Global mental health

1. Week one Global mental health

2. Global Mental Health • Vikram Patel Clip: Video Clip: Mental Health for All, By All URL: http://www.youtube.com/watch?v=yzm4gpAKrBk

3. Global Mental Health • World Health Organisation Report- 2001 • Mental Health: new understanding, new hope • Raised profile of global mental health • 10 recommendations: • Medication access • Care in the community • Involvement of families, communities, users and carers; public

4. World Health Report (2001) • Need for national policies; programmes and legislation • Inter-sectoral collaboration • Human resource development for professionals specialized in mental health • Monitoring mental health of communities • Further research required

5. Lancet series: 2007 • Launch of Global Mental Health Movement: “ 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”

6. Global mental healthcare movement • Limited progress to date; neglected area • Relevance to other global health challenges • Inequitable and insufficienct distribution of mental health resources • Need to scale up mental health services in face of existing evidence • Need for political leadership and advocacy; financial support and training

7. Global Mental Healthcare movement • Emphasised relevance of a ‘public health’ approach • Advocacy network established • Moral critique: sufferers existing in worst moral conditions. • Stigma of mental illness – individuals marked as non-human • Mental health professionals themselves

8. Moral condition (Kleinman) • Moral critique: sufferers existing in worst moral conditions. • Stigma of mental illness – individuals marked as non-human • Mental health professionals themselves are most effective and efficient transmitters of stigma • Some positive global changes • Need for protection by the state

9. Ethical imperative • Movement for global mental health must seek to improve the moral conditions of those with chronic mental illness: past moral failure of humanity must not longer be tolerated

10. “No health without mental health’ • Key message of Lancet series • Mental health and conversely mental illness is intimately linked to many other physical conditions – co-morbidity rates are high • Notable reduction in life expenctancy by at least 10 years, probably longer in LMIC

11. Global Burden of Disease • Neuropsychiatric illnesses responsible for 14% of global burden of disease • Most notable: depression (350m worldwide); alcohol use disorders • Dementia rates to triple by 2020 with demographic transition

12. Disability • Disability is significant and disproportionate: 1/3 of years lost due to disability worldwide DALY: Disability Adjusted Life Year (one year lost of healthy life)

13. Treatment Gap • The absolute difference between the true prevalence of the disorder and the treated proportion of individuals with the disorder. • Varies across conditions and countries • Worldwide: 50% for mental disorders, probably 90% in lowest resource settings