WHO makes urgent call for services for mental disorders to be scaled up

Oct 13 2008

The World Health Organisation (WHO) says millions of people with mental disorders in the developing world are deprived of necessary treatment and care and has called for an urgent scaling up of services.

According to the WHO more than 75% of people suffering from mental disorders in the developing world receive no treatment or care and a huge treatment gap exists for a number of mental, neurological and substance use disorders.

A new WHO programme highlights the plight of many and says across Africa nine out of ten people suffering from epilepsy are untreated - unable to access simple and inexpensive anticonvulsant drugs which cost less than $5 a year per person.

WHO is calling on governments, donors and mental health stakeholders to rapidly increase funding and basic mental health services to close this huge treatment gap.

The programme, Mental health Gap Action Programme (mhGAP) calls for the scaling up of care for mental, neurological and substance use disorders and says with proper care, psychosocial assistance and medication, tens of millions could be treated for diseases such as depression, schizophrenia, and epilepsy and begin to lead healthy lives, even where resources are scarce.

Dr. Margaret Chan, Director-General of WHO says governments across the world need to see mental health as a vital component of primary health care and need to change policy and practice.

Dr. Chan says only then will essential mental health services reach the tens of millions in need.

The mhGAP focuses on the gap between what is needed to treat a range of priority disorders and what is actually available worldwide - in the majority of countries, less than 2% of health funds are spent on mental health.

According to the WHO in any one year, one-third of people living with schizophrenia, more than half of those suffering from depression, and three-quarters of those with alcohol use disorders are unable to access simple and affordable treatment or care, and worldwide, every 40 seconds, one person dies of suicide - one of the leading causes of death among young adults, yet suicide is a condition that is preventable.

A national primary care programme in Chile now includes treatment of depression for all who need it bringing much needed care to hundreds of thousands of people and an epilepsy project in China which integrated a model of epilepsy control into local health systems achieved excellent results.

This project which was started in six provinces has now been extended to 15 provinces and tens of thousands of sufferers have been treated and it has confirmed that epilepsy can be treated with an inexpensive anti-convulsant medicine by health professionals who had undergone basic training.

The WHO says the extra costs of scaling up services for mental disorders is not too large. and even in low-income countries, scaling up a package of essential interventions for three mental disorders - schizophrenia, bipolar disorder and depression - and for one risk factor - hazardous alcohol use - required an additional investment as low as $US 0.20 per person per year.

Dr. Benedetto Saraceno, Director of WHO's Mental Health and Substance Abuse Department, says people with mental disorders are stigmatized and are subjected to neglect and abuse.

Dr. Saraceno says the proper care of mental, neurological and substance use disorders should not only be evidence based but also value based and it is necessary to ensure that people with these disorders are not denied opportunities to contribute to social and economic life and that their human rights are protected.

The mhGAP programme sets out a number of cost-effective strategies to tackle the treatment gap for mental, neurological and substance use disorders, including assessing countries needs and resources; developing sound mental health policy and legislation; and increasing human and financial resources.

The WHO says the programme relies on partnerships to scale up services with the objective of reducing the burden of mental, neurological and substance use disorders.