scholarly journals Mapping actions to improve access to medicines for mental disorders in low and middle income countries

2017 ◽  
Vol 26 (5) ◽  
pp. 481-490 ◽  
Author(s):  
C. Barbui ◽  
T. Dua ◽  
K. Kolappa ◽  
B. Saraceno ◽  
S. Saxena
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Essential Medicines ◽  
World Health ◽  
Evidence Based ◽  
Appropriate Use ◽  
Psychotropic Medicines ◽  
Access To Essential Medicines ◽  
Evidence Based Guidelines ◽  
Improve Access

Aims.In recent years a number of intergovernmental initiatives have been activated in order to enhance the capacity of countries to improve access to essential medicines, particularly for mental disorders. In May 2013 the 66th World Health Assembly adopted the World Health Organization (WHO) Comprehensive Mental Health Action Plan 2013–2020, which builds upon the work of WHO's Mental Health Gap Action Programme. Within this programme, evidence-based guidelines for mental disorders were developed, including recommendations on appropriate use of medicines. Subsequently, the 67th World Health Assembly adopted a resolution on access to essential medicines, which urged Member States to improve national policies for the selection of essential medicines and to promote their availability, affordability and appropriate use.Methods.Following the precedent set by these important initiatives, this article presents eleven actions for improving access and appropriate use of psychotropic medicines.Results.A 4 × 4 framework mapping actions as a function of the four components of access – selection, availability, affordability and appropriate use – and across four different health care levels, three of which belong to the supply side and one to the demand side, was developed. The actions are: developing a medicine selection process; promoting information and education activities for staff and end-users; developing a medicine regulation process; implementing a reliable supply system; implementing a reliable quality-control system; developing a community-based system of mental health care and promoting help-seeking behaviours; developing international agreements on medicine affordability; developing pricing policies and a sustainable financing system; developing or adopting evidence-based guidelines; monitoring the use of psychotropic medicines; promoting training initiatives for staff and end-users on critical appraisal of scientific evidence and appropriate use of psychotropic medicines.Conclusions.Activating these actions offers an unique opportunity to address the broader issue of increasing access to treatments and care for mental disorders, as current lack of attention to mental disorders is a central barrier across all domains of the 4 × 4 access framework.

scholarly journals Economic burden of silent mental disorders: a case study of agnosia in schizophrenia

2017 ◽  
Vol 5 (1) ◽  
pp. 401
Author(s):  
Vijay Kumar Chattu ◽  
Paula Mahon
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Action Plan ◽  
Developed Countries ◽  
World Health ◽  
Economic Output ◽  
The World

Mental health problems affect society as a whole, and not just a small, isolated segment. In developed countries with well-organized healthcare systems, between 44% and 70% of patients with mental disorders do not receive treatment whereas in developing countries the treatment gap being close to 90%. Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. People with schizophrenia are 2-2.5 times more likely to die early than the general population. The case study highlights about agnosia in a schizophrenic patient in a primary care setting and how to address the management at a broader perspective using the appropriate antipsychotic medication and ensuring the support from a family without violating the human rights of the patient. The World Economic Forum estimated that the cumulative global impact of mental disorders in terms of lost economic output will amount to US$ 16 trillion over the next 20 years, equivalent to more than 1% of the global gross domestic product. Mental health should be a concern for all of us, rather than only for those who suffer from a mental disorder. The mental health action plan 2013-2020, endorsed by the World Health Assembly in 2013, highlights the steps required to provide appropriate services for people with mental disorders including schizophrenia. A key recommendation of the action plan is to shift services from institutions to the community. Mental health must be considered a focus of renewed investment not just in terms of human development and dignity but also in terms of social and economic development.

The scale of the problem

Psychiatry ◽  
2019 ◽  
Author(s):  
Rebecca McKnight ◽  
Jonathan Price ◽  
John Geddes
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Mental Disorder ◽  
Mental Health Problems ◽  
Clinical Medicine ◽  
Well Being ◽  
World Health ◽  
The Social ◽  
Definition Of ◽  
Health Organization

One in four individuals suffer from a psychiatric disorder at some point in their life, with 15– 20 per cent fitting cri­teria for a mental disorder at any given time. The latter corresponds to around 450 million people worldwide, placing mental disorders as one of the leading causes of global morbidity. Mental health problems represent five of the ten leading causes of disability worldwide. The World Health Organization (WHO) reported in mid 2016 that ‘the global cost of mental illness is £651 billion per year’, stating that the equivalent of 50 million working years was being lost annually due to mental disorders. The financial global impact is clearly vast, but on a smaller scale, the social and psychological impacts of having a mental dis­order on yourself or your family are greater still. It is often difficult for the general public and clin­icians outside psychiatry to think of mental health dis­orders as ‘diseases’ because it is harder to pinpoint a specific pathological cause for them. When confronted with this view, it is helpful to consider that most of medicine was actually founded on this basis. For ex­ample, although medicine has been a profession for the past 2500 years, it was only in the late 1980s that Helicobacter pylori was linked to gastric/ duodenal ul­cers and gastric carcinoma, or more recently still that the BRCA genes were found to be a cause of breast cancer. Still much of clinical medicine treats a patient’s symptoms rather than objective abnormalities. The WHO has given the following definition of mental health:… Mental health is defined as a state of well- being in which every individual realizes his or her own po­tential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.… This is a helpful definition, because it clearly defines a mental disorder as a condition that disrupts this state in any way, and sets clear goals of treatment for the clinician. It identifies the fact that a disruption of an individual’s mental health impacts negatively not only upon their enjoyment and ability to cope with life, but also upon that of the wider community.

