The Mental Health Atlas 2017 acquires new importance as it is providing information and data on the progress towards the achievement of objectives and targets of the Comprehensive Mental Health Action Plan 2013–2020. The World Health Organisation’s (WHO's) Mental Health Atlas 2017 reveals that although some countries have made progress in mental health policy-making and planning, there is a global shortage of health workers trained in mental health and a lack of investment in community-based mental health facilities.
“This latest edition of the Mental Health Atlas provides us with yet more evidence that scale-up of resources for mental health is not happening quickly enough. We know what works. Failure to invest in mental health as a matter of urgency will have health, social and economic costs on a scale that we have rarely seen before,” said Dr Shekhar Saxena, director of WHO’s department of mental health and substance abuse.
The Atlas provides information on the existence of policies, plans and laws for mental health, and their alignment with established human rights instruments; the human and financial resources available; the type of facilities providing care; and mental health programmes for prevention and promotion.
It is based on data provided by 177 WHO Member States, representing 97% of the world’s population, and measures the extent to which countries are strengthening leadership and governance for mental health; providing comprehensive mental health and social care; implementing strategies to promote mental health and prevent problems, and strengthen evidence and research – as outlined in WHO’s Comprehensive Mental Health Action Plan 2013-2020.
In low-income countries, the rate of mental health workers can be as low as 2 per 100,000 population, compared with more than 70 in high-income countries. This is in stark contrast with needs, given that 1 in every 10 persons is estimated to need mental health care at any one time.
Less than half of the 139 countries that have instituted mental health policies and plans, have these aligned with human rights conventions which stress the importance of transition from psychiatric institution to community-based services and the participation of people with mental disorders in decisions concerning them. And all too often, when mental health plans are made, they are not supported by adequate human and financial resources.
Despite the transition in a number of high-income countries towards psychiatric wards in general hospitals and the provision of community-based residential care places, there remain far too few facilities for community-based mental health care throughout the world.
The global rate of beds in mental hospitals was reported to be six times more (11.3 per 100,000 population) than the rate of beds in the psychiatric wards of general hospitals.
Levels of public expenditure on mental health are very low in low- and middle-income countries. Government expenditure on mental health is less than $1 per capita in low and lower middle-income countries whereas high-income countries spend more than $80. The majority of spending is going to mental hospitals, which serve a small proportion of those who need care.
In addition, more than two-third of countries report that care and treatment of persons with severe mental disorders is not included in national health insurance or reimbursement schemes.
“Nobody should be missing out on mental health care because of the cost,” said Saxena “That’s why WHO’s push towards universal health coverage is so important: to ensure that everyone, everywhere, can access the care they need: including mental health care.”
WHO estimates that a little under 800,000 people die by suicide each year. Despite a slight increase in the number of countries reporting having a national suicide prevention strategy since the Mental Health Atlas 2014, only a third of upper-middle and high-income countries reported having such as strategy, with just 10% of low- and lower-middle income countries with a strategy.
Every $1 invested in scaling up treatment for common mental illnesses such as depression and anxiety leads to a return of $4 in better health and ability to work. On the contrary, failure to act is costly. According to a recent analysis, which calculated treatment costs and health outcomes in 36 low-, middle- and high-income countries for the 15 years from 2016-2030, low levels of recognition and access to care for depression and another common mental disorder, anxiety, result in a global economic loss of a trillion US dollars every year.
[link url="http://www.who.int/mental_health/evidence/atlas/atlas_2017_web_note/en/"]World Health Organisation material[/link]
[link url="http://apps.who.int/iris/bitstream/handle/10665/272735/9789241514019-eng.pdf?ua=1"]Mental Health Atlas[/link]