Mind the Gap

The World Health Organization state that treatment gaps for mental health may affect 75% of individuals suffering from mental health difficulties in low income countries: http://www.who.int/mental_health/mhgap/en/


However, treatment gaps are not exclusive to particular economic groups. 


The Mental Health Policy Group at the London School of Economics has today released a publication drawing attention to the fact that 75% of affected individuals are not receiving treatment for mental health in the United Kingdom: http://cep.lse.ac.uk/_new/research/mentalhealth/default.asp


For a summary of this report, please see this article published in the Guardian: http://www.guardian.co.uk/society/2012/jun/18/mental-illness-people-help


Whilst there is a focus on low and middle income countries in the movement for Global Mental Health (and quite rightly so), let us not forget that this is a Global movement. 


In 2006, the World Health Report advocated utilising 'task-shifting'- an effective strategy for tackling the lack of specialised human resources for healthcare by delegating specific tasks to health workers who were less specialised. In the first instance, this was appropriated for low/middle income regions where HIV/AIDS was particularly prevalent. 


The UK has adopted a model developed in low/middle income regions in order to address the shortage of human resources for mental health: Improving Access to Psychological Therapies. This programme has adopted a task-shifting approach. Non-specialised human resources are trained to deliver specific psychological therapies: http://www.iapt.nhs.uk/


The general assumption is that (countries like) the UK are the flagship for international development, research, health care and so on. 


Scaling up services for mental health may well involve a bi-directional sharing of knowledge between all countries. For Global Mental Health: each country should be its own flagship. 

Summarising the Lancet Series for Global Mental Health (Aiysha)

2007 saw the publication of the first Lancet Series on Global Mental Health, highlighting the urgent need for scaling up services for mental health all over the world: http://www.thelancet.com/series/global-mental-health

2011 saw the follow-up to this series, drawing our attention to the progress that had been made since the call for action in 2007, and future steps: http://www.thelancet.com/series/global-mental-health-2011

Following, is a representation summarising the premise, outcomes and next-steps from both series.

Treatment Gaps for mental health are BIG: In some countries, up to 9 out of 10 individuals with mental health difficulties are not receiving basic care:

Unfortunately, there are some unhelpful common assumptions as to why this treatment gap might exist:

So, what are some of the barriers for global mental health?

What progress has been made since the publication of the 2007 Lancet series?

For more information, see:

mhGAP: http://www.who.int/mental_health/mhgap/en/

Movement for Global Mental Health: http://www.globalmentalhealth.org/

Grand Challenges for Global Mental Health: http://grandchallengesgmh.nimh.nih.gov/

What next? 

The global issue of human rights abuses of individuals with mental health difficulties must be addressed

And? 

Much more research must be conducted: how to deliver effective evidence-based treatments; how to address mental health and poverty...and so on... 

Finally? 

Resources must still be increased in order to scale-up care

And so the push to make mental health a global agenda continues...

The overview of global mental health and two major projects from WHO to tackle it. (By Kanna)

When I tell my friends that I work in “Global Mental Health” they often say 

“What do you mean global? Isn’t mental health a rich people’s or country’s disease?” 

Or they say, 

“Ah, there must be a lot of work in post conflict area and post disaster areas.” 

What many don’t realize is that global mental health is bigger then those impressions. Instead, it is about the availability, affordability, accessibility and quality of services for people with mental disorders worldwide.

Below are the some materials that can help us understand “global mental health”

This 5 min video describes where the world is on global mental health and what WHO suggests as a way forward.

This 7 min video describes how we can scale up mental health services in low resourced settings.

After the UN adopted the CRPD (Convention on the Rights of Persons with Disabilities), discussions around a human rights based approach are becoming more active. Under the CRPD, mental health services become something a country must have rather then something that is good to have. However, human rights can only be realized when the availability, affordability, accessibility and quality of services for people with mental disorders are operationalized.

Below is a description of how we can realize improved human rights in mental health services.
http://www.who.int/mental_health/policy/quality_rights/en/