February 28, 2012

expert reaction to paper on global mental health challenges

The SMC circulated reactions to a report on the challenges facing global mental health, published in PLoS Medicine.

Graham Thornicroft, Professor of Community Psychiatry, Institute of Psychiatry, King’s College London, said:

“In my view this is a very important paper.

“The fact is that, despite decades of (largely) concerted action, global mental health has not changed much, and mental health has not become a higher priority (data from WHP m h atlas 2011 compared with 2005).

“What has changed is that we now know more clearly the huge global impact of mental disorders.”

Andrew McCulloch, Chief Executive of the Mental Health Foundation, said:

“In today’s world, mental health simply can’t be “swept under the carpet”, consigning millions of people to a life of hopelessness.

“It’s essential that we improve awareness of the effective responses that help people recover from mental illness and play a full role in their communities.

“The evidence is there, but we need a coherent, accessible and centralised international evidence base. This will drive forward mental health policies and services on a global scale.

“Governments also need to understand that physical health and mental health are inextricably linked. Poor mental health is associated with an increased risk of diseases such as cardiovascular disease, cancer and diabetes, while good mental health is a known protective factor. Good health only comes when both physical and mental health needs are addressed.”

Dr Peter Byrne, Associate Registrar of the Royal College of Psychiatrists, said:

“This is a welcome and timely paper, highlighting that even in developed countries, mental health spending is being cut. In the minds of mental health professionals, we think we have won the arguments about disease burden and cost-effective interventions, but the authors evidence our failure to convince national governments and beyond. We have much to learn from patients, clinicians and researchers who have brought other issues (maternal mortality, HIV) to international attention, and worked with governments to reduce morbidity and mortality from them. We agree that speaking with one voice about key mental health challenges is the necessary first step.”

Dr Lucie Cluver, Lecturer in Evidence-Based Social Intervention, University of Oxford, said:

“Crick and Tomlinson’s excellent paper comes in the same month as the World Health Organisation’s new resolution to reduce the global burden of mental health. But behind these documents are millions of real people who need and deserve our help. Yesterday, in rural South Africa, a fourteen-year old girl told me she was going to kill herself, because she couldn’t bear to live with the unhappiness she felt. Last week I met a woman who was too depressed to take essential medication. For them, and for the other millions of people affected by mental health challenges, now is the time to take action.”

Vikram Patel, Professor of International Mental Health, London School of Hygiene and Tropical Medicine, said:

“The authors rightly draw upon one of the key, and possibly unique, barriers facing global mental health, which are the continuing debates around the validity of the diagnoses of some mental disorders, leading to the risk of medicalising the trials and tribulations of everyday life and exporting inappropriate concepts to different cultures around the world. While these concerns are important, they must not be allowed to become excuses to avoid addressing the intolerable levels of denial of care and the right to a life with dignity which so many millions with mental disorders around the world have to contend with every day.”

‘Why Does Mental Health Not Get the Attention It Deserves? An Application of the Shiffman and Smith Framework’ by Tomlinson, M. and Lund, C., be published in Public Library of Science Medicine on Tuesday 28th February 2012.