WHO Vows to Fill World’s MH Resource Gap

Despite the fact that mental illnesses can be treated successfully, few people throughout the world actually get the kind of care they need and deserve. For instance, according to the World Health Organization (WHO), 41 percent of the world’s countries do not have a mental health policy, and 37 percent do not have community mental health care facilities. Moreover, 70 percent of the world’s population has access to fewer than one psychiatrist per 100,000 people.

To address these striking holes in mental health care, WHO launched the mental health Global Action Program (known as mhGAP) at the beginning of this year to focus on suicide prevention and the prevention and management of certain mental disorders in areas of the world that are woefully lacking in mental health services. These disorders are depression, schizophrenia, alcohol and drug dependence, dementia, and epilepsy. WHO program administrators hope to increase government awareness of mental disorders, enhance the quality of mental health services, and reduce the stigma associated with mental illness worldwide.

Several Strategies

According to a report on the mhGAP initiative, released in April, WHO will use a number of strategies to improve mental health services and strengthen mental health policy throughout the world. One strategy will use the power and speed of the Internet to disseminate different types of mental health–related information to the public.

For instance, WHO plans to establish an electronic database with statistics on the prevalence of mental illness and substance abuse in a number of countries. This information will be helpful because, according to the WHO report, almost 30 percent of the world’s nations do not have a system for monitoring and reporting on mental health problems.

Shekhar Saxena, M.D., coordinator of WHO’s Mental Health and Research Division, told Psychiatric News that WHO is building a system to monitor substance abuse and dependence. It will include “information on the use and abuse of and dependence on legal and illegal substances that have an impact on health” in countries that lack monitoring systems.

In addition, WHO is planning to expand its Internet-based database on global mental health resources. Data from WHO’s Project Atlas, including the availability of mental health services, legislation, and mental health budgets in more than 100 countries, is available on the Web at mh-atlas.ic.gc.ca.

The Web site allows users to click on the name of a country to access its related mental health information. For example, by clicking on “Cameroon,” users will learn that there are .08 psychiatric beds per 10,000 people and just .03 psychiatrists per 100,000 people.

“These data will facilitate action by policymakers and researchers,” said Saxena. “[They] will also empower public health institutions and consumer associations in their advocacy efforts.”

Health Care Workers

WHO’s mental health program isn’t just targeting the public with its educational efforts. Even some health care workers in certain corners of the world live in ignorance of the barriers to quality treatment of mental disorders. To better educate this group, WHO staff will distribute literature on the treatment of mental disorders, including “information on how mental disorders, especially depression, negatively influence adherence to medical regimens. . .for a range of physical conditions,” according to the report.

Much of this information about mental health, however, does not pertain to residents of third-world countries, according to the WHO report. Most of the psychiatric literature is based on research that has been conducted in the world’s wealthiest nations.

To ensure that psychiatric research is more representative of people throughout the world, the mhGAP initiative will provide research training fellowships to psychiatrists and professionals in other disciplines in developing countries. Said Saxena, “The fellowships will benefit researchers with an interest in mental health from all fields.” As part of the initiative, WHO has contacted universities in some of these countries about training faculty in mental health and substance abuse research, he added.

The report, “Close the Gap, Dare to Care,” is posted on the Web at www5.who.int/mental_health/download.cfm?id=0000000265, and the Project Atlas Web site is mh-atlas.ic.gc.ca. ▪