A global problem
Mental health issues are an increasing concern globally and have escalated to significant proportions in the last decade. According to the World Health Organization (WHO), mental health disorders are now the leading cause of disability worldwide.
Mental health disorders can have a profound impact on individuals, families, organizations, communities, and societies. They can lead to a whole range of negative outcomes including a reduced quality of life, decreased productivity, stress and breakdown, and increased risk of physical health problems. Secondarily, the collateral effect of this problem, on the spouse, children, family, caregivers, and others can cause immense negativity and stress.
Earlier, people were hesitant to talk about their mental health struggles due to stigma, lack of understanding, and the fear of being judged or ostracized. This also prevented them from seeking help and mental health services were often inaccessible. However, in recent years, especially during Covid, mental health gained attention and awareness, and post Covid, people are more open to talking about their mental health struggles.
Common mental health concerns such as depression and anxiety contribute to the global burden of disease, and this is compounded by the widening “mental health treatment gap” where, worldwide, more than 70% of persons who need mental health services lack access to care. This huge “mental health treatment gap” is the result of increased demand, lack of insurance coverage, shortage of mental health professionals and mental health facilities, the stigma surrounding mental illness, a lack of access to mental health services in rural or remote areas, and several other factors.
Requires a multi-pronged approach
To address these challenges, globally, there are several initiatives being undertaken. To help decrease the global mental health treatment gap, the World Health Organization (WHO) has developed the Mental Health Gap Action Programme Intervention Guide (mhGAP-IG), through a systematic review of evidence followed by an international participatory consultative process. The mhGAP-IG comprises straightforward, user-friendly, diagnosis-specific clinical guidelines for providing evidence-based practices.
Mental health awareness campaigns launched by various organizations are helping to reduce the stigma associated with mental illness and encouraging people to seek treatment without fear of discrimination or negative social consequences.
Also, there is a growing trend towards telemental health services, which allow people to access mental healthcare services remotely. This is particularly helpful for those living in rural or remote areas where there is a shortage of mental health professionals. There is also the comfort of anonymity while seeking telemental health services.
Another initiative that is being undertaken is the integration of mental health care into primary care settings. This approach recognizes that mental health conditions often co-occur with physical health conditions, and integrating mental health care into primary care can improve outcomes for patients with both types of conditions.
A prioritization for governments
Addressing this challenge of the treatment gap also requires governments to institute policies and laws that require insurance providers to offer comprehensive mental health coverage. A serious shortage of mental health professionals in underserved regions is another area that needs attention and hence governments must invest in mental health workforce training programs and incentivize mental health professionals to work in such areas.
Governments and healthcare organizations should increase funding for research on mental health which can help identify effective treatments and interventions and provide policymakers with evidence-based recommendations for improving mental health care. Telepsychiatry and other digital mental health intervention platforms should be set up by the government to help increase access to mental health care in underserved regions and reduce the treatment gap.
Special focus on women and children is important
Given the magnitude of the burden of mental disorders, treatment alone will be insufficient to close the mental health treatment gap. Creating awareness, prevention, and seeking timely help also can help in bridging this gap. One promising area of prevention includes focusing on the mental health of children.
Research shows that onset of mental disorders could occur as early as during childhood and adolescence. Undetected and untreated mental disorders occurring early in life lead to lifelong disability and to early, preventable death. Thus, attention to child mental health should be a priority and governments should introduce early screening programs in schools and colleges.
Focusing on women’s mental health should be another component of a strategy for preventing mental disorders. In a longitudinal study in the USA, children of women with depression were found to be five times more likely to develop depression during the course of their lives, compared to children of women without depression. Therefore, the government should have effective mental health screening and interventions for mothers, during the perinatal period as this could potentially prevent the onset of common mental disorders in these mothers and ultimately influence the mental health of their offspring.
In summary, improving access to quality mental health care for all and reducing the global mental health treatment gap requires a collective effort from governments, healthcare organizations, mental health professionals, and communities.
Vasudha Raghunandan
Sr. Mental Health Counselor,
Merago Inc. Mountain View, California
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