Scale-up resources to meet global targets of Mental health says WHO. The Mental Health Atlas 2017 of WHO reveals that there is a global shortage of health workers trained in mental health and a lack of investment in community-based mental health facilities.
The Atlas provides information on the existence of policies, plans and laws for mental health, and their alignment with established human rights instruments; the human and financial resources available; the type of facilities providing care; and mental health programmes for prevention and promotion.
It is based on data provided by 177 WHO Member States, representing 97% of the world’s population, and measures the extent to which countries are strengthening leadership and governance for mental health; providing comprehensive mental health and social care; implementing strategies to promote mental health and prevent problems, and strong evidence and research – as outlined in WHO’s Comprehensive Mental Health Action Plan 2013-2020.
In low-income countries, the rate of mental health workers can be as low as 2 per 100 000 population, compared with more than 70 in high-income countries. This is in stark contrast with needs, given that 1 in every 10 people is estimated to need mental health care at any one time.
Less than half of the 139 countries that have instituted mental health policies and plans have these aligned with human rights conventions which stress the importance of the transition from psychiatric institution to community-based services and the participation of people with mental disorders in decisions concerning them. And all too often, when mental health plans are made, they are not supported by adequate human and financial resources.
Transition to care in the community needs to be accelerated
Despite the transition in a number of high-income countries towards psychiatric wards in general hospitals and the provision of community-based residential care places, there remain far too few facilities for community-based mental health care throughout the world.
The global rate of beds in mental hospitals was reported to be six times more (11.3 per 100 000 population) than the rate of beds in the psychiatric wards of general hospitals.
Substantial scale-up of financial resources needed
Levels of public expenditure on mental health are very low in low- and middle-income countries. Government expenditure on mental health is less than 1 US$ per capita in low and lower middle income countries whereas high-income countries spend more than US$ 80. The majority of spending is going to mental hospitals, which serve a small proportion of those who need care.
In addition, more than two-thirds of countries report that care and treatment of persons with severe mental disorders are not included in national health insurance or reimbursement schemes.
“Nobody should be missing out on mental health care because of the cost,” said Dr. Shekhar Saxena “That’s why WHO’s push towards universal health coverage is so important: to ensure that everyone, everywhere, can access the care they need: including mental health care.”
Few countries have suicide prevention strategies
WHO estimates that a little under 800 000 people die by suicide each year. Despite a slight increase in the number of countries reporting having a national suicide prevention strategy since the Mental Health Atlas 2014, only a third of upper-middle and high-income countries reported having such as strategy, with just 10% of low- and lower-middle income countries with a strategy.
Investment in mental health: good for health, good for economies
Every US$ 1 invested in scaling up treatment for common mental illnesses such as depression and anxiety leads to a return of US$ 4 in better health and ability to work.
On the contrary, failure to act is costly. According to a recent analysis, which calculated treatment costs and health outcomes in 36 low-, middle- and high-income countries for the 15 years from 2016-2030, low levels of recognition and access to care for depression and another common mental disorder, anxiety, result in a global economic loss of a trillion US dollars every year.
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Dr. Kamal Kant Kohli
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