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Breaking down the Silo Mentality in Global Mental Health: The New Role for the Schools of Public Health.

What resources are needed? How can progress towards these goals be monitored? What should be the priorities for mental health research? Three questions that have arisen from the work of the Global Mental Health Group are still pending and looking for the answers (WHO, Lancet, 2007). Is there any institutional and human resources capacities within the schools of medicine and schools of public health to develop the strategy for global mental health? The fourth question does not have only implication for the institutional health arena, the field of medical science or health services organization. It speaks in favor of integrated health services and more profound understanding of broader determinants of health. Global Burden of Global Mental Disorders What does epidemiological evidence from global research have to say? The evidence from the epidemiological studies shows that traditional clinical- based approach to mental disorders does not have a potential for the solution of the growing burden of mental illness and disease epidemics. The number of persons with major mental illnesses and the societal burden of mental health problems was increasing substantially in the last three decades. And it is expected to keep the negative trend in the future. This probability should be attributed to the impact of globalization. Although it 's hard to measure, quantify and predict the impact of globalization on the prevalence and course of mental health and psychiatric disorders today we know much more than a few decades ago (WHO, 2016). More than 450 million people around the world suffer from mental health or neurological disorders positioning mental illness and disorders among the leading causes of ill-health and disability worldwide. Close to "30% of the population worldwide has some form of mental disorder, and at least two- thirds of those people receive no treatment, even in countries with the most resources" (WHO, 2007). In the USA, for example, 31% of individuals are affected by mental disorder every year, but 67% of them are not treated (Kohn et al, 2004). In Europe, the mental disorder affects 27% of people every year, 74% of whom receive no treatment (Kessler et al, 2005). The situation might have improved with proper care, psychosocial assistance and medication and hundreds of millions could be treated if we know that stigma, discrimination and neglected, prevent care from reaching people with mental disorders. Globalization and broader social phenomena such as migrations and access to technologies serve as “key forces affecting biology, psychology, and health in contemporary society. Poverty compounds the factors that perpetuate mental disorders and leaves those in the “bottom trillion particularly vulnerable to illness and lack of safe and effective treatments.” (Harvard Medical School, 2016). The measurable effect of such a situation is evident from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD, 2010) that offers eve more precise inquiry into the problem. The burden of disease attributable to mental disorders expressed in disability- adjusted life years (DALYs) is showing that not only the situation is challenging. The trends are those that worries even more. The burden of mental and substance use disorders increased by 37·6% between 1990 and 2010. Mental and substance use disorders accounted for 183·9 million DALYs or 7·4% of all DALYs worldwide. Such diseases accounted for 8·6 million Years of Life Lost (Witherford et al, 2013). Mental and substance use disorders were the leading cause of life lost or disabilities worldwide. Depressive disorders accounted for 40·5% of DALYs caused by mental and substance use disorders, with anxiety disorders accounting for 14·6%, schizophrenia for 7·4%, pervasive developmental disorders for 4·2%, childhood behavioral disorders for 3·4%, and eating disorders for 1·2% DALYs varied by age and sex, with the highest proportion of total DALYs occurring in people aged 10– 29 years (Witherford et al, 2013).

Mental Health ; Global Health ; Strategy ; Lancet ; WHO

PMID: 27855420