Millenium Development Goals fail to include the goal of improving the mental health of the poor

Because the Millenium Development Goals fail to include the goal of improving the mental health of the poor, the world may not reach many of the goals, say researchers in an analysis published by PLoS Medicine.

Vikram Patel and Jaime Miranda of the London School of Hygiene and Tropical Medicine say that there is compelling evidence that in developing countries mental disorders are among the most important causes of sickness, disability, and, in certain age groups, premature mortality.

In their analysis, they make the case that three of the goals cannot be achieved unless mental disorders are also addressed--these goals are eradicating extreme poverty and hunger (goal 1), reducing child mortality (goal 4), and improving maternal health (goal 5).

Poverty and mental disorders are linked, say Patel and Miranda--poverty is a risk factor for mental disorders while these disorders are themselves impoverishing (because of out-of-pocket health care costs and loss of employment). Treating mental disorders, they argue, would facilitate the conditions necessary to rise out of poverty.

The authors explain why treating mothers with depression will be crucial to achieving goals 4 and 5. Children of depressed mothers are more likely to suffer "failure to thrive" (being underweight and stunted), and children with failure to thrive are more likely to die.

Depressed mothers are also less likely to breastfeed, and their children are more likely to suffer diarrhea (a major cause of childhood death in poor countries) and less likely to get their immunizations.

Depressed mothers are much more disabled and less likely to care for their own needs, while suicide is a leading cause of maternal death in developed countries.

"There is no health without mental health," say the authors. "Advocacy is needed to challenge the nihilism of global health planners regarding the role of mental health."