Key Messages of the Series
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Mental disorders are so intimately linked with other health concerns that there can be no health without mental health. Examples of such concerns are heart disease, diabetes, HIV infection, maternal and child health, and injuries and accidents.
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Mental disorders affect people in all societies, and disproportionately affect the poor, and those who are disadvantaged and vulnerable.
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Mental disorders are, even in the poorest countries of the world, a leading cause of disability and loss of economic productivity, and are associated with an increased risk of dying prematurely.
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Global mental health resources are characterised by three features: scarcity in all countries (when compared to their burden), but more marked in the poorest countries; inequity in their distribution between rich and poor communities and between urban and rural areas; and inefficiency in their allocation, with the lion’s share being spent on psychiatric hospitals and institutional care rather than community care.
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There is evidence that low-cost treatments (both drug and psychosocial) are feasible, affordable and effective for many mental disorders in developing countries. These treatments can be delivered by community or general health workers with adequate training and supervision.
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Despite this evidence, in many countries the treatment gap, i.e. the gap between those who need treatment and those who actually receive it, exceeds 50% even for the most severe disorders.
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This grotesque lack of access to affordable and effective care, and the continuing abuse of human rights of people with mental disorders, stains the conscience of the global health community.
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Despite the overwhelming evidence of suffering, solutions and lack of access, most new global health initiatives completely ignore mental health.
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A number of barriers can be identified which challenge the scaling up of services for people with mental disorders. The lack of a coherent and consensual advocacy message for a global call to action for all stakeholders is a major barrier.
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