Mental Disorders and Burden of Disease: How was Disability Estimated and is It Valid?

2001 ◽  
Vol 35 (5) ◽  
pp. 668-676 ◽  
Author(s):  
Kristy Sanderson ◽  
Gavin Andrews
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
General Practitioners ◽  
Burden Of Disease ◽  
Rating Scale ◽  
Rank Order ◽  
Mental Health Policy ◽  
Health States ◽  
Trade Off ◽  
Disability Weights

Objective: The Global Burden of Disease study found mental disorders to be the world's leading cause of disability. Few studies have examined the validity of the novel approach used to estimate disability, the person trade-off preference method. This paper describes, and examines the validity of, the burden of disease person trade-off protocol. Method: The person trade-off provides preferences for health states (how good or bad you think it is in relation to perfect health). General practitioners (n = 20) with training in mental health provided preferences for 19 mental disorders using the person trade-off method. Descriptions for the mental disorders were derived from the average symptom severity and disability observed in the Australian National Survey of Mental Health and Wellbeing. Validity was investigated by comparison with two other methods (rating scale and rank order). Results: The general practitioners found the person trade-off complex and affronting. Only a moderate concordance was observed with two validity comparisons, however, validity was significantly increased following the opportunity for group discussion among the clinicians. The disability weights were higher than those used in the global study, a possible consequence of differences in disorder descriptions. Conclusions: The present study is limited by small subject numbers and by using only one type of key informant (clinicians). While this study provided some evidence for the validity of the person trade-off, it also echoes concerns from recent commentaries about the feasibility of this method. These concerns are particularly relevant for mental disorder burden, which relies heavily on the magnitude of the disability weights. Further work is required to ensure that disability burden is validly estimated, and thus can appropriately be used to inform mental health policy.

The WHO World Mental Health (WMH) Surveys

2009 ◽  
Vol 06 (01) ◽  
pp. 5-9 ◽  
Author(s):  
S. Aguilar-Gaxiola ◽  
J. Alonso ◽  
S. Chatterji ◽  
S. Lee ◽  
T. B. Üstün ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Treatment Effectiveness ◽  
Age Of Onset ◽  
Common Mental Disorders ◽  
Mental Health Policy ◽  
Unmet Need ◽  
Cost Effective ◽  
World Mental Health ◽  
Prevalence Estimates

SummaryThe paper presents an overview of the WHO World Mental Health (WMH) Survey Initiative and summarizes recent WMH results regarding the prevalence and societal costs of mental disorders. The WMH surveys are representative community surveys that were carried out in 28 countries throughout the world aimed at providing information to mental health policy makers about the prevalence, burden, and unmet need for treatment of common mental disorders. Results show that mental disorders are commonly occurring in all participating countries. The inter-quartile range (IQR: 25th-75th percentiles) of lifetime DSM-IV disorder prevalence estimates (combining anxiety, mood, disruptive behavior, and substance disorders) is 18.1-36.1%. The IQR of 12-month prevalence estimates is 9.8-19.1%. Analysis of age-of-onset reports shows that many mental disorders begin in childhood-adolescence and have significant adverse effects on subsequent role transitions. Adult mental disorders are found in the WMH data to be associated with high levels of role impairment. Despite this burden, the majority of mental disorders go untreated. Although these results suggest that expansion of treatment could be cost-effective from both the employer perspective and the societal perspective, treatment effectiveness trials are needed to confirm this suspicion. The WMH results regarding impairments are being used to target several such interventions.

Mental health data: A case for the African communities in New South Wales

2021 ◽  
Vol 42 (1) ◽  
pp. 64-80
Author(s):  
Daniel Kwai Apat ◽  
Wellington Digwa
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
New South ◽  
Mental Health Policy ◽  
New South Wales ◽  
Community Members ◽  
South Wales ◽  
Health Related

This paper examines mental health policies in relation to African communities residing in New South Wales, Australia and the attitudes of African communities toward mental disorders and mental health services. Current mental health policy frameworks have shown an inadequate inclusion of African communities. This may negatively affect the design of mental health interventions and how African communities engage with mental health services. The available mental health literature on African communities showed disjointed and uncoordinated data which focuses on specific community-groups within African communities. Insufficient mental health or suicide data, combined with African community members’ perception toward mental disorders and mental health services, makes it very difficult to progress engagement and interventions. There is a need for proper and sizable data on mental health related to people of African descent in NSW and Australia wide, if positive outcomes are to be realised.

