Several Strategies Could Reduce the Staggering Global MH Burden
Abstract
The National Institutes of Health reports that schizophrenia, depression, alcohol dependence, and other mental disorders make up 13 percent of the worldwide disease burden suggests a strong demand for more mental health care on a global scale.
While some U.S.-based psychiatrists are addressing barriers faced by the national mental health care system, some psychiatrists are tackling mental health care issues on a global scale.
Pamela Collins, M.D., M.P.H., of the National Institute of Mental Health says that the lack of mental health services is a global problem that needs to be addressed globally.
Last month, Pamela Collins, M.D., M.P.H., director of the Office for Research on Disparities and Global Mental Health at the National Institute of Mental Health (NIMH), visited APA headquarters to discuss a range of issues that affect mental health and mental health care from a global perspective.
“Global health does not equate to international health,” Collins said. “Global health emphasizes the importance of interconnections among countries and is informed by globalizing influences. It emphasizes equity, respect, and human rights.” According to the World Health Organization, more than 450 million people across the globe suffer from mental illness, which, according to NIMH, contributed to an economic burden of more than $2.5 trillion globally in 2010.
Collins, who served as guest speaker at
APA’s February Lunch and Learn event in celebration of African-American History Month, said that access to adequate mental health care is a major problem everywhere.
“Lack of adequate mental health care is a constant that we see in high- , middle- , and low-income countries,” she said in a later interview with Psychiatric News. “But it is even magnified in places where there are so few mental health providers per population,” such as Rwanda, where no more than seven psychiatrists serve a population of 9 million people.
Collins stated that though the United States has shortages of mental health care providers, particularly in rural areas, the country’s mental health care infrastructure is different from that in less-affluent countries. “Here, we have implemented some technological solutions to address the lack of providers, such as telepsychiatry. This allows an avenue for some of our citizens to access quality care, but even telepsychiatry is not available everywhere in this country.”
Collins told Psychiatric News that in order to treat any population that is underserved when it comes to mental health care, it is crucial for those countries to construct a workforce that will meet the mental health needs of its people, which will require modifying their educational systems to incorporate mental health in education for doctors, nurses, and other caregivers.
Once the foundation for education and training in mental health care is solid, explained Collins, then the stage may be set for a method known as task shifting—a process used in HIV clinical care in which an expert trains local care providers to deliver a treatment intervention.
“With psychiatrists being the most specialized providers in mental health services,” Collins said, “task shifting will allow us to train nurses, primary care physicians, or laypersons to deliver mental health interventions, thereby extending the number of people available to deliver some form of mental health care.”
Collins added that global “marketing” for available mental health services will also have to be addressed so that people can know where to go if they or a loved one displays symptoms of a mental disorder.
“We are a part of the globe,” Collins said. “We have the opportunity to have equitable collaborations with a broader number of people than ever before. Since we have a global community that is now connected through informational technology and our ability to travel, we can take advantage of this community to collectively reduce the burden of disease associated with mental disorders.” ■
