Huge increase in resources for mental disorders required worldwide

Scarcity of resources for mental health, inequity in access to them, and inefficiencies in their use have serious consequences, the most direct of which is that people who need care get none. In this second paper in The Lancet Series on Global Mental Health, titled “Resources for mental health", Dr Shekhar Saxena, World Health Organisation, Geneva, Switzerland, and colleagues say that, particularly in low- and middle-income countries, government spending on mental health is far lower than needed. Almost a third of countries worldwide do not have a specified budget for mental health and one-fifth of those that have, spend less than 1% of their health budget on mental health.

The authors also discuss how mental health depends on human, rather than technological, resources. Shortages of health-care professionals have been shown to the main limiting factor in delivering mental health care in most low and middle income countries. Inequities are also rampant in the mental health field: While poverty and low education predispose people to mental disorders, services seem to be less accessible to the very same groups. Stigma around mental disorders further constrains use of available resources. People with mental illness are also vulnerable to abuse of their human rights, particularly where treatment is involuntary. Inefficiencies in the use of resources are widespread; while community-based care has been demonstrated to be more cost-effective, most mental health systems still allocate majority of their budget to mental hospitals.

The authors say that increased global awareness on the mental health needs has yet not been translated into greater investment of resources. The result is that as many as one in three people with schizophrenia and one in two with other mental disorders do not receive any treatment. Referring to what they consider to be the three obstacles of severe scarcity of resources, inequities in their distