Question

Distribution of resources globally: what is the impact on mental health care and what are possible solutions?

Answer 1

• impact on mental health care
• The treatment gap for serious mental disorders ranges from 76.3% to 85.4% in developing countries and resources are insufficient in this regard . For example, about a third of people with schizophrenia do not receive any treatment in their life.
• Scarcity of resources is evident in different areas: about a third of the countries do not have a mental health policy. Although the majority of countries have legislation on mental health, this has not been updated for 15 years in half of them.
• People with mental disabilities do not even benefit from disability benefits in 45% of low-income countries.
• Only about half of the low-income countries have community mental health services. About a quarter of low-income countries do not even provide essential antidepressant medicines, for example.
• Low-income countries have a median of 0.05 psychiatrists and 0.16 psychiatric nurses per 100 000 populations, while the same figures are about 200 times higher in developed countries.
• In most developing countries there is no specified public budget or there is only a small budget for mental health insurance.
• Not only is access to mental health services limited but service utilization is also quite low , Which is commonly due to lack of awareness about mental illness, attributing it to superstitious causes or due to stigma attached to mental illness which is further intensified by dominance of isolated hospital based interventions instead of integrated services

  solutions

• Development of cheaper, user friendly methodologies and instruments to assess mental health needs.
• Scaling up of mental health services through fund-raising, and equitable distribution of such services.
• Identification of risk factors for mental disorders through well planned research and systematic reviews so that primary prevention strategies can be built on the evidence generated. Unavailability of early detection and management could be considered a risk factor for disease burden as well. Relevant research in the second area is equally required.
• Development of policies and legislation (top down approaches) to improve quality of services and the dignity and rights of patients’ needs to be complemented with bottom up approaches such as the chain-free initiative.
• Support of harm reduction strategies globally, hand-in-hand with evidencebased prevention and promotion interventions to deal with substance abuse problems. Developing/amending legislation may be important to facilitate harm reduction. Brief interventions in primary health care are effective means to manage the problem of high numbers of substance and alcohol users in the community.
• Adherence to IASC guidelines complemented further on how to provide full coverage to survivors and how to apply psychological interventions at different levels of need.
• Planning of advocacy activities, antistigma campaigns and fund-raising within results-based formats.
• Strengthening and support of mental health directorates/units in ministries of health with appropriate budgets.
• Unification of substance abuse and mental health units under one umbrella.