NYAPRS Note: We were pleased last week when many of our readers commented on the article I sent related to the WHO report regarding service access disparities. The below article takes a slightly broader look, but of course with any study like this there are so many things overlooked. The data doesn’t speak for itself; it must be analyzed with an understanding of cultural and historical contexts and impressions about behavioral health. Generally, a lack of resources for behavioral health services and supports-be they acute clinical interventions or community rehabilitation-is correlated worldwide with longer recovery times and worse outcomes. Access is important. But there are certainly low-income countries where recovery from certain serious diagnoses like schizophrenia is viewed as highly probable, whereas in high-income countries these diseases are treated as chronic with needs for indefinite psychopharmacology. Despite Gross National Income, stigma persists everywhere but to degrees incumbent on cultural nuances and norms. The relative wealth of countries also does not explain gaps in the social determinants that contribute to overall well-being; in an area where safe housing and access to nutritious food may be an issue, community inclusion and bonded relationships with family can increase resilience to trauma. Alternatively, high bonded relationships with little social or geographic mobility can contribute to greater challenges in finding appropriate resources once a behavioral health challenge is faced, and these gaps can exist in either high or low income countries depending on family and community structure.The one thing that is clear from the WHO report is that more resources are needed to address mental health and substance abuse around the world. But what those resources look like mustn’t come in the form of a single set of priorities or initiatives, but must be respective of the specific cultural context of the country. As recommended below, a strategic plan for each nation-state could be crafted by internal and external leaders to recognize best practice and relevant strategies.
Mental Health Services 50 Times Less Accessible In Poorer Countries, WHO Report Finds
Huffington Post; Rachel Moss, 7/19/2015
Being able to access relevant help and support is vital for anyone who has a mental health<http://www.huffingtonpost.co.uk/news/mental-health/> condition, but a new report highlights that around the world, this isn’t always possible.
According to the WHO’s newly released Mental Health Atlas 2014<http://www.who.int/mental_health/evidence/atlas/mental_health_atlas_2014/en/>, almost one in 10 people suffer from a mental health condition, but just 1% of global health workers are working as psychiatrists, occupational therapists or social workers.
The report also highlights that those in the poorest countries are least likely to be able to access support.
The WHO’s statistics suggest that in the world’s poorest countries, there is less than one mental health worker for every 100,000 people.
In countries defined as wealthy, there is thought to be an average of 52.3 mental health workers for every 100,000 people.
Countries with a gross national income per capita (GNI) of $1,045 (£668) or less are defined as low income while countries with a GNI of more than $12,736 are defined as high income under the WHO’s guidelines.
Dr Shekhar Saxena, director of the WHO’s department of mental health and substance abuse, told The Guardian: “The gap is very large and it’s the reason<http://www.theguardian.com/global-development/datablog/2015/jul/20/mental-healthcare-world-health-organisation> for the neglect of mental health in low and middle income countries, which should be unacceptable.
“The prevalence of most severe mental illnesses – for example psychosis, bipolar disorder<http://www.huffingtonpost.co.uk/news/bipolar-disorder/>, severe depression<http://www.huffingtonpost.co.uk/news/depression/> – they are more or less the same across the world, so it would not be true to say that developed countries have a higher burden.”
He goes on to suggest that natural disasters such as typhoon Haiyan in the Philippines and conflicts such as the ongoing conflict in Syria have contributed to the lack of health services available in poorer countries, as well as caused more stress among communities.
He said: “Mental health needs to be taken at a higher level of priority within the public health planning and that needs to happen in all countries, whether they are in low-income or high-income groups.
“That means essentially that more resources need to be made available and a strategic plan within each country needs to be developed for increasing and strengthening the mental healthcare services.”
Here in the UK, it was announced last week that around 6,000 11 to 14 year olds from 76 schools will receive school lessons in mindfulness<http://www.huffingtonpost.co.uk/2015/07/16/teens-school-lessons-in-mindfulness-protect-against-mental-illness_n_7807704.html?utm_hp_ref=uk-mental-health>, as part of an experiment to determine whether such training can protect against mental illnesses.
The initiative comes after statistics revealed that more than 75% of mental health conditions begin before the age of 24 in the UK, with 50% starting before the age of 15.
http://www.huffingtonpost.co.uk/2015/07/20/mental-health-services-who-report-income_n_7830644.html