Home treatment services for acute mental disorders: an all-Ireland survey

2018 ◽  
Vol 36 (1) ◽  
pp. 7-17 ◽  
Author(s):  
B. O’Keeffe ◽  
V. Russell
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
Positive Impact ◽  
Mental Health Policy ◽  
Free Text ◽  
Staffing Levels ◽  
Treatment Services ◽  
Home Based

ObjectivesTo determine the distribution, functioning and perceived impact of home-based treatment (HBT) teams for acute mental disorders on the island of Ireland.MethodsA 28-item questionnaire exploring the structure, staffing and operation of HBT teams was emailed to all clinical directors of mental health services in Ireland (n=26) and Northern Ireland (NI) (n=5). Quantitative data was analysed using the Survey Monkey package, while free-text responses to open questions were analysed for thematic content.ResultsIn total, 11 of 16 (68%) mental health services in Ireland and four of five (80%) in NI confirmed the presence of HBT teams. For 80% of respondents the primary function of HBT was as an alternative to inpatient admission. All NI respondents reported provision of a 24/7 HBT service. A 7 day a week service was reported by 82% of Republic of Ireland respondents. In total, 70% of respondents reported a gate-keeping role for their teams. Staffing levels and multidisciplinary representation varied widely. Most respondents perceived HBT as improving patient/carer experience and cost-effectiveness.ConclusionsOur findings suggest that the implementation of the HBT model in Ireland has not fulfilled the aspirations set out in mental health policy in both Irish jurisdictions. Many areas have no HBT services while wide variations in staffing levels and functioning persist. However, mental health services with established HBT teams appear convinced of their positive impact. An All-Ireland forum on HBT may help to define the model in an Irish context and standardise its future resourcing, operation and evaluation.

Economics and Mental Health: an International Perspective

2011 ◽  
pp. 231-256
Author(s):  
Richard G. Frank
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Policy ◽  
Mental Disorders ◽  
Mental Health Policy ◽  
Institutional Care ◽  
Health Spending ◽  
Health Resources ◽  
Mental Illnesses ◽  
Health Care Rationing

This article notes that problems of incomplete information are particularly salient in the context of mental health. It considers how different nations address economics and mental health in the formulation of mental health policy. It focuses on three key economic phenomena that are central to understanding the allocation of resources to the treatment of mental disorders. These are externalities, methods for efficient rationing of health resources, and incentives for allocating funds across different types of mental health services. This article provides some background on mental disorders and organization of mental health care in different OECD countries. It considers determination of mental health spending as part of health care rationing schemes in various nations. It discusses the role of government and how each country aligns its financing arrangements with stated policy goals of reducing reliance on institutional care for people with mental illnesses. Finally, it offers some concluding observations on mental health policy.

All of us? An exploration of the concept of mental health literacy based on young people’s responses to fictional mental health vignettes

2015 ◽  
Vol 32 (1) ◽  
pp. 129-136 ◽  
Author(s):  
D. Chambers ◽  
F. Murphy ◽  
H. S. Keeley
Keyword(s):  
Mental Health ◽  
Health Policy ◽  
Health Literacy ◽  
Young People ◽  
Mental Disorders ◽  
Mental Health Literacy ◽  
Full Range ◽  
Mental Health Policy ◽  
Current Definition ◽  
Definition Of

