Shortage of mental health treatment around the world

In Canada the area of mental health is often referred to as the orphan of our health care system.

It is widely known that mental health care receives less attention and funding than other major areas of health even though mental illness affects roughly one in five Canadians, causes significant disability and costs our economy billions every year.

Although I have discussed this shortfall in the Canadian system in several past columns, I have not directly addressed the state of mental health care around the world. Unfortunately, Canada is not the only country where the mentally ill are neglected by the national health care system.

Mental illness remains a peripheral issue on the global health agenda even while the World Health Organization reports depression will be the second leading cause of disability worldwide within a very few years.

Because of this and since there are strong linkages between mental and other health problems, the entire global health community needs to become involved and must act on the knowledge that global health is not solely about controlling infectious diseases.

As with many medical conditions, most people with mental disorders live in low or middle income countries while the majority of mental health resources are found in high income countries.

In developing countries, the vast majority of people living with mental illness do so in communities where they receive little or no care or are placed in very primitive mental hospitals.

Socioeconomic factors such as housing, employment and stability are very important when dealing with mental illness. Not only do these factors affect the trajectory of a disease – making it worse if they are not in place – but these survival necessities are often lost as a result of mental illness.

If we don’t deal with the social determinants of health by improving living conditions we will make no progress in reducing the burden of mental illness around the world.

Even with more resources, high income countries like Canada, the US and European nations are not exempt from the burden of mental illness.

Unlike most other health problems including heart disease and many cancers, mental illnesses are the chronic health problems of young people. Half of all adults with mental illness experience symptoms by the age of 14 even when diagnosis and treatment are usually at least a decade away.

Battling the onset of disability from such a young age can tremendously affect a person’s potential in pursuit of education, employment and meaningful relationships.

Of course, mental illness is also implicated in virtually all of the almost 4,000 suicides in Canada each year as well as in many homicides.

According to US data, mental illness including substance abuse accounts for 40 percent of non-infectious disease in the US and people with mental illness are the largest group drawing federal disability payments in that country as well.

Any way you look at it, the burden of mental illness is huge for individuals, families, nations and the world. We have the knowledge to solve many of the compounding problems associated with mental illness. Unfortunately, this knowledge is not being used effectively in the field.

 

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