The WHO have estimated that mental health problems are the leading cause of global ill health and disability. And yet, few resources are directed to tackle this problem by the donor community, not treated as seriously as other, more seemingly pressing, (more visible?), demands. Dr. Margaret Chan, Director-General of the WHO, says: "Almost three quarters of the global burden of neuropsychiatric disorders occurs in low‐and middle‐income countries. We can measure the costs to individuals, families, societies, and economies. And the costs of these disorders, which tend to have an early onset and are chronically disabling, are enormous. Taking action makes good economic sense. These disorders interfere, in substantial ways, with the ability of children to learn and the ability of adults to function in families, at work, and in society at large." It is a vicious cycle: Poverty = increased risk of mental health = increased level of poverty and so on. Mental health problems can also lead to or exacerbate phsyical health problems.
An article in the March 2010 edition of the 'Psychiatric Services' journal states that mental health issues are highly prevalent in Latin America and the Caribbean, with high annual prevalence found in Colombia by the WHO of 17.8% (compare with, say, Germany - 9.1%). In the region, in 1990, 8.8% of the overallburden of diseases resulted from psychiatric and neurological disorders. By 2002, this burden had grown morethan two-fold to 22%. So, we can safely say that mental health is a significant issue in this part of the world.
According to Dr. Vikram Patel, psyciatrist and senior lecturer at The London School of Hygiene & Tropical Medicine, "A common myth, even among those who accept that mental disorders are prevalent in poor countries, is that these illnesses cannot be treated affordably. There is now much evidence that this is not true. Despite this, the treatment gap — the gap between the number of people with disorders and the number who actually receive evidence-based care — is as high as 70 to 80 per cent in many developing countries."
To close this gap, he argues that mental health service provision needs to be at the "front line" of general healthcare services, less focused on 'specialists'. The WHO agrees, stressing the need for mental healthcare provision to be integrated into primary healthcare services. One of the barriers to access is, of couse, huge stigma that surrounds these issues, which only advocacy, awareness-raising and education can eradicate.
When treatment is sought, sufferers are confronted by a severe lack of resources to help them. The estimated figuresof 1.6 psychiatrists, 2.7 psychiatric nurses, 2.8 psychologists, and 1.9 social workers per 100,000 in Latin American are far below those of Europe or the US. The greater concentration of these professionals in metropolitan areas leave unattended at least 45% of the total population in need. Training given to professionals is itself often insufficient and staff in this area are among the lowest paid.
My reason for posting this up as an inspiration, is to encourage integrated thinking around the issue of 'health' - as a concept of physical, mental and social well-being. Although other health concerns can seem more pressing, a person's mental health can be the difference between being able to cope, survive and develop, and ending up deeper in the povery trap. How can we try to integrate mental healthcare provision into concepts? What examples of social business can we find addressing the problem? What ideas can we come up with? What conditions can our concepts try to create to try to combat mental health ailments - greater connectivity between people, strong communities, eradication of stigmatisation, less isolation, greater understanding etc? How can we create a health platform which views physical and mental health on the same, mutually supporting, level....?