scholarly journals Mental health consequences of urban air pollution: prospective population-based longitudinal survey

2020 ◽  
Author(s):  
Ioannis Bakolis ◽  
Ryan Hammoud ◽  
Robert Stewart ◽  
Sean Beevers ◽  
David Dajnak ◽  
...  
Keyword(s):  
Mental Health ◽  
Air Pollution ◽  
Air Quality ◽  
Mental Disorders ◽  
Population Based ◽  
Physical Symptoms ◽  
Poor Mental Health ◽  
World Health ◽  
Potential Health ◽  
Prospective Longitudinal

Abstract Purpose The World Health Organisation (WHO) recently ranked air pollution as the major environmental cause of premature death. However, the significant potential health and societal costs of poor mental health in relation to air quality are not represented in the WHO report due to limited evidence. We aimed to test the hypothesis that long-term exposure to air pollution is associated with poor mental health. Methods A prospective longitudinal population-based mental health survey was conducted of 1698 adults living in 1075 households in South East London, from 2008 to 2013. High-resolution quarterly average air pollution concentrations of nitrogen dioxide (NO2) and oxides (NOx), ozone (O3), particulate matter with an aerodynamic diameter < 10 μm (PM10) and < 2.5 μm (PM2.5) were linked to the home addresses of the study participants. Associations with mental health were analysed with the use of multilevel generalised linear models, after adjusting for large number of confounders, including the individuals’ socioeconomic position and exposure to road-traffic noise. Results We found robust evidence for interquartile range increases in PM2.5, NOx and NO2 to be associated with 18–39% increased odds of common mental disorders, 19–30% increased odds of poor physical symptoms and 33% of psychotic experiences only for PM10. These longitudinal associations were more pronounced in the subset of non-movers for NO2 and NOx. Conclusions The findings suggest that traffic-related air pollution is adversely affecting mental health. Whilst causation cannot be proved, this work suggests substantial morbidity from mental disorders could be avoided with improved air quality.

scholarly journals Stemming the tide: promoting mental health and preventing mental disorders in low- and middle-income countries

2015 ◽  
Vol 2 ◽  
Author(s):  
W. A. Tol
Keyword(s):  
Mental Health ◽  
Health Promotion ◽  
Mental Disorders ◽  
Global Mental Health ◽  
Action Plan ◽  
Mental Health Promotion ◽  
World Health ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

The first World Health Organization's global action plan for mental health recognizes the importance of mental health promotion and prevention of mental disorders, through the inclusion of one of four objectives focused on this crucial area of research and practice. This paper aims to provide an ‘aerial view’ of the field of mental health promotion and prevention of mental disorders with a focus on low- and middle-income countries. Starting with reasons why promotion and prevention need to take center stage in global mental health efforts, the paper provides a framework and four general principles to guide such efforts: a socio-ecological perspective (place); an inter-sectoral and interdisciplinary approach (collaboration), a developmental perspective (timing), and a participatory and empowerment approach (strengths), or PaCTS. Evidence-based examples of mental health promotion, universal, selective, and indicated prevention are described.

The Dissemination of Evidence-Based Practices by Federal and State Mental Health Agencies

2015 ◽  
Author(s):  
Jeanne C. Rivard ◽  
Vijay K. Ganju ◽  
Kristin A. Roberts ◽  
G. Michael Lane
Keyword(s):  
Mental Health ◽  
State Mental Health ◽  
Psychological Interventions ◽  
Evidence Based ◽  
Evidence Based Practices ◽  
Mental Health Agencies ◽  
Health Agencies ◽  
Financial Infrastructure ◽  
State Mental ◽  
Improve Access

This chapter provides an overview of state efforts initiated at both the federal and state levels to improve access to evidence-based psychological interventions (EBPIs). Several novel strategies for facilitating implementation, such as university-state mental health system collaborations, as well as the importance of the development of financial infrastructure for the initiation and maintenance of these efforts are described.

scholarly journals Development and piloting of a plan for integrating mental health in primary care in Sehore district, Madhya Pradesh, India

2016 ◽  
Vol 208 (s56) ◽  
pp. s13-s20 ◽  
Author(s):  
Rahul Shidhaye ◽  
Sanjay Shrivastava ◽  
Vaibhav Murhar ◽  
Sandesh Samudre ◽  
Shalini Ahuja ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Disorders ◽  
Action Plan ◽  
Mental Healthcare ◽  
Theory Of Change ◽  
World Health ◽  
Care Workers ◽  
Care Models ◽  
Health Organization

BackgroundThe large treatment gap for mental disorders in India underlines the need for integration of mental health in primary care.AimsTo operationalise the delivery of the World Health Organization Mental Health Gap Action Plan interventions for priority mental disorders and to design an integrated mental healthcare plan (MHCP) comprising packages of care for primary healthcare in one district.MethodMixed methods were used including theory of change workshops, qualitative research to develop the MHCP and piloting of specific packages of care in a single facility.ResultsThe MHCP comprises three enabling packages: programme management, capacity building and community mobilisation; and four service delivery packages: awareness for mental disorders, identification, treatment and recovery. Challenges were encountered in training primary care workers to improve identification and treatment.ConclusionsThere are a number of challenges to integrating mental health into primary care, which can be addressed through the injection of new resources and collaborative care models.

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