Mental Health Care Often Lacking, Especially in Low-Income Nations

The Nation's Health, November 2007 | Go to article overview

Mental Health Care Often Lacking, Especially in Low-Income Nations


As many as half of all people with severe mental disorders and a vast majority of those with mild to moderate disorders do not receive any treatment, and even those who do receive treatment often face institutionalization or stigma, a recent global survey found.

Results from the World Mental Health Survey Initiative were published in the Sept. 15 issue of the Lancet and concluded that the overall picture for the world's mental health care is bleak. The gap between needs and services is especially wide in low-income countries, and available mental health interventions for people who are exposed to conflict and other disasters are often nonexistent.

"The current situation means that people with mental illnesses are at best, ignored, and at worst, actively discriminated against, in many countries," said Benedetto Saraceno, MD, the World Health Organization's director of mental health and substance abuse.

WHO's Mental Health Atlas database shows that a majority of countries in Africa and southeast Asia spend less than 1 percent of their health budgets on mental health. Low-income countries have an average of 0.05 psychiatrists and 0.16 psychiatric nurses per 100,000 population--about 200 times fewer than in high-income countries.

On the positive side, the health survey concluded that effective, locally feasible and affordable treatments for depression and schizophrenia in low- and middle-income countries do exist. For example, a model of community-based rehabilitation for chronic schizophrenia in rural India had local community members trained as rehabilitation workers to deliver comprehensive, home-based treatment. Clinical and disability outcomes for clients in the community-based program were better than for those who received outpatient care alone. …

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