Here are five ways we can make mental healthcare better

Mental Health 2018

WHO/Marko Kokic A mental health counsellor talks with clients in the Democratic Republic of the Congo.

This article is brought to you thanks to the strategic cooperation of The European Sting with the World Economic Forum.

Author: Vanessa Candeias, Head of Global Health and Healthcare System Initiative, World Economic Forum & Rihana Diabo, Project Specialist, Global Health and Healthcare, World Economic Forum


One in four people in the world will be affected by mental ill health at some point in their lives, according to estimates. Currently, about 450 million people are living with mental disorders. Depression alone is thought to affect more than 300 million people, while 21 million people suffer from schizophrenia and 50 million from Alzheimer’s disease. Approximately one person dies from suicide every 40 seconds, with indications that for every adult who dies, there may be 20 others making suicide attempts.

Country-level mental ill health numbers are even more concerning. Together, China and India account for one third of the global burden of mental illness. Some estimate that 36% of the Indian population suffers from major depression. In 2012, 250,000 suicides were reported, with over 40% of these individuals under the age of 30. Among Indian women and teenage girls aged between 15 and 19, suicide has now surpassed maternal mortality as the leading cause of death. China accounts for 26% of suicides and is the only country in the world where the female suicide rate is higher than the male rate, with experts estimating that 25-40% more women are killing themselves every year compared to men.

Healthy populations are the engine for sustainable growth. When such a large proportion of the population suffers from mental ill health, the negative impact is costly to society. People with severe mental illness die up to 20 years younger, have higher unemployment and are poorer than the rest of the population. It is estimated that direct and indirect costs of mental ill health amount to over 4% of global GDP. This is more than the cost of cancer, diabetes and chronic respiratory disease combined. By 2030, mental illness costs are expected to reach more than $6 trillion annually.

Image: Source: Bloom, D.E., Cafiero, E.T., Jané-Llopis, E., Abrahams-Gessel, S., Bloom, L.R., Fathima, S., Feigl, A.B., Gaziano, T., Mowafi, M., Pandya, A., Prettner, K., Rosenberg, L., Seligman, B., Stein, A.Z., & Weinstein, C. (2011). The Global Economic Burden of Noncommunicable Diseases. Geneva: World Economic Forum

There is no health without mental health

We are not doing enough to address this crisis. Despite these alarming costs, and despite research showing that for every $1 spent scaling up treatment for depression and anxiety, the return amounts to $4 in terms of better health and ability to work, between 76% and 85% of people with serious mental disorders have received no treatment in the previous year in low- and middle-income countries (LMICs).

Low-income countries spend an average of just 0.5% of their health budgets on mental health, with the vast majority of the money going to hospitals that are more like asylums than adequate treatment centres. Mental health spending made up just 0.4% of global aid spending on health between 2000 and 2014. While recent years have seen a movement to treat and prevent non-communicable diseases, mental health has yet to make it to the global health agenda as an area or priority.

It is time to fix our extraordinary failure to embrace mental health.

We know how to improve populations’ mental health

Mental health happens wherever a person is. We believe global mechanisms will only make a difference if we also empower communities, including in workplaces, schools and homes, to provide good mental healthcare. However, a global-level consolidation of efforts is essential to address systemic issues affecting the provision of care. Public and private collaboration will be critical for success.

Here are five priorities for cooperation in mental health.

1. Promote multi-stakeholder collaboration to advance local, national and global efforts in favour of good mental health

Mental health is a complex issue that requires collaboration among all stakeholders, including grassroot and community organizations, civil society groups, local and national governments, international organizations, private sector companies, religious groups and academic institutions.

The private sector is a key stakeholder in this. Unfortunately, very few countries engage it formally in plans to address mental health provision, not even in its capacity as the biggest employer in most advanced economies. Coordinating stakeholders and connecting the dots among initiatives, including private sector activities but also advocacy, financing and campaign efforts (such as those being led by United for Global Mental Health), would go a long way to optimizing outcomes for individuals and their families.

2. Create policies that ethically frame and guide the use of new technologies and data for early diagnosis and prevention of mental ill health

Progress has been made in recent years in leveraging data and technology to enable early and precision diagnostics. For example, some apps are able to use built-in cellphone sensors to collect information on a user’s typical behaviour pattern, providing signals that help is needed before a crisis occurs. These offer exciting opportunities, but raise the need to build governance systems that will guide the ethical and appropriate use of such technologies to enable positive outcomes that matter to the patient.

