An estimated 10 to 20 per cent of children worldwide have one or more mental or behavioural problems. Many disorders commonly found among adults, such as depression, can begin during childhood, the World Health Organization (WHO) reports. Categories specific to childhood and adolescence include disorders of pscyhological development, including dyslexia and autism, as well as behavioural and emotional disorders, such as attention deficit/hyperactivity and conduct disorders. Their treatment requires a continuum of care over time linking settings such as families, schools, hospitals and out-patient facilities.
This grim assessment comes even as the World Health Report 2001, Mental Health: New Understanding, New Hope, published by WHO, says that as many as 450 million people worldwide suffer from mental and neurological disorders. The Report invites Governments to seek solutions that have become affordable and to foster positive changes in the acceptance of such disorders.
Depression, also known as unipolar mood disorder, for instance, is a common mental illness characterized by sadness, loss of interest in activities, decreased energy and recurring feelings of despair. The intensity and frequency of the symptoms differentiate the illness from normal mood swings. Currently, 121 million people suffer from depression. Every year, one million people commit suicide, 60 per cent of which are the outcome of depressive disorders and schizophrenia. The causes of depression vary from psychosocial factors to genetics, and its first-line treatment involves antidepressant medications and psychotherapy.
Despite the pervasiveness of psychiatric disorders, the Report affirms, nearly two thirds of people with such illness do not seek help from mental health care professionals because of the stigma and discrimination attached to the disorders. Often, untreated mental illness is the result of downright neglect. "Mental illness is not a personal failure", said Dr. Gro Harlem Brundtland, Director-General of WHO. "In fact, if there is failure, it is to be found in the way we have responded to people with mental and brain disorder."
According to the Report, it is the lack of urgency, misinformation and competing demands that prevent policy makers from recognizing that mental and neurological disorders have become the leading causes of illness and disability worldwide, affecting one in every four persons.
Depression is already the fourth cause of the global disease burden, and by 2020 it is expected to rank second following ischaemic heart disease.
The effectiveness of the response to mental health problems however does not match their magnitude, points out the Report. "Project Atlas', a new WHO project seeking to locate mental health resources around the world, found that of all the countries studied, 4] per cent are without any mental health policy. Some 25 per cent have no legislation on mental health and 28 per cent have no separate budget for it; 41 per cent lack treatment facilities for severe psychiatric disorders in primary health care and 37 per cent have no community care facilities.
While a small range of medications is sufficient to treat the symptoms of the majority of mental disorders, the Report says, about 25 per cent of countries do not have the three most commonly prescribed medications for schizophrenia, depression and epilepsy at the level of primary health care. In more than half the countries around the globe, there is only one psychiatrist per 100,000 people, and 40 per cent of countries have less than one hospital bed per 10,000 people set aside for mental illness.
People with limited financial resources are faced with the greater burden of psychiatric disorders, the Report emphasizes. Exposure to stressful events, dangerous living conditions, exploitation and poor health make them more vulnerable to develop such disorders. …