ObjectivesMental health literacy is increasingly referenced as a goal of mental health policy. However, the current definition of this concept has a relatively narrow focus on mental disorders. The objectives of this study were to explore mental health literacy through the use of vignettes and to begin to articulate a broader definition.MethodsSix groups of young people (n=42) aged between 16 and 25 years old responded to open-ended questions about vignettes depicting fictional characters with diagnosable mental health problems. The responses were analysed using Foucault’s governmentality theory.ResultsThe responses to the vignettes highlighted a range of determinants of our mental health. The young people suggested informal mental health-promoting techniques and highlighted the importance of talking. Ambiguity was reported in relation to the types of knowledge that are important in responding to mental health need. Finally, the responses were reflective of young people who are empathetic and view mental health from the perspective of our shared humanity, rather than as a marginal issue.ConclusionsAs mental health literacy is increasingly becoming a goal of mental health policy, it is timely that a shared understanding of this important concept is articulated. The current definition of mental health literacy is narrow in its focus on the recognition of mental disorders. A more broad-based definition of mental health literacy should be adopted by policy makers, reflecting the full range of determinants of mental health and recognising the importance of mental wellbeing.

Workforce Deployment: Reconciling Demands and Resources

1995 ◽  
Vol 29 (3) ◽  
pp. 394-402 ◽  
Author(s):  
Gavin Andrews
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Mental Disorders ◽  
Health Services ◽  
General Practitioners ◽  
Unmet Need ◽  
Public Mental Health ◽  
Epidemiological Data ◽  
Mental Illnesses ◽  
National Mental Health

Objective: The purpose of the study was to review the information in a Consultancy prepared for the National Mental Health Policy which suggested that half of the people with serious mental illnesses were untreated, while persons with “mental problems” were being overserviced by the specialist mental health services. The fate of the large group of persons with mental disorders of mid-range severity was not addressed. Method: Epidemiological data was reconciled with the service patterns of the clinical workforce and the extent of the unmet need estimated. Results: It was estimated that 25–30% of the Australian population meet criteria for a mental disorder in any year, yet less than one third will receive treatment. Of those that are treated, three quarters will receive their treatment from general practitioners and the remaining quarter will be treated by either the public mental health services, the addiction services, or private psychiatrists. The problem is that less than one half of those with serious mental disorders and only two thirds of those with chronic and disabling disorders appear to be being treated by anyone. Even if there were no slippage of services away from these serious and chronic groups of patients, there would still be a workforce shortfall, especially in rural and remote areas. Conclusions: Strategies to remedy this shortfall that involve psychiatrists, clinical psychologists and general practitioners are noted, and the need for a National Mental Health Survey to provide accurate data is stressed.

Mental disorders and referrals to mental health specialists by general practitioners

1999 ◽  
Vol 34 (3) ◽  
pp. 128-135 ◽  
Author(s):  
K. W. Sørgaard ◽  
I. Sandanger ◽  
T. Sørensen ◽  
G. Ingebrigtsen ◽  
O. S. Dalgard
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
General Practitioners

Representing the citizenship of mental health users in French mental health policy: A critical analysis of the official French texts on mental health policies since 2005

2020 ◽  
pp. 026101831989737
Author(s):  
Dimitrios Lampropoulos ◽  
Thémis Apostolidis
Keyword(s):  
Mental Health ◽  
Mental Disorders ◽  
Social Inclusion ◽  
Mental Health Policy ◽  
Mental Healthcare ◽  
Health Policies ◽  
Self Management ◽  
Neoliberal Governmentality ◽  
Mental Health Policies ◽  
French Texts

Research has shown that mental healthcare policies aimed at achieving autonomy and integration for people with mental disorders have been developing all over the world. Critics working from a governmentality perspective have argued that these changes are associated with broader neoliberal strategies and aims. In France however, there is no systematic work on this development. In this study, we have applied Bacchi’s ‘What’s the Problem Represented to Be’ approach to the main texts published by the French Ministry of Health since 2005, in order to study how the citizenship of mental health users is problematized. According to our analysis, the objectives of the autonomization, responsibilization and self-management of users have become increasingly central, following the recognition of users’ rights, social inclusion and the fight against the stigma of mental disorders. These developments have many points of contact with neoliberal governmentality. We conclude with recommendations for empirical research on discourses and practices in the field, where mental health policies are translated into mental health projects and practice.

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