Global Mental Health: How Are We Doing?

At Home

The landscape of mental health in the United States is constantly changing. The deinstitutionalization of mental health care, i.e., the shutting down of mental health facilities, has been the pursued mental health policy in the United States for the last 50 years, according to James Panero, writing for the New York Daily News.

According to the Treatment Advocacy Center, 7.9 million in adults in the United States — or 3.3 percent — have severe mental illness. Panero wrote, “In 1955, there were nearly 600,000 mentally ill patients in state psychiatric hospitals. Fifty-five years on, only 43,000 state psychiatric beds remain available for use.”

The Affordable Care Act, aka Obamacare, has expanded coverage for mental health and substance use disorder to include Americans previously without access to health coverage, and expanding coverage by health plans that previously did not include it.

African Countries in Crisis

In the war-torn countries of Africa — Congo, South Sudan, Mogadishu and Uganda — and in refugee camps in Somalia and Dadaab, photojournalist Robin Hammond documented the shocking indignities inflicted upon the mentally ill in those regions.

Hammond’s feature, CONDEMNED – Mental Health in African Countries in Crisis reveals a grim treatment of shackling, exile and beatings.

Shamans and witch doctors are often the only source of treatment. Hammond wrote, “In regions where both fortune and sickness are attributed to the spirit world, mental illness is considered a curse. Spiritual remedies are often sought, and chains regularly used as restraints.”

The suffering of the mentally ill in these countries goes unseen and unaddressed. Hammond hopes his series will create awarementss and inspire action.

China

The World Health Organization has determined that mental illness has overtaken cancer and heart disease as the number one health concern in China. Huang Yueqin, the director of the National Centre for Mental Health in China, conservatively estimates the number of Chinese suffering from mental illness to be 100 million, according to an article in The Telegraph.

During China’s cultural revolution, between 1966 and 1976, mental illness was considered a “bourgeois self-delusion.” While psychiatric care does exist since the end of the cultural revolution, care is limited by a shortage of doctors and facilities.

According to the WHO Mental Health Atlas 2011, there are only 1.53 psychiatrists per 100,000 people in China. Compare that with 7.79 psychiatrists per 100,000 people in the United States. For lack of other options, even the violently mentally ill are habitually released to the care of relatives.

Sharon LaFraniere, writing for the New York Times stated, “China has no national mental health law, little insurance coverage for psychiatric care, almost no care in rural communities, too few inpatient beds, too few professionals and a weak government mental health bureaucracy.”

Europe

A 2010 study published by the European College of Neuropsychopharmacology, estimates that nearly 40 percent of Europeans suffer from mental disorders. The study covered 30 countries, encompassing 514 million people.

Mental and neurological disorders were considered, including depression, bipolar disorders, anxiety disorders, insomnia, addiction and schizophrenia, as well as several neurological disorders, including stroke, epilepsy, Parkinson’s disease and multiple sclerosis.

Disorders of the brain were found to occur much more frequently, and constitute a greater burden of disease, than was previously understood. The ENCP deemed mental illness to be the greatest health challenge of the 21st century.

Latin America

In Latin America, less than 2 percent of the total health budget is allocated to mental health. Like China, Latin America has a dearth of mental health professionals, an estimated 1.9 psychiatrists per 100,000 people, and most of these are in highly populated urban areas, according to World Psychiatry.

Renato Alarcon, writing for World Psychiatry, reported that 64.5 percent of Latin American countries have specific mental health policies, 80.6 percent have plans and programs, 67.9 percent have specific mental health legislation, and 87.1 percent provide disability benefits for psychiatric patients.

Mexico, Argentina, Costa Rica, Chile and Brazil are the most progressive countries with regard to mental health resources and legislation. Alarcon asserted that “Latin American psychiatry has produced significant research contributions, particularly in the areas of epidemiology, clinical studies, cultural issues, and psychopharmacology.”

Sources:

1) The Americanization of Mental Illness. nytimes.com. Retrieved July 2, 2015.
http://www.nytimes.com/2010/01/10/magazine/10psyche-t.html?_r=0

2) Life in Shadows for Mentally Ill in China. nytimes.com. Retrieved July 2, 2015.
http://www.nytimes.com/2010/11/11/world/asia/11psych.html

3) CONDEMNED – Mental Health in African Countries in Crisis. robinhammond.co.uk. Retrived July 7, 2015.
http://www.robinhammond.co.uk/condemned-mental-health-in-african-countries-in-crisis

4) Mental Illness in the Happiest Nation on Earth. psychologytoday.com. Retrieved July 9, 2015.
https://www.psychologytoday.com/blog/know-your-mind/201405/mental-illness-in-the-happiest-nation-earth

5) Nearly 40 percent of Europeans suffer mental illness. reuters.com. Retrieved July 9, 2051.
http://www.reuters.com/article/2011/09/04/us-europe-mental-illness-idUSTRE7832JJ20110904

6) Mental health and mental health care in Latin America. ncbi.gov. Retrieved July 9, 2015.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1525063

7) The danger of closing ‘asylums’. nydailynews.com. Retrieved July 9, 2015.
http://www.nydailynews.com/opinion/insane-violent-street-article-1.1225716

8) The Size and Burden of Mental Disorders in Europe. ENCP Neuroscience applied. Retrieved July 9, 2015.
https://www.ecnp.eu/publications/reports/sizeandburden.aspx

9) China has 100 million people with mental illness. telegraph.co.uk. Retrieved July 10, 2015.
http://www.telegraph.co.uk/news/worldnews/asia/china/5235487/China-has-100-million-people-with-mental-illness.html

10) Mental Health Atlas-2011 country profiles. who.int. Retrieved July 10, 2015.
http://www.who.int/mental_health/evidence/atlas/profiles/en

Reviewed July 13, 2015
by Michele Blacksberg RN
Edited by Jody Smith

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• Emotional Health