Investing in MENTAL HEALTH - World Health Organization

1 Investing inMENTAL HEALTHThis publication was produced by the Department of MENTAL HEALTH and Substance Dependence, Noncommunicable Diseases and MENTAL HEALTH , World HEALTH Organization , further information and feedback, please contact: Department of MENTAL HEALTH and Substance Dependence, Avenue Appia 20, 1211 Geneva 27, SwitzerlandTel: +41 22 791 21 11, fax: +41 22 791 41 60, e-mail: website: Library Cataloguing-in-Publication DataWorld HEALTH in MENTAL disorders - economics disorders - therapy HEALTH services - economics HEALTH services - economics of illness 92 4 156257 9(NLM classification: WM 30) World HEALTH Organization 2003 All rights reserved.

2 Publications of the World HEALTH Organization can be obtained from Marketing and Dissemination, World HealthOrganization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel: +41 22 791 2476; fax: +41 22 791 4857; Requests for permission to reproduce or translate WHO publications whether for sale or for noncommercialdistribution should be addressed to Publications, at the above address (fax: +41 22 791 4806; email: The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatso-ever on the part of the World HEALTH Organization concerning the legal status of any country, territory, city or area or of its authorities,or concerning the delimitation of its frontiers or boundaries.))

3 Dotted lines on maps represent approximate border lines for which theremay not yet be full mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended bythe World HEALTH Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, thenames of proprietary products are distinguished by initial capital World HEALTH Organization does not warrant that the information contained in this publication is complete and correct and shallnot be liable for any damages incurred as a result of its by Tushita Graphic Vision S rl, CH-1226 Th nex, GenevaCover photo: World HEALTH OrganizationPrinted by Nove Impression, Switzerland Introduction3 Executive Summary4 What is MENTAL HEALTH ?

4 7 The magnitude and burdens of MENTAL disorders8 The economic burden of MENTAL disorders14 Promoting MENTAL HEALTH ; preventing and managing MENTAL ill health26 The gap between the burden of MENTAL disorders and resources36 WHO Global Action Programme (mhGAP)40 Much can be done; everyone can contribute to better MENTAL health43 References46 For more information48 Content2 Photo: WHO, P. Virot3 MENTAL HEALTH has been hidden behind a curtain of stigma and discrimination for too long. It is time to bring it out intothe open. The magnitude, suffering and burden in terms of disability and costs for individuals, families and societiesare staggering.

5 In the last few years, the World has become more aware of this enormous burden and the potential for MENTAL HEALTH gains. We can make a difference using existing knowledge ready to be need to enhance our investment in MENTAL HEALTH substantially and we need to do it kinds of investment? Investment of financial and human resources. A higher proportion of national budgets should be allocated to develop-ing adequate infrastructure and services for MENTAL HEALTH . At the same time, more human resources are needed toprovide care for those with MENTAL disorders and to protect and promote MENTAL HEALTH .

6 Countries, especially thosewith limited resources, need to establish specifically targeted policies, plans and initiatives to promote and supportmental needs to invest? All of us with interest in the HEALTH and development of people and communities. This includesinternational organizations, development aid agencies, trusts/foundations, businesses and can we expect from such investment?It should be able to provide the much-needed services, treatment and support to a larger proportion of the nearly 450 million people suffering from MENTAL disorders than they receive at present: services that are more effective andmore humane; treatments that help them avoid chronic disability and premature death; and support that gives them a life that is healthier and richer a life lived with dignity.

7 We can also expect greater financial returns from increasedproductivity and lower net costs of illness and care, apart from savings in other sector outlays. Overall, this investment will result in individuals and communities who are better able to avoid or cope with the stress-es and conflicts that are part of everyday life, and who will therefore enjoy a better quality of life and better Jong-wookIntroductionby the Director-General4 For all individuals, MENTAL , physicaland social HEALTH are vital and inter-woven strands of life. As our under-standing of this relationship grows, it becomes ever more apparent thatmental HEALTH is crucial to the overallwell-being of individuals, societies andcountries.

8 Indeed, MENTAL HEALTH canbe defined as a state of well-beingenabling individuals to realize theirabilities, cope with the normal stressesof life, work productively and fruitful-ly, and make a contribution to theircommunities. Unfortunately, in mostparts of the World , MENTAL HEALTH andmental disorders are not accordedanywhere near the same degree ofimportance as physical HEALTH . Rather,they have been largely ignored publication aims to guide you inthe discovery of MENTAL HEALTH , in themagnitude and burdens of MENTAL dis-orders, and in understanding what canbe done to promote MENTAL HEALTH inthe World and to alleviate the burdensand avoid deaths due to MENTAL disor-ders.

9 Effective treatments and inter-ventions that are also cost-effectiveare now readily available. It is there-fore time to overcome barriers andwork together in a joint effort to nar-row the gap between what needs tobe done and what is actually beingdone, between the burden of mentaldisorders and the resources being usedto address this problem. Closing thegap is a clear obligation not only forthe World HEALTH Organization , butalso for governments, aid and devel-opment agencies, foundations,research institutions and the businesscommunity. Executive SummaryThe magnitude and burdens of the problem As many as 450 million people suffer from a MENTAL or behavioural disorder.

10 Nearly 1 million people commit suicide every year. Four of the six leading causes of years lived with disability are due to neuropsychiatric disorders (depression, alcohol-use disorders, schizophreniaand bipolar disorder). One in four families has at least one member with a MENTAL disorder. Family members are often the primary caregivers of people with mentaldisorders. The extent of the burden of MENTAL disorders on family membersis difficult to assess and quantify, and is consequently often ignored. However, it does have a significant impact on the family s quality of life.