Uneven Global Progress On Treatment Of Mental Illness

Four years ago, the influential medical journal The Lancet ran six papers and assorted editorialson mental illnesses. The themed collection, under the banner “No health without mental health,” was a call to action for the world humanitarian community.

So how much influence did the articles have? The journal’s editors commissioned a new batch of papers to find out. The latest reports come from researchers and policy analysts at universities, non-governmental organizations and governments around the world.

Turns out there’s been some encouraging progress in figuring out what needs to be done, but progress in actually getting help for people has been slow.

One of the things the new studies show is that different treatments work, but they have to be selected carefully.

For example, an analysis of programs that address poverty — a fellow traveler with mental illness — show that just giving people money, in the form of microloans or cash, often doesn’t help. The study showed more consistent improvement with interventions such as individual or group talk therapy, or psychiatric drugs.

An analysis of psychiatric aid offered to victims of traumatic situations such as war or natural disaster found that at least for adults, psychotherapy and setting up social supports like education and group discussions helps. But the authors of the report say funders often lose interest after the initial crisis passes.

That’s a common refrain. Spend any time talking to folks who work with mentally ill people in poor countries, and they’ll tell you that they consider their programs seriously underfunded, in no small part because of stigma. “Many people don’t want to be associated with mental illness,” says Julius Kayiira, who runs Mental Health Uganda. And others “think there’s no hope,” he adds.

A survey of 87 countries showed more than half the countries reported more or much more awareness of mental illnesses in the past three years. The downside? There’s not a whole lot of new money behind that awareness.

There are other signs that show mental illnesses are struggling to get the attention of funders. World Mental Health Day came and went last week without much notice.

In September, the United Nations sponsored a major conference on non-communicable diseases. Mental illnesses got a short mention in the list of goals, but the conference itself focused on cardiovascular diseases, lung diseases, diabetes and cancer. There was almost nothing on mental illness.

That’s despite an analysis by the World Economic Forum that showed that the direct and indirect costs of mental illnesses in 2010 totaled $2.5 trillion — three times the cost of cardiovascular diseases.

Christina Ntulo, a co-author of one of the papers in The Lancet and head of the Uganda division of BasicNeeds, a mental health NGO, says the trick may be to show how mental health affects physical health. “And in the last three years, there’s been a lot of research showing links between mental health, maternal health and child health,” she says.

Another author — a leader of the global mental health movement — says what’s holding things back is the lack of appreciation of mental illnesses as real diseases, with real burdens. What’s needed, says Vikram Patel of the London School of Hygiene and Tropical Medicine, is for the various advocates to get together and speak with one voice about the need for the global health community to focus on mental illness. Will that happen? “Yes,” he says, “because there’s growing demand for it.”

By Joanne Silberner


Americans’ Mental Health Disabilities on the Rise

A new study discovers American adults are reporting an increase in mental health disability compared to prior decades.

Ramin Mojtabai, M.D., Ph.D, of the Johns Hopkins Bloomberg School of Public Health also found that the prevalence of disability attributed to other chronic conditions decreased while the prevalence of significant mental distress remained unchanged.

“These findings highlight the need for improved access to mental health services in our communities and for better integration of these services with primary care delivery,” said Mojtabai.

“While the trend in self-reported mental health disability is clear, the causes of this trend are not well-understood.”

For the study, Mojtabai reviewed data from the U.S. National Health Interview from 1997 to 1999 and from 2007 to 2009. He discovered nearly 2 million more disabled adults self-reported mental health disability in the current decade.

Mojtabai noted the increase in the prevalence of mental health disability was mainly among individuals with significant psychological distress who did not use mental health services in the past year.

Findings showed that 3.2 percent of participants reported not receiving mental health care for financial reasons between 2007 and 2009, compared to 2.0 percent from 1997 to 1999.

The findings will appear in the November edition of the American Journal of Public Health.

Reported by Rick Nauert PhD
Psych Central

UN summit puts global disease cost at $47 trillion by 2030

More and more people around the world are suffering from heart disease, chronic respiratory disease, cancer, diabetes and mental health woes. Now a new study from the World Economic Forum puts a price tag on the burden of these non-communicable diseases.

The study – called The Global Economic Burden of Non-communicable Diseases – found these five common, chronic diseases will cost the world $47 trillion by 2030. Mental health illnesses alone will account for $16 trillion in costs and lost wages. The findings were released before a United Nations summit on non-communicable diseases.

“Until now, we’ve been unable to put a figure on what the World Health Organization calls the ‘world’s biggest killers’,” Olivier Raynaud, the WEF’s senior director of health, said in a written statement. “The numbers indicate that non-communicable diseases have the potential to not only bankrupt health systems but to also put a brake on the global economy.”

Non-communicable diseases – diseases that aren’t infectious – kill 36 million people per year. Low and middle-income countries have it worst – 80 percent of non-communicable disease deaths occur in poorer countries, prematurely killing working age people. The study found that heart disease, chronic respiratory disease, cancer, and diabetes will cost low- and middle-income countries are estimated $500 billion per year.

But there’s a silver lining. The World Health Organization (WHO) says these diseases can be prevented and treated for as little as $1.20 per person.
“Noncommunicable diseases are the leading cause of death worldwide, killing ever more people each year,” Dr. Ala Alwan, assistant director-general for non-communicable diseases and mental health at the WHO, said in a written statement. “This study proves that there are affordable steps all governments can take to address non-communicable diseases.”

The organization outlined several tactics for preventing chronic disease. There are measures that target the population, such as alcohol and tobacco taxes, smoke-free environments, public health initiatives, and campaigns to reduce salt and trans fat consumption. On an individual level, tactics focus on disease screening, counseling, immunizations – like the HPV and Hep-B vaccines that prevent cervical, liver cancer – and drug therapy. The organization said countries that have already taken these steps have seen a “marked reduction” in disease incidence and deaths.

“Think of what could be achieved if these resources were productively invested in an area like education,” Professor Klaus Schwab, executive chairman of the World Economic Forum, said in a written statement. “The need for immediate action is critical to the future of the global economy.”

Click here to read the World Economic Forum’s report.

Reported by Ryan Jaslow

Study Shows More Mental Illness, but Decline in Getting Help

A few months ago, Dr. Ken Duckworth, a psychiatrist in Massachusetts, was swimming in his community’s pool, chatting with other swimmers. When he mentioned his profession, one man wanted Duckworth’s opinion on his struggles with depression; another asked for advice on a family member’s schizophrenia.

“I was sort of amazed. They were talking openly about their psychological vulnerabilities with a stranger in a swimming locker room,” said Duckworth, the medical director for the National Alliance on Mental Illness. “That wouldn’t have happened 15 years ago.”

New research shows that these swimmers aren’t the only ones opening up. According to a new study, more American adults than ever are reporting being disabled by the symptoms of depression, anxiety or other emotional problems.

The report, published Thursday in the American Journal of Public Health, found that people who said they couldn’t perform everyday tasks or engage in social and leisure activities because of a mental illness increased from 2 percent in 1999 to 2.7 percent in 2009. That increase amounts to nearly 2 million more people disabled by mental distress in the past decade, the report said….

Reported by CARRIE GANN