In honor of Mental Health Awareness Month, this week’s column will delve into the state of global mental health. Sadly, mental health is not improving at the rate it should be for such a severe, widespread issue. In 2000, the World Health Organization published a report on the topic, and today’s column is a deconstruction of that report.
First, it’s important to note that mental disorders are universal, affecting 20 to 25 percent of people throughout all countries and societies. Poorer individuals have a higher prevalence of disorders, while simultaneously having less access to treatment and care. This is most apparent in countries recently traumatized from a political or natural disaster. Some examples include: Syria, Nepal and Sierra Leone. This results in a severe socioeconomic gap between countries, with the wealthier ones having more access to treatment.
In the report, the WHO outlines three scenarios for countries to improve on mental health care. The first deals with economically poor countries which have little to no resources. To close the gap, it is recommended that they train personnel, provide essential drugs and move the mentally ill out of prisons. The training of personnel allows for easy and widespread access to care for those with a mental health disorder. On the other hand, making psychotropic drugs available is often a first-line treatment that is especially effective when skilled professionals are not available. Moving the mentally ill out of prisons is also an important step toward decriminalizing mental disorders while providing care within the community.
The next scenario involves countries with modest levels of resources. To improve mental health in thesclose custodial mental hospitals and instead integrate mental health care into general health care. Historically, insane asylums, now our mental hospitals, isolate patients and stigmatize disorders. Having a mental disorder is not uncommon, nor is it shameful, so our treatment shouldn’t be either. That’s why integrating mental health care into general care and phasing out mental hospitals is the way to go.
The third scenario applies to countries with high access to resources: Provide further improvements in the management of mental disorders within primary healthcare and create community care facilities that offer 100-percent coverage. With community involvement, treatment becomes more personalized to the individuals living within the local area and thus more effective.
Although this report was written in 2001, we still have a ways to improve. In 2012, suicide, which is strongly linked with depression, was the second leading cause of death globally among 15 to 29-year-old people. Schizophrenia currently affects more than 21 million people worldwide. Similarly, approximately 50 million people worldwide have epilepsy, making it one of the most common neurological diseases globally. These are just a few examples, but they demonstrate our point. Mental health is a global public health issue and should be treated as such. After all, as the WHO points out, there is no health without including mental health.