2003年-世界发展银行全球_Mental_Health_4页_72kb

Mental Health Summary

Core Content

Mental health is a critical component of overall health and well-being, with significant implications for individuals, families, and societies. Mental and neurological disorders are among the leading causes of disability globally, contributing to a substantial portion of the global burden of disease. These disorders not only affect the individual's quality of life and productivity but also impose heavy economic and social costs, often pushing vulnerable populations into poverty.

Main Points

• Prevalence and Impact: Mental disorders are widespread and disabling, ranking second only to infectious diseases in terms of global burden. They are more burdensome than combined rates of AIDS, TB, and malaria. Depression, in particular, is a major concern, projected to become the leading cause of disability for women by 2020.

• Cost and Disability: Mental disorders reduce employment and productivity, increase health service utilization, and lead to the use of other services such as social services, education, and legal systems. Poor communities are disproportionately affected, with higher rates of mental distress.

• Causes and Myths: Mental illnesses are caused by a complex interaction of social, genetic, traumatic, and infectious factors. There are many myths about their causes, which can hinder effective treatment and support.

• Link to Other Issues: Mental health is closely linked to physical health, economic productivity, and broader development issues. It intersects with areas like violence against women, alcoholism, and HIV/AIDS, highlighting the need for integrated approaches.

Key Strategies for Improvement

1. Policy and Program Development

• Establish or strengthen mental health delivery systems within the framework of primary health care, community-based rehabilitation, and school-based health care.
• Integrate mental health into other health services using a life cycle approach.

2. Information, Education, and Communication (IEC)

• Increase awareness about mental health, its causes, prevention, and available interventions.
• Activities include radio programs, posters, pamphlets, newspaper articles, and education sessions in communities and workplaces.

3. Training and Capacity Building

• Train health workers, teachers, social workers, and community-based rehabilitation personnel to recognize and manage or refer patients with mental health problems.
• Develop training curricula and workshops for continuous education and core training.

4. Quality and Standards

• Develop and implement standards and guidelines for the management of common mental health problems.
• Train all service providers to use these guidelines and evaluate successful interventions.

5. Referral and Supervisory Systems

• Establish or strengthen referral systems to ensure appropriate care pathways.
• Develop support supervisory systems to monitor and improve the quality of care provided by frontline workers.

6. Data Collection and Management

• Implement a mental health Management Information System (MIS) to collect, compile, analyze, and disseminate routine mental health data.
• This system should be integrated across all levels of care and relevant sectors.

Do's and Don'ts in Mental Health Services

Do's

• Create Demand: Invest in health education to combat stigma and raise awareness about mental health disorders and their management.
• Improve Access: Integrate mental health into primary health care, community-based rehabilitation, and school health programs.
• Include in Policies: Ensure mental health is part of national and local health, social, and educational policies and budgets.
• Develop Standards: Create sector-specific standards and guidelines for mental health care.
• Ensure Drug Access: Include common mental health drugs in the Essential Drug List based on safety, cost, and effectiveness.
• Engage Traditional Therapists: Explore the role of traditional healers in mental health care, especially in regions where they are widely used.
• Promote Inter-Sectoral Collaboration: Strengthen linkages between health, education, social welfare, and other sectors through a Mental Health Co-ordinating Committee.

Don'ts

• Avoid stigmatizing mental health issues and ignore the role of social determinants in mental health.
• Do not neglect the integration of mental health into broader health and development strategies.

Examples of Potential Best Buys in Different Situations

Key References

• World Bank Group Note on Alcoholic Beverages, 2001
• WHO, Integrating a Mental Health Component into Primary Health Care, 1990
• WHO, Global Action for the Improvement of Mental Health Care: Policies and Strategies, 1996
• R. Desjarlais et al, World Mental Health: Problems and Priorities in Developing Countries, 1995
• WHO World Health Report 2001: Mental Health: New Understanding, New Hope

Key Web Sites

• World Health Organization
• World Bank
• International Consortium for Mental Health Policy and Services