"Unity in diversity" may be a political slogan but it is also a fact. Over the last three decades, studies carried out in culturally diverse areas have consistently shown that mental health problems are present in all regions in more or less similar proportions, despite wide diversity of causes, symptoms, pathways to care and management strategies.
These problems have a significant burden associated with them, which may not be measurable with the tools currently available. The disability-adjusted life year (DALY) calculations have helped to show the importance of mental illnesses as a public health problem, but they miss many aspects of the real burden. These include the stigma, discrimination and abuse to which the mentally ill are subjected, and the fear, shame, guilt and loss of morale they suffer. A uniform system of measurement which includes these dimensions and can be used globally would help a great deal to facilitate comparisons across cultures, and WHO should support such an initiative. The following notes represent further points to be taken into consideration in setting WHO's agenda for mental health (1).
* WHO has met with considerable success in building systems to classify mental disorders and disabilities, show their prevalence, and assess their effect on the quality of life. This work can provide the building blocks for policies which lead to effective and just mental health services. Experience has shown that a clearly enunciated policy framework which is supported by governments and stakeholders is a prerequisite for improving the mental health indicators of a given population. While there is no universally applicable template for formulating and implementing a mental health policy, some of the necessary elements are widely known. WHO is in a unique position to make this knowledge available to individual Member States, together with mechanisms to evaluate their performance. WHO can also help by working with other United Nations agencies and donor agencies to make mental health an essential item in their policy dialogue with governments.
* The prevalence of neuropsychiatric disorders is expected to rise steeply in developing countries in the coming years because of the rising numbers of people reaching the age of risk of onset of these disorders. Stigma is probably the single largest hidden contributor to the burden that neuropsychiatric disorders impose on a population. It affects individuals, families, communities, professions and institutions alike. The way to combat this hidden burden is to bring it out into the open by exposing it to the light of "mental health literacy" at all levels, from local to international. …