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Around 450 million people worldwide suffer from some form of mental health disorder. In developing countries depression is ranked the seventh biggest health burden. War, poverty and disease all increase levels of mental illness further, but lack of resources, and competing priorities, mean most developing countries put less than 1% of their health expenditure towards this area. Across the developing world mental health disorders cause staggering economic and social costs.
Mental health is a fundamental part of a person’s well-being, allowing them to function effectively on their own and in their communities. Not surprisingly, mental illness becomes more common among the disadvantaged – those living in poverty, with little education, poor housing, and limited access to health care – as feelings of insecurity and hopelessness increase. Fast changes in society, increased levels of violence, and physical ill health all further undermine mental health.
People with mental health disorders also face stigma, discrimination, and even violence in many parts of the world. Ostracised in their communities they are often left without any care, while those who do receive care in institutions can find they are subject to degrading treatment, abuse and neglect. Discrimination makes accessing services harder, and legislation in some countries even curtails their basic rights to things such as voting, marriage and children.
Excluded from health systems and funding
In most developing countries mental health services have suffered decades of neglect and underfunding, and are chronically short of money and skilled staff. Developing countries have only 0.05 psychiatrists and 0.16 psychiatric nurses per 100,000 people. This is 200 times less than in wealthy countries. Most developing countries have only one child psychiatrist for every 1–4 million people. Where money is spent, it usually goes towards providing specialist treatment in psychiatric hospitals, rather than integrating mental health into more general health services and promoting community health solutions.
Global health initiatives have also tended to ignore mental health issues, making the fight against infectious diseases such as HIV and tuberculosis a higher priority. But unless better care and treatment for mental illness becomes available, developing countries will be further handicapped in the future by its rising social and economic costs.
Efforts to promote mental health need to take a holistic view, taking into account the broad range of economic and social issues that support or undermine mental health. Early support to children, promoting gender equality, tackling stigma and discrimination against marginalised and vulnerable groups, and reducing violence are all cost-effective ways of improving mental health.
Health Poverty Action says:
- Governments must do more to raise awareness and change attitudes to mental health. This includes promoting human rights in general, and in mental health institutions in particular.
- Governments need to prioritise funding for mental health and challenge the view that investment in mental health is not cost-effective.
- Mental health promotion needs to be considered in the policies and plans of all parts of government, from health and education, through to justice, transport, environment, housing and welfare.
