) are (is) Christian and Muslim. The life expectancy at birth is 68.4 years for males and 75.5 years for females (WHO, 2004). The healthy life expectancy at birth is60 years for males and 65 years for females (WHO, 2004).
There is a paucity of epidemiological data on mental illnesses in Mauritius in internationally accessible literature. Reynolds et al (2000) used the Schizotypal Personality Questionnaire in a sample of 1201 subjects and found that the three-factor model (cogni-tive-perceptual deficits, interpersonal deficits and disorganization) underlies individual differences across widely varying groups.
Venables (1996, 1997) found that women’s exposure to influenza in pregnancy was associated with an elevation of positive schizo-typy scores and electrodermal hyperresponsivity (associated with schizophrenia), whereas exposure to low environmental tempera-tures was associated with
an elevation of anhedonia scores and electrodermal hyporesponsiveness in their offspring.
MENTAL HEALTH RESOURCES
Mental Health Policy A mental health policy is present. The policy was initially formulated in 1983. The components of the policy are promotion, prevention, treatment and rehabilitation.
Substance Abuse Policy A substance abuse policy is present. The policy was initially formulated in 1996. A Substance Abuse Strategic Plan was formulated in 2004.
National Mental Health Programme A national mental health programme is present. The programme was formulated in 2000. A Mental Health Decentralization and Integration of Mental Health in Primary Health Plan was prepared in 2002.
National Therapeutic Drug Policy/Essential List of Drugs A national therapeutic drug policy/essential list of drugs is present. It was formulated in 1972.
Mental Health Legislation There is a Mental Health Care Act (act no 24). It repealed the older Lunacy Act. The Act is detailed and has provisions for procedure of admission and discharge of patients, rights of patients, living conditions of the hospitals, legal issues pertaining to courts and ability to stand for trial. There are also provisions for actual treatment issues like person responsible for care, plan of treatment, follow-up, etc. A new Mental Health Care Act is under preparation to cover developments related to community psychiatric services/care. The latest legislation was enacted in 1998.
Mental Health Financing There are budget allocations for mental health. The country spends 0.3% of the total health budget on mental health. The primary sources of mental health financing in descending order are tax based, out of pocket expenditure by the patient or fam-ily and private insurances.
The country has disability benefits for persons with mental disorders. Two types of benefits are present: (1) basic invalidity pension for those who have 60% of mental handicap; (2) basic invalidity pension and carer’s allowance for those who are non-ambulant, have severe disability and who need constant carer’s assistance.
Mental Health Facilities Mental health is a part of primary health care system. Actual treatment of severe mental disorders is available at the primary level. Primary care is provided as an outpatient service and as follow-up after treatment at the main psychiatric hospital. Regular training of primary care professionals is carried out in the field of mental health. There are community care facilities for patients with mental disorders. Six centres provide community care facilities.
Psychiatric Beds and Professionals
Total psychiatric beds per 10 000 population
Psychiatric beds in mental hospitals per 10 000 population
Psychiatric beds in general hospitals per 10 000 population
Psychiatric beds in other settings per 10 000 population
Number of psychiatrists per 100 000 population
Number of neurosurgeons per 100 000 population
Number of psychiatric nurses per 100 000 population
Number of neurologists per 100 000 population
Number of psychologists per 100 000 population
Number of social workers per 100 000 population
There are 5 occupational therapists and 4 assistants.
Non-Governmental Organizations NGOs are involved with mental health in the country. They are mainly involved in rehabilitation.
Information Gathering System There is mental health reporting system in the country. Details about services, morbidity, cause of death are published in the Annual Health Statistics. Some information is available about neurotic disorders and alcohol dependence as per ICD 9 criteria.
The country has data collection system or epidemiological study on mental health. Details are given in the Annual Health Statistics. Hospital and community clinic attendance and discharge are reported under the broad group of ‘mental disorders’. An epidemiological survey was carried out in 1997-1998 under the aegis of Ministry of Health/Mauritius Institute of Health and Mauritius Psychiatric Association in collaboration with Ins CCOMS Paris, under the title ‘Recherche Epidemiologique Multicentrique: La Santé Mentale en Population Generale. Image et Realite’.
The Republic of Mauritius publishes two separate Annual Health Statistics from its two islands of Mauritius and Rodrigues.
Programmes for Special Population The country has specific programmes for mental health for elderly and children.
Therapeutic Drugs The following therapeutic drugs are generally available at the primary health care level of the country: carbamazepine, ethosuximide, phenobarbital, phenytoin sodium, sodium valproate, amitriptyline, chlorpromazine, diazepam, fluphenazine, haloperidol, lithium, biperiden, carbidopa, levodopa.Other anti-cholinergics (benzhexol, orphenadrine and procyclidine) and newer anti-psychotics (olanzapine, risperidone) and anti-depressants (paroxetine) are also available. All the drugs are strictly controlled and dispensed against prescriptions. The prices are Government controlled. Other drugs are available from private pharmacies.