Produced by James Ives, MPsych
The global burden of mental health and the need for mental health support services remain major health issues throughout the world. Mental illnesses are often overlooked and not prioritized by governments and other stakeholders.
The World Health Organization (WHO) defines health as “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” There are challenges embedded within this definition as more people with chronic complex co-morbidities are living longer.
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Mental health, as with any other aspects of health, can be affected by a range of socioeconomic factors that need to be addressed through comprehensive strategies involving access to preventions, treatments and facilitating recovery as well as raising awareness.1
The treatment of mental health is becoming recognized as one of the leading global health challenges today and incorporates a diverse range of conditions affecting all ages and populations, from autism in childhood through to depression in adults and dementia in older people.
The treatment gap, that is the gap between the need for treatment and its provision, exists throughout the world. According to the WHO, between 76% and 85% of people with severe mental health disorders receive no treatment for their disorder in low- and middle-income countries.1
The corresponding range for high-income countries is also significant, with between 35% and 50% receiving no treatment.1 The treatment gap varies depending upon the psychiatric conditions that are most prevalent, social attitudes towards mental health and the availability of resources for treatment.
Stigma and misconceptions associated with mental disorders contribute to the discrimination and human rights violations experienced by those affected. Discrimination related to mental disorders has been described as having worse consequences than the conditions themselves,7 therefore raising awareness of mental health is fundamental to providing a better life to those with mental illnesses.
Not surprisingly, the stigma related to mental health disorders and the discrimination against those suffering from them acts as a barrier to accessing mental health service. In turn, this delays people seeking care preventing timely diagnosis, treatment and recovery. This type of discrimination can affect an individual’s education, employment, access to care and reduces their capacity to contribute to society.8
Despite a noticeable increase in acknowledgement and awareness of mental health in recent years, stigma remains. While a reduction in the stigma around mental illness can bring about improved knowledge and understanding, it does not necessarily lead to a change in attitude or behavior towards people with mental illness.
As a result, the ability to form any meaningful social pressure to bring about government action can be restricted and Government’s must take a lead in mental health awareness, legislating to improve service provision and reducing discrimination.
Raising the profile of mental health requires advocacy with local communities as well as global experts who can help set the health agenda in countries across the world. Those who recognize the importance of mental health must continuously engage with experts and the media to help make the voices of patient advocacy groups heard, with an emphasis on ‘Think National and Act Local’.
Despite efforts by many to raise the profile of mental health, there is still a lack of international mental health charities and those there are have insufficient resources and struggle to raise funds for their cause.
With many mental health illnesses, it is harder to generate empathy as there may not always be obvious external symptoms. With the allocation of funds of correlated to the marketability of a cause, the lack of captivating and emotive imagery for mental illnesses, can make it difficult for mental health charities and NGOs to raise funds.
Government health reform agendas throughout the world should incorporate mental health. National health policies must meet not only the needs of the individuals diagnosed with mental illnesses, but promote good mental health in all citizens and push for parity of esteem between mental and physical health.
Mental health evolves throughout a person’s life; therefore, governments have the duty to implement preventative measures as well as treatments. The early stages of life present a particularly important opportunity to promote mental health, up to 50% of mental disorders begin before the age of 14 years.1
There are several human rights covenants and conventions urging governments to ensure that persons with mental illnesses experience equality. This includes, the United Nations Convention on the Rights of a Child, which sets out the civil, political, economic, social, health and cultural rights of children throughout the world.
The World Psychiatric Accociation (WPA) led an international survey of 193 countries looking at discrimination against people with mental illness in four areas: the right to vote, the right to marry, the right to inherit property and the right to employment.
Despite the fact that all countries surveyed had signed up to the United Nations Convention on the Rights of Persons with Disabilities Directive, only between 36-40% countries actually had any protection for these rights.9 In response to this, the WPA has developed a Bill of Rights for people with mental illness.
The Bill of Rights reiterates that persons with mental illness, mental disability or mental health problems should not be discriminated against based on their mental health status. These individuals also have the capacity to hold rights and exercise their rights and should, therefore, be treated on an equal basis with other citizens.9
Dr Dinesh Bhugra is currently President of the World Psychiatric Association, the world’s leading psychiatry organization. He is Emeritus Professor of Mental Health and Diversity at the Institute of Psychiatry at King’s College London. He is past President of the Royal College of Psychiatrists.
The WPA is the world’s leading psychiatry organization. It is an association of national psychiatric societies, which aims to enhance the knowledge and skills necessary to work effectively in the field of mental health and in the care of people with mental illness. It has 139 member societies from 117 countries representing over 225,000 psychiatrists.
The WPA has more than 72 individual scientific sections that cover almost every aspect of psychiatry. The purpose of the sections is to collect, analyze and disseminate information on research, training and services in the specific areas of psychiatry and mental health that they represent.
The WPA works to achieve the objectives through meetings, research, education, publications and collaboration with other health/ mental health and government organizations. Visit http://www.wpanet.org/ for further information.