Mentally ill getting little or no treatment worldwide

11 September, 2007

Most mentally ill people in the world are not getting any treatment at all and scarce mental health resources are not reaching those who need them most.

A study conducted by Dr Philip Wang and colleagues of the United States National Institute of Mental Health has said that the treatment data they have are “pretty troubling.”

The study has been published in the British medical journal The Lancet.

Dr Philip Wang and his team studied mental health treatment data on 84,850 adults in 17 developed and developing countries taken from the World Health Organization's mental health surveys.

The lack of mental health treatment was most severe in less-developed countries, where only a few people with serious disorders received any treatment in 2006.

But, even in developed nations, roughly half of those with severe disorders got no care at all.

“Even in the United States,” Dr Wang noted, “which is by far the country with the most resources, mental health treatment is by no means adequate. In the US, of the folks who meet the criteria for the most serious illness, only about half get anything. Many are not receiving healthcare at all. The situation is concerning.”

Patients who are male, married, less-educated, and at the extremes of age or income got the least amount of care, the researchers found.

As was expected, the number of people using any mental health services was generally lower in developing countries compared with developed countries.

The researchers also found a correlation between use of mental health services and the percentage of a nation’s gross domestic product spent on
health services.

Dr Wang and colleagues also found that resources are poorly allocated when they are used.

Meanwhile, the United Nations’ World Health Organization (WHO) has appealed to countries to increase their investment and support for those with mental disorders.

Catherine Le Galès-Camus, WHO’s assistant director-general for Non-communicable Diseases and Mental Health said “this topic should matter to everyone, because people living with mental disorders in low-income and middle-income countries are systematically locked out of the benefits of development that are open to others. When not addressed, mental disorders deprive people of opportunities to escape from poverty and deny them a voice to claim their rights.”

Even when treatment is available, it is often delivered in institutional settings, which in many countries are associated with stigma and human rights violations, WHO noted.

Low-income countries have an average of 0.05 psychiatrists and 0.16 psychiatric nurses per 100,000 people (about 200 times less than in high-income countries) and those extremely low rates make it impossible for satisfactory services to be delivered.

The current situation means that people with mental illnesses are at best ignored and at worst actively discriminated against in many countries, according to Benedetto Saraceno WHO’s director of Mental Health and Substance Abuse.