The millions around the world living with treatable mental health conditions cannot wait
"The millions around the world living with treatable mental health conditions cannot wait – while the world faces a $16.1 trillion price tag for inaction"
The numbers are staggering.
An estimated 350 million people around the world suffer from depression, 60 million people are affected by bipolar disorder and 21 million people live with schizophrenia. These disorders rob people of their most productive years - when they are learning, working, growing families or striving to contribute productively to the communities they are part of.
Depression alone will become the leading cause of disability globally by 2030, and current investments in mental health are woefully insufficient. Only 1 percent of the global health workforce is working in the field of mental health today. In low and middle-income countries, only $2 per person are spent on mental health, compared to $50 in high-income countries – this despite recent models in South East Asia and Sub-Saharan Africa showing that delivering a defined package of mental health services would only cost $3-4 per person per year.
There has been commitment to tackle this issue, but we still see today under-investment in resources and a largely siloed approach to fixing what is in fact an issue of extreme complexity. Addressing such problems needs a comprehensive approach of targeting health and social systems as well as communities to achieve the overall health outcomes we aim for globally. In most low-income countries, mental health services are only available in large cities and psychiatric hospitals - such services are inaccessible for large parts of the population. The organisation that we work for, International Medical Corps, is one of a handful of international non-governmental organisations (iNGOs) which help integrate mental health care into general health care services. By doing this, mental health care can be made more widely available and easily accessible as well as less stigmatising. Our charity works in over 35 countries, and with support from our donors we are able to help governments build up mental health services in communities affected by disease, conflict, or disaster across the globe.
We see the need for these integrated services in the field every day.
In 2015 our team in Iraq were made aware of the plight of a 26 year old woman suffering from depression who had tried to take her own life. The toll of her mental health condition, living with an incapacitating physical disability, facing the financial problems that accompany fleeing her home due to conflict and having arguments with her family members had become too much for her – when her brother in law accused her of being a financial burden she had tried to overdose on medication.
While she was rushed to hospital for medical treatment, one of our psychosocial workers went by her side to provide support. In the days that followed, she was linked to our IMC medical team and a treatment plan was put into place which included discussion and education about depression involving her and her family to help them cope with the illness, keep her safe and find solutions for problems at home. The psychosocial worker kept following up with her and continued monitoring her symptoms and suicidal thoughts. She started gradually improving and formed stronger positive relationships with several of her family members such as her sister in law.
If it was not for these interventions, this woman may not have been alive today to tell her story.
This is just one success story but many more resources are needed to scale up mental health care in the most difficult places and governments including the UK play a key role. They have the chance to play the leadership role which is central to any success.
Next week parliamentarians, technical experts and representatives from over 30 international non-governmental organisations (iNGOs) gather in London to meet with the All-Party Parliamentary Group on Global Health to hear from iNGOs about their experiences and barriers in addressing mental health needs and to discuss what governments and donors can do.
There are positive steps being taken, including the World Health Organization (WHO) Mental Health Action Plan 2013–2020, which was adopted by the 66th World Health Assembly, and the inclusion of mental health within the Sustainable Development Goals, but the WHO 2014 Mental Health Atlas tells us that only some tangible progress has been made to integrate mental health policy, funding and programming within health agendas globally.
Any decision about investment must not only involve a calculation that considers human suffering on a massive scale but also needs to take into account the consequences and financial cost of not addressing mental health. Recent data shows that from 1990 to 2010 the burden of mental, neurological, and substance use (MNS) disorders increased by 41 percent, and now accounts for one out of ten years lost to ill health globally. A 2011 report by the World Economic Forum and the Harvard School of Public Health states that between 2011 and 2030 mental health conditions will account for the loss of $16.1 trillion in economic growth.
If we truly aim for development through health, we need stronger investment in effective, integrated and low cost mental health programmes. Mental health is critically important to the overall health, economy and social development of whole communities and societies - not just individuals experiencing mental illness. If governments, iNGOs and other agencies work together to prioritise and integrate mental health into the development agenda, we can help people with mental illness to rejoin their families and communities to pursue jobs, education, and better health - building better lives for all.
The costs of scaling up urgently needed mental health care for millions are small, when compared to the economic costs and real consequences of not systematically addressing mental health as part of development.
The necessary funding for effective integrated mental health programmes needs to be found, and we are waiting for nations to fully realise the consequences of not funding them.
About the authors:
Inka Weissbecker has been with International Medical Corps for more than six years. She provides remote and on-site technical oversight and support to International Medical Corps’ project countries in the areas of assessment, program design, project implementation, and evaluation of mental health and psychosocial programs in over 20 countries. Her recent assignments have seen her work in West Africa for the Ebola crisis, and Middle East and Europe for the current refugee response.
Ashley Leichner joined International Medical Corps in 2013. She provides guidance and support to global Mental Health and Psychosocial Support programs, focusing on documenting lessons learned, evaluations and case studies for evidence based practices. She is the focal point for child and youth MHPSS programming and her recent assignments have been in Gaza, Jordan and the Philippines.