3. Improve access to mental healthcare and encourage the development of novel drugs and therapies for the treatment of mental health conditions

Successful mental health treatment should combine behavioural and psychological interventions with other medical ones when appropriate. Unfortunately, many of those who need treatment do not receive it because they live in areas of low access, or simply cannot afford medication.

It is estimated that about 75% of people in LMICs have no access to mental health treatment. Even in an advanced economy such as the US, it is estimated that one in five adults with a mental illness are not able to get the treatment they need. And this alarming number only includes individuals who are actually seeking treatment but facing barriers to getting it.

Furthermore, there has been significant divestment from brain research in the past few years, and the number of drugs being developed for brain diseases has halved since 2010. As a result, for many mental health conditions, either very limited or no drugs currently exist to defer, slow or improve symptoms. This is notably the case for Alzheimer’s disease, even though the number of individuals affected by that disease globally is expected to increase to 100 million by 2050. By then, the cost of Alzheimer’s care is set to reach $1 trillion in the US alone.

Moving the needle to encourage brain research, the development of novel pharmacological and non-pharmacological therapies and better access to treatment for people living in low-resource and low-access settings would go a long way to improving mental health outcomes.

4. Improve care pathways and insurance schemes for treating specific mental disorders by defining and adopting standards of care

Pathways for mental healthcare tend not to be clearly defined, implemented or standardized across care centres. They also do not always reflect relationships between stakeholders, variability of illness and patient individuality. For example, psychiatric and psychological services are often not integrated. Furthermore, mental disorders are often not included in reimbursement schemes, resulting in individuals being faced with daunting financial consequences for seeking mental healthcare.

Self-reported data from 177 countries in 2017 shows that less than 70% of these states explicitly list severe mental disorders in national insurance or reimbursement schemes. Twenty-seven percent of countries reported that mental care and treatment are not included in national health insurance or reimbursement schemes. Of those, 19% explicitly list mental disorders as excluded conditions from the national health insurance and reimbursement schemes.

An evidence-based yet flexible approach to treating mental ill health that is consistently deployed, appropriate to country-level cultural context and covered under national insurance schemes would ensure that everyone who enters the healthcare system for mental healthcare is treated appropriately and not put at risk of financial hardship.

5. Increase the number of mental health specialists and train non-specialists to deliver mental healthcare at the community level

There is a dearth of mental health workers, including psychiatrists, psychologists, nurses, social workers, occupational therapists and other paid mental health workers, in both emerging and mature economies. The 2017 WHO Mental Health Atlas revealed that median numbers of mental health workers per 100,000 population vary from below two in low-income countries to over 70 in high-income countries. The global median is nine per 100,000 people. That’s less than one mental health worker per 10,000 people. In comparison, Washington DC has a higher ratio of Starbucks coffee stores.

Furthermore, mental healthcare needs to happen on the community level. More non-specialists should be trained to deliver basic care to those who need it. For example, an innovative programme in Zimbabwe, The Friendship Bench, trains grandmothers to provide problem-solving therapy to people suffering from common mental disorders, with encouraging success. Building on the strength of communities to deliver mental health in the patient’s immediate environment would sustainably improve lives.

This can be done

The World Economic Forum is committed to coordinating global efforts in this space by harnessing the recent momentum from a multisectoral global community on mental health. As we look ahead to our Annual Meeting in January 2019, to the global calendar of events on mental health and to our programmatic activities throughout the year, we seek to create impact in the above areas.

We also seek to contribute to global efforts on advocacy and stigma reduction by normalizing conversation about mental health and socializing the message that all of us, at all times, have mental health. This first post in a series on unpacking and tackling global mental health challenges provides an overview of the issue, as well as some ways in which public-private cooperation is critical.

It’s time to recognize, acknowledge and understand the complexity of mental health, create opportunities and solutions to improve the lives of millions, and redefine humanity. It can be done. The time to act is now.

