Millions with mental disorders in the developing world are deprived of necessary treatment and care

WHO calls for urgent scaling up of services for mental disorders

More than 75% of people suffering from mental disorders in the developing world receive no treatment or care. A new WHO programme launched today, on World Mental Health Day 2008 highlights the huge treatment gap for a number of mental, neurological and substance use disorders. Across Africa for example, nine out of ten people suffering from epilepsy go untreated, unable to access simple and inexpensive anticonvulsant drugs which cost less than US$5 a year per person.

WHO is now 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): Scaling up care for mental, neurological and substance use disorders asserts that 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.
“Governments across the world need to see mental health as a vital component of primary health care. We need to change policy and practice. Only then can we get the essential mental health services to the tens of millions in need”, said Dr Margaret Chan, Director-General of the World Health Organization.

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. 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. Worldwide, every 40 seconds, one person dies of suicide that is one of the leading causes of death among young adults. Suicide is a condition that is preventable.

It does not have to be this way. In Chile, the national primary care programme now includes treatment of depression for all who need it bringing much needed care to hundreds of thousands of people. An epilepsy project in China which integrated a model of epilepsy control into local health systems achieved excellent results. This confirmed that epilepsy could be treated with an inexpensive anti-convulsant medicine by health professionals who had undergone basic training. The project which started in six provinces has now been extended to 15 provinces and tens of thousands of sufferers have been treated.

The extra cost to scale up services for mental disorders is not too large. A study conducted by WHO showed that 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 – requires an additional investment as low as $US 0.20 per person per year.

People with mental disorders are stigmatized and are subject to neglect and abuse. "The proper care of mental, neurological and substance use disorders should not only be evidence based but also value based," said Dr Benedetto Saraceno, Director of WHO’s Mental Health and Substance Abuse Department. "We need 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 programme sets out a number of cost-effective strategies to tackle the treatment gap for mental, neurological and substance use disorders. These include: assessing countries needs and resources; developing sound mental health policy and legislation; and increasing human and financial resources. The programme relies on partnerships to scale up services with the objective of reducing the burden of mental, neurological and substance use disorders.

WHO