The Truth About...

The first 24 hours are the most crucial in their survival for the 15 million premature babies born every year. And the stark truth is that survival depends on where in the world a baby is born.

Professor Joy Lawn is in the studio with Claudia and Suhail Haleem reports from Goa, where simple measures are producing dramatic results. And, we hear from professor Neil Marlow about the study which has followed babies born at less than 26 weeks for 19 years, to find out the long term effects on the lives of very premature babies.

(Photo: A baby holds an adult's finger, Credit: Simon Fraser/Science Photo Library)

Claudia Hammond exposes a hidden problem which occurs before life has even begun. Nosiphiwo was ostracised by her husband’s family in South Africa after years of trying, in vain, for a baby. Stories like Nosiphiwo’s, of social stigma and even physical abuse and destitution, are common in low-income countries, where most of the millions of infertile women in the world reside. While programmes tackle the causes of infertility, such as preventing and treating sexually transmitted infections, calls to provide affordable fertility services have been overlooked by agencies which tend to focus on the problem of over population.

Claudia visits Tygerberg Hospital in Cape Town where infertility treatment is being offered at a fraction of the cost of private clinics. Programme Director, Dr Matsaseng, is pioneering differing ways to keep costs down, from using cheaper medications in smaller amounts, to taking on the jobs of several staff himself, texting and supporting patients through each stage of their cycle to co-ordinate their treatments.

The next step is to find a way to take low-cost infertility treatment to rural areas. But this requires a laboratory. The Walking Egg Project, a shoe-box sized portable laboratory for performing IVF, could provide the answer. By the start of 2014, sixteen babies had been born using the system and the team in South Africa now hope to trial it at the hospital.

In Japan hundreds of thousands of young people withdraw from society for years or even decades.

They are known as hikikomori and Claudia Hammond travels to Tokyo to discover more about this mysterious condition and why it is so prevalent in Japan.

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.

July 22, 2011 has been described as the day Norway cried. After detonating a car bomb in Oslo, killing eight and injuring many more, Anders Breivik took a ferry to the island of Utoya. There, dressed as a policeman, he began a murderous spree, hunting down and indiscriminately shooting young people on the island who were attending a youth camp. Seventy seven people were killed in total, many of them teenagers, and hundreds injured.

This was the worst mass murder in Norwegian post-war history and the whole country was in shock. But Norway used this national tragedy to pioneer new ways of caring for their citizens. Claudia Hammond reports on the ground-breaking new ways Norway has been road testing to deliver psychological and mental health support to those who survived, and to those who lost relatives and friends.

Solitary confinement is a form of torture that undermines identity and mental health. In “The Truth About Mental Health - Four Walls” Claudia Hammond talks to ex political prisoners about their experiences and how they dealt with living in such inhumane conditions. Advice too from Professor Craig Heaney who works with prisoners in Supermax prisons in the United States of America and psychiatrist Professor David Alexander who has worked with many hostages.

It's a common misconception that children, unlike adults, are so resilient that they can bounce back from the emotional and psychological impact of war and conflict. The evidence contradicts this and world experts in the field warn that, while some children do recover fully from exposure to the horrors of war, others experience long-term mental health problems.

As the war and fighting in Syria continues to claim more lives and destroy many others, Claudia Hammond reports from Jordan on how this latest conflict is exposing yet another generation to the traumatic impact of violence, killing and loss. She investigates what actually helps to alleviate the suffering of these children and prevent a life-time of recurring emotional distress.

From the Al Zatari refugee camp in the north of Jordan she hears about the scale of the challenge facing international organisations like Save the Children. And she meets a group of Syrian mental health professionals from the Arab Foundation for Care of Victims of War and Torture who, as refugees themselves, are running a mass outreach programme, developed by some of the world's leaders in child trauma at the Children and War Foundation, to teach as many Syrian children as possible, psychological techniques and coping strategies.

From time to time we all find ourselves in some kind of emotional turmoil. But when do everyday anxieties or unusual thoughts tip over into a mental health problem? And who decides what’s normal, and whether a treatment that works in one country will work elsewhere?