“No health without mental health”
Today is World Mental Health day, a chance to raise awareness of global mental health and the often sobering statistics. The theme this year is “Making mental health a global priority - scaling up services through citizen advocacy and action.” Raising the profile of mental health is essential for putting it on the public health agendas, improving services and reducing stigma. A WHO report, released yesterday aims to do this and provide workable strategies, especially for low- and middle-income countries. With this in mind, we’d like to mention the Movement for Global Mental Health, a collection of individuals and organisations giving a call for action (which anyone can join), formed after the Lancet’s series on global mental health last year. In this week’s Lancet there’s an editorial on the movement and a viewpoint on what the Lancet’s series has achieved one year on, so we’d urge you to have a look at those too (they’re all free but you do have to register first). We’d also like to draw your attention to an article on mental health in Sierra Leone that we put up a few days ago. In the words of the WHO report, “the time to act is now!” - the call is for governments and policy makers but also for everyone, including students and student organisations; our advocacy can make all the difference.
Last but by no means least, we’ve posted our Lancet digest, a summary of what’s in the Lancet this week - Rafi, Vanessa and Hannah.
Photo from Oxfam
The title of this post, a quote from the WHO, emphasises the huge importance of mental health as part of general wellbeing. In fact, measured in Disability-Adjusted Life Years (DALYs), mental health disorders account for 14% of the global disease burden - and that’s 30% of the total non-communicable disease burden. This is probably an underestimate due to the difficulties and lack of diagnosis in many settings and the fact that mental health is inextricably linked with many other conditions. Despite this, less than 2% of health funds are given over to mental health in most countries. Against this background and where mental health is often stigmatised, ignored or misunderstood, a global step-up is needed for mental healthcare.
In some positive news, the US congress has recently passed a bill requiring health insurers to provide the same coverage for mental health and substance abuse treatments as they do for other conditions (termed “mental health parity”). While mental health measures are (gradually) improving in developed countries, a huge burden of disease rests on poorer countries, which lack the resources necessary to help those in need.
Stark examples of this are often in regions of current or recent conflict, where the need is particularly great. There has long been a recognition by many groups (including MSF) that mental health support must be part of any response to a crisis. Too often though, coverage is low and sometimes nearly non-existent in later years. For instance, it has been reported that in Liberia, only five years out of a long civil war where the UN estimated about 1 in 10 children were recruited as soldiers (often a very traumatic event), there is only one specialist mental health doctor in the country.
The WHO estimates that three quarters of the global neuropsychiatric disease burden is in low- and lower middle-income countries. The WHO mental health gap action program (mhGAP), launched yesterday, aims to convince governments to invest more in mental health and put in place effective, evidence-based strategies in these countries. It also defines priority mental health disorders that are high burden, with high economic costs or that are associated with human rights violations; these are depression, schizophrenia and other psychotic disorders, suicide, epilepsy, dementia, alcohol abuse, drug abuse and mental disorders in children. They call for a massive scaling-up in addressing these and the human rights abuses so often associated with them, the biggest barrier to which is, they say, the almost complete absence of mental health from public health priority agendas. The UN Millenium Development Goals (MDGs), for instance, make no mention of mental health.
Mental health disorders are a major problem and a major source of misery in the world today. Concerns have already been voiced that the financial crisis will make things worse and in a recent WHO conference on setting the research agenda for climate change and health (more on that to come in TLS…), it was noted that mental health will no doubt suffer in the face of impoverishment, displacement and natural disasters as a result of climate change. The need is pressing and we can only hope that mental health will now get the attention it surely deserves.
Some related links -
The Movement for Global Mental Health - http://www.globalmentalhealth.org/
The World Federation for Mental Health - http://www.wfmh.com/index.html
Mind (a UK mental health charity) - http://www.mind.org.uk/
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