Advertising

Advertising

Advertising

Advertising

Advertising

Advertising

the sting Milestone

Featured Stings

Can we feed everyone without unleashing disaster? Read on

These campaigners want to give a quarter of the UK back to nature

How to build a more resilient and inclusive global system

Stopping antimicrobial resistance would cost just USD 2 per person a year

A Europe that Protects: Commission calls for continued action to eradicate trafficking in human beings

Syria: Urgent, concrete actions needed, to protect children too young to ‘make sense of this senseless war’

Brazil must immediately end threats to independence and capacity of law enforcement to fight corruption

Climate negotiations on the road to a strong Paris agreement rulebook

UN spotlights ‘explosive’ obesity rates, hunger in Latin America and Caribbean

Barcelona’s ‘superblocks’ could save lives and cut pollution, says report

UN experts report: Business ‘dragging its feet’ on human rights worldwide

Will the end of QE come along with ECB’s inflation target?

A Sting Exclusive: “Climate change-the biggest global health threat of the 21st century, yet overlooked in climate negotiations?” IFMSA wonders from COP21 in Paris

EU to Telcos: Stop Mergers and Acquisitions but please help me urgently with 5G development

Eurozone stagnates after exporting its recession to trading partners

Parliament approves €34m in EU aid to Greece, Poland, Lithuania and Bulgaria

Can alternatives to rhino horn save these gentle giants?

Draghi keeps the euro cheap, helps debt refinancing, recapitalization of banks and growth

Working with millennials, leaders say humility works better than bossing around

Strong multilateral institutions key to tackling world’s dramatic challenges, UN chief says In Moscow

India’s economy is growing fast, but its poorest areas lag behind. Here’s why this could be about to change

“ASEM: Global Partners for Global Challenges”, a Sting Exclusive by China’s Ambassador to the EU

OECD will follow Canadian proceedings addressing allegations of political interference in foreign bribery prosecution

UK Labour Party leader Corbyn readies to change Brexit political backdrop

IMF: When high yield goes boom

Will Cameron succeed in keeping UK inside the EU and reverse the present economic downturn?

EU trade agreements deliver on growth and jobs, support sustainable development

Ukraine takes EU money and runs to sign with Russia

Cryptocurrency mining could become the new face of energy storage. Here’s how

COP25: MEPs push for CO2 neutrality by 2050

‘At risk’ Mediterranean forests make ‘vital contributions’ to development

The eight types of AI you should know about

Prospect of lasting peace ‘fading by the day’ in Gaza and West Bank, senior UN envoy warns

Is the English language too powerful?

Essential services on verge of shutdown in Gaza as emergency fuel set to run out

Your chocolate can help save the planet. Here’s how

Your next pair of sneakers could be made from coffee

Syrian civilians must be protected amid ISIL executions and airstrikes: Bachelet

Sponsored content: when QUALITY meets OPEX in manufacturing

European Commission launches infringement proceedings against the UK following its failure to name a candidate for EU Commissioner

In aftermath of Libya airstrike deaths, UN officials call for refugees and migrants to be freed from detention

Siege of Syria’s eastern Ghouta ‘barbaric and medieval’, says UN Commission of Inquiry

Big data is coming to agriculture. Farmers must set its course

Over 40 million people still victims of slavery

How tech can help businesses balance profit and purpose

This digital currency could build a more sustainable global economy

Israel @ MWC14: Israel The Start App Nation

Why social working cultures are happier and more productive

New UN report on families in a changing world puts ‘women’s rights at their core’

Education in Emergencies: EU announces record humanitarian funding for 2019 and launches #RaiseYourPencil Campaign

MEPs call for decisive action to fight inequalities in the EU

Costa Rica has doubled its tropical rainforests in just a few decades. Here’s how

South Sudan: ‘Horrific acts’ by government may constitute ‘war crimes’ says UN, demanding justice

Faith can overcome religious nationalism. Here’s how

Amid troop build-up in Rohingya’s home state, UN appeals to Myanmar for peaceful solution

All sides in Yemen conflict could be guilty of war crimes, UN experts find

INTERVIEW: ‘Defend the people, not the States’, says outgoing UN human rights chief

EU leaders let tax-evaders untouched

Why this is the year we must take action on mental health

Drinking coffee could help you live longer, research finds

Europe’s top court hears Intel and sends € 1.06 bn antitrust fine to review

IMF: Sorry Greece it was a mistake of 11% of your GDP

Countries must make teaching profession more financially and intellectually attractive

Not enough resettlement solutions for refugees worldwide, says UN

More Stings?

Speak your Mind Here

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s