World Mental Health Day – Time to invest

Dr Sima Barmania

109691210 293x300 World Mental Health Day   Time to invest Today marks World Mental Health Day, a day designed to raise public attention about mental health issues whilst also encouraging open and honest discussion about the topic.

This year’s theme is “investing in mental health” which seems highly apt given that the World Health Organisation estimates that the resources allocated for mental health are “inadequate especially in low resource countries”. “Low- and middle-income countries spend less than two per cent of their health budget on mental health” (WHO 2011) which is woefully insufficient given the global burden of mental health disorders is immense.

In July of this year, the journal Nature published a report by ‘Grand Challenges in Global Mental health’, a global conglomerate of researchers and clinicians specialising in mental health. The report outlined some of the key research priorities and called for “urgent action and investment”.

It also highlighted some of the key challenges concerning global health, including the “need for research that uses a life-course approach”, building mental capacity, drawing attention to the impact of poverty and war and the need to draw attention to social exclusion and discrimination, to name but a few.

Co-author of the paper, Professor Daar believes that the precise extent of mental health illness has been “grossly underestimated” and that resource allocation is insufficient due to the fact that there is “not much in health budgets in developing countries for mental health”.

A case example is Somalia, 20 years of war has resulted in an estimated prevalence of one in three having some form of mental illness, but with only three trained psychiatrists in the entire country equipped to deal with it. Furthermore, those with mental illness face severe discrimination and stigma, including being chained up. In fact the WHO claims that 90% of those mentally ill in Somalia will be chained at one point in their life.

In addition, Professor Daar is keen to promote the need for prevention of mental health illness in youth and strengthening mental health resilience, a concept that Dr Carys Williams is actively encouraging.

Dr Carys Williams is a psychiatrist based in London and founder of 16 to 25 support, an organisation caring for the health needs of adolescents and young adults. She believes it is achievable to build mental health resilience “through educating people about the mental health impact of certain stressors and how to manage them correctly”. “Resilience can be gained through preventing mental illness not treating people in crisis.  Education and prevention, empowers people leading to resilience”.

However, in the current economic environment this can be problematic she adds:

In today’s financial climate, mental health is not the priority and services are being cut due to the recession.  Mental health is also costly as to treat a patient takes a long period of time; it’s not like repairing a fractured arm that takes 6 weeks”.

She further explains “also due to the current economic and social stresses, more people are suffering from mental health problems.  If measures were put into place to prevent the occurrence of mental health problems and early treatment was available the impact on society would be far less”

Williams believes that although the experience of stigma associated with having a mental health illness in England, differs to that of a developing country, such as Somalia, there is still widespread prejudice for those in the UK.

“For generations’ people with mental health issues have been labelled and stigmatised, I am glad to say with more publicity this is reducing and people are asking for help at earlier stages of their illness”

In fact, nine out of ten people will experience stigma and discrimination as a result of having mental health problems, according to ‘Time to Change’.

‘Time to Change’ which is run jointly between MIND and Rethink Mental Illness, has been running since 2007 and is a national programme to “improve public attitudes and behaviour towards people with mental health problems”.

According to Claire Monger, of ‘Time to Change’ the campaign has been thus far successful with a 4% reduction in the discrimination that people with mental illness report.

In my opinion, having such influential and affable people such as Stephen Fry, the new president of MIND, advocating and telling their own narratives of living with mental illness is incredibly important for changing public perception.

In conclusion, greater research, reducing stigma and caring for those with mental health problems adequately is not insurmountable; however, it takes time, understanding, compassion and a concerted effort to “invest in mental health”

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