The World Health Organization reports the majority of people in the world do not receive treatment for mental illness. Figures show up to 50 percent of people suffering from mental disorders in Europe and North America do not receive treatment, and up to 85 percent of people in developing countries do not receive treatment.
Who knows how many people simply do not report their symptoms.
The reason for this massive gap between suffering and treatment is because thousands of people with mental health issues are deprived of their human rights. In both health facilities and communities, individuals with mental illness are often marginalized and stigmatized.
Poor quality of care fueled by a lack of qualified health professionals breeds a cycle of further ill treatment. According to WHO’s 2014 “Mental Health Atlas,” across income groups in 41 countries, mental health spending represents less than 5% of general government health expenditures. Out of the sample of countries, only seven allocated more than 5%.
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In the past, global health officials have focused primarily on deadly infectious diseases such as malaria and H.I.V. However, last month the UN made a commitment to achieving Global Goal #3, which seeks to “promote good health and well being.” By doing so, the international community is making an effort to address premature deaths from mental disorders by 2030.
With that in mind, what are countries doing right? What are they doing wrong? And how can we fix it?
The Good...
Denmark is an example of the good--one of the many positive aspects of life in Denmark is its universal health care system. In this system, mental illness receives significant investment and attention. Particularly with the Danish Psychiatric Research Register--a resource that provides scientists with a treasure trove of data. Since 1969, this register provides a comprehensive picture of treatment for psychological problems.
According to the register's data, researchers estimated that 38% of Danish women and 32% of Danish men will receive treatment for a mental disorder at some point during their lifetime. The Danes bring up a good point, good data on the subject is instrumental to achieving better health care.
Get into the details of the system a bit. What are some common mental disorders that are respected here that are discredited elsewhere?
The Bad…
Access to mental healthcare is limited in India. There are only 43 government mental health hospitals to provide services for the estimated more than 70 million people living with psychosocial disabilities in the country.
For every 1 million people, there are three psychiatrists, with psychologists even more scarce. Only 25% of hospitals, clinics and mental health professionals are in rural areas, where 70% of the population lives. Additionally, mental illness is highly stigmatized, especially among women. They often find themselves with no legal rights, receiving involuntary treatment, and incorrect diagnoses.
There is hope for improvement. In October 2014, India unveiled its first mental health policy, which aims to reduce the treatment gap by providing universal access to mental health care through increased funding and human resources. Whether or not the Indian government will be successful in securing proper mental health services for all is unclear, but it is good to know that the issue is receiving some international attention.
And the Unfortunately Inhumane...
This part of the piece breaks my heart. The New York Times did an excellent job of illustrating a practice that is too often used to treat individuals suffering with some form of mental illness. In West Africa, where mental health services are nearly non-existent, interventions made up of religious retreats known as prayer camps are set up as “makeshift psychiatric wards” to treat individuals.
The video shows a forest of mentally ill humans shackled to trees.
Due to strong cultural beliefs, people in this region believe that schizophrenia is the result of possession by evil spirits. Beliefs like this are very common, and people use different techniques to try to get rid of the evil spirits. For example, they'll chain people — to beds in the house, to trees outside-- often leaving them to starve.
Much of this has to do with the strong cultural stigma associated with mental health and the lack of awareness surrounding it. For countries such as Ghana, Togo, and Nigeria, mental health is not often discussed. Access to services and information is extremely limited and sometimes non-existent. There is simply no infrastructure available to properly treat or educate individuals suffering from some form of illness.
According to the WHO, most countries in Africa, devote an average of less than 1 percent of their health spending to the problem, compared with 6 to 12 percent in the wealthy countries of the West. Mental health surveys reveal Liberia had just one practicing psychiatrist, Niger three, Togo four and Benin seven and Sierra Leone none.
So what can we do…
Continue to shine a light on an issue often ignored.
Poor mental health is both a cause and a consequence of poverty, compromised education, gender inequality, ill-health, and violence. It impedes an individual's capacity to work productively, realize their potential, make a contribution to their community and live a fulfilling life. It is crucial the health community recognizes the complexity behind various mental illnesses. Whether it is a specific phobia, anxiety disorder, schizophrenia, bipolar disease, and post-traumatic stress - each deserves specialized care and our full attention. Although the effects of mental disorders are not necessarily tangible, access to proper mental health care is essential to helping people achieve happy and healthy lives.
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To fix this, we must stand behind the Global Goals and encourage leaders to do so as well. Rather than regarding mental health as a separate issue, let’s talk about it in relation to the Global Goals and all they are trying to achieve.