-----Original Message-----
From: Equity, Health & Human Development on behalf of Ruggiero, Mrs. Ana Lucia (WDC)
Sent: Fri 9/7/2007 9:59 AM
To: [log in to unmask]
Subject: [EQ] Global Mental Health
 
Series, Global Mental Health

The Lancet, Volume 370, Number 9590, 8 September 2007

 

No health without mental health

Martin Prince, Vikram Patel, Shekhar Saxena, Mario Maj, Joanna Maselko,
Michael R Phillips, Atif Rahman


Full Text available online:
http://www.thelancet.com/journals/lancet/article/PIIS0140673607612380/fu
lltext
<http://www.thelancet.com/journals/lancet/article/PIIS0140673607612380/f
ulltext>  [Free subscription required] 

 

 

".....About 14% of the global burden of disease has been attributed to
neuropsychiatric disorders, mostly due to the chronically disabling
nature of depression and other common mental disorders, alcohol-use and
substance-use disorders, and psychoses. Such estimates have drawn
attention to the importance of mental disorders for public health.
However, because they stress the separate contributions of mental and
physical disorders to disability and mortality, they might have
entrenched the alienation of mental health from mainstream efforts to
improve health and reduce poverty. 

 

The burden of mental disorders is likely to have been underestimated
because of inadequate appreciation of the connectedness between mental
illness and other health conditions. Because these interactions are
protean, there can be no health without mental health. Mental disorders
increase risk for communicable and non-communicable diseases, and
contribute to unintentional and intentional injury. Conversely, many
health conditions increase the risk for mental disorder, and comorbidity
complicates help-seeking, diagnosis, and treatment, and influences
prognosis. 

 

Health services are not provided equitably to people with mental
disorders, and the quality of care for both mental and physical health
conditions for these people could be improved. We need to develop and
evaluate psychosocial interventions that can be integrated into
management of communicable and non-communicable diseases. Health-care
systems should be strengthened to improve delivery of mental health
care, by focusing on existing programmes and activities, such as those
which address the prevention and treatment of HIV, tuberculosis, and
malaria; gender-based violence; antenatal care; integrated management of
childhood illnesses and child nutrition; and innovative management of
chronic disease. 

 

An explicit mental health budget might need to be allocated for such
activities. Mental health affects progress towards the achievement of
several Millennium Development Goals, such as promotion of gender
equality and empowerment of women, reduction of child mortality,
improvement of maternal health, and reversal of the spread of HIV/AIDS.
Mental health awareness needs to be integrated into all aspects of
health and social policy, health-system planning, and delivery of
primary and secondary general health care...."

 

 

Resources for mental health: scarcity, inequity, and inefficiency

Shekhar Saxena, Graham Thornicroft, Martin Knapp, Harvey Whiteford

 

Full Text available online:
http://www.thelancet.com/journals/lancet/article/PIIS0140673607612392/fu
lltext
<http://www.thelancet.com/journals/lancet/article/PIIS0140673607612392/f
ulltext>   [Free subscription required] 

 

".....Resources for mental health include policy and infrastructure
within countries, mental health services, community resources, human
resources, and funding. We discuss here the general availability of
these resources, especially in low-income and middle-income countries.
Government spending on mental health in most of the relevant countries
is far lower than is needed, based on the proportionate burden of mental
disorders and the availability of cost-effective and affordable
interventions. 

 

The poorest countries spend the lowest percentages of their overall
health budgets on mental health. Most care is now institutionally based,
and the transition to community care would require additional funds that
have not been made available in most countries. Human resources
available for mental health care in most low-income and middle-income
countries are very limited, and shortages are likely to persist. Not
only are resources for mental health scarce, they are also inequitably
distributed-between countries, between regions, and within communities. 

 

Populations with high rates of socioeconomic deprivation have the
highest need for mental health care, but the lowest access to it. Stigma
about mental disorders also constrains use of available resources.
People with mental illnesses are also vulnerable to abuse of their human
rights. Inefficiencies in the use of available resources for mental
health care include allocative and technical inefficiencies in financing
mechanisms and interventions, and an over concentration of resources in
large institutions. Scarcity of available resources, inequities in their
distribution, and inefficiencies in their use pose the three main
obstacles to better mental health, especially in low-income and
middle-income countries...."

 

 

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