World Mental Health Day 2011
- © CBM
CBM welcomes ‘The Great Push: Investing in Mental Health’. This is the theme of the 2011 World Mental Health Day, inviting a multisectoral approach in removing barriers to and highlighting highlights long term cost effectiveness of investing in mental health care.
‘The Great Push: Investing in Mental Health’
There are several other barriers to appropriate mental health care:
- In 40% of countries, primary health care providers do not receive any training in mental health.
- Stigma is a major barrier. In many parts of the world - including the ‘developed’ world - people with mental disorders are victimised because of their illness and become targets of unfair discrimination resulting in little or no access to housing, employment, social welfare or health insurance.
- Another significant barrier to appropriate health care is the lack of psychotropic medication at the primary care level. While most countries have an essential drug list that includes basic psychotropic medications, 20% of countries do not have this essential package at the primary care level.
- Almost half the countries in the world do not have significant mental health legislation, policy or a national level programme. This is a major barrier in ensuring the right to health care and accountability in human rights violations.
Closing the gap
The gap between the burden of mental illness and the resources used to address the problem is the widest in low income countries. Closing this gap is not only the obligation of the respective governments but for International NGOs, foundations, communities, families, and mental health professionals.
Investing in mental health can generate enormous returns in terms of reducing disability and preventing premature death. Besides increasing productivity of people with mental illness and their care givers, commitment in reducing the gap would also instil dignity in their lives and give voice to people with mental disorders who continue to suffer from human rights violations.
The economic burden of mental disorders is huge. The core costs in terms of treatment and service fees, and usually long periods of hospitalisation, are much more compared to other types of morbidity which are usually less chronic. In terms of indirect costs like that due to loss of productivity at work and job retention, the loss is staggering. Statistics are unavailable from developing countries but in developed countries like the United States of America, it has been estimated that 35-45% of absenteeism from work is due to mental health problems, namely depression and substance abuse.
Since mental disorders generate huge costs in terms of long term treatment and loss in productivity, logically they would also contribute to poverty. Conversely, insecurity, low income levels and malnutrition contribute to mental disorders. Therefore, this results in a vicious cycle of poverty and mental disorders.
Therefore, timely and appropriate investment in mental health intervention can break this vicious cycle and result in decreased overall economic burden of mental disorders.
Investments in primary care services can prove to be very cost effective in treating burdensome psychiatric conditions like chronic Schizophrenia. Such investments in service provision are not only required but worthwhile. Commitment to prevention of mental disorders can also pay rich dividends in the long term. Detection and suitable intervention for depression, delinquent behaviour, suicide and substance abuse in childhood and adolescence will result in mental well being of the potentially productive adult population.
The great push in investing in mental health is a timely call, recognising the human misery, disability and economic cost caused by poor commitment to mental health service provision
- Psychosocial disabilities are common. About one out of eight to half (12–48%) of all people will suffer from psychosocial disabilities at some point during their life.
- 450 million people worldwide have mental or behavioural disorders.
- There are more than 75 million people with alcohol use disorders and more than 15 million people with other substance use disorders in the world.
- Epilepsy affects 50 million people worldwide, 80% of whom live in resource poor countries.
- Unipolar Depression is the second leading contributor to the global burden of disease after cardiovascular diseases. More than 350 million people suffer from depression at any one time.
- Nearly one million people commit suicide every year.
- Physical restraint- this inhuman and degrading treatment of people with chronic mental illness like schizophrenia continues to be widely practised in the developing world.
- Based on a 2004 world survey, 35–50% of people with serious psychosocial disabilities in high income countries had received no treatment in the previous year. For low and middle income countries, more than three-quarters of those with serious psychosocial disabilities (76–85%) had not received any treatment during the same period.
- There are effective treatments for most psychosocial disabilities. Most of them can be delivered in primary care settings.
- Treatment does not always mean medication. Many psychosocial disabilities can be treated using psychosocial methods.