WHO calls for greater mental health priority

The World Health Organisation (WHO) is appealing to countries to increase their support for mental health services.

The appeal is part of a series of six reviews on global mental health which is being published today in the journal The Lancet. WHO has worked closely with the journal to generate the evidence and formulate the call for action.

Mental disorders are common but as many as half of all people with severe mental disorders and a vast majority of those with mild or moderate disorders worldwide do not receive any treatment. Even when treatment is available, it is often delivered in institutional settings which in many countries are associated with stigma and human rights violations.

The reasons for this bleak situation are clear: mental health services are being starved of both human and financial resources. WHO's Mental Health Atlas database shows that a majority of countries in Africa and South-East Asia spend less than 1% of their health budget 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 less than in high-income countries); these extremely low rates make it impossible for satisfactory services to be delivered in these countries.

WHO is supporting a call for action to increase the coverage of mental health services for mental disorders in low- and middle-income countries. The call is targeted at public health planners and urges them to assign a higher priority to mental health.

"This topic should matter to everyone, because people living with mental disorders in low- and middle-income countries are systematically locked out of the benefits of development that are open to others. When not addressed, mental disorders deprive people of opportunities to escape from poverty and deny them a voice to claim their rights," said Dr Catherine Le Galès-Camus, WHO Assistant Director-General for Noncommunicable Diseases and Mental Health.

"The current situation means that people with mental illnesses are at best ignored and at worst actively discriminated against in many countries. We can only improve the services available to people with mental disorders if there is a major and rapid increase in investment in this area," said Dr Benedetto Saraceno, WHO Director of Mental Health and Substance Abuse.

Estimates show that the amount of money required to deliver a core package of mental health care is approximately USD 2 per person per year in low-income countries and USD 3-4 in lower-middle income countries. This package, based on treatment of mental disorders in primary health care and in community-based facilities would increase the treatment coverage to 80% for severe mental disorders and 25-33% for less severe ones. These targets are currently the best attainable level for most low- and middle-income countries given the current poor infrastructure and scarcity of human resources for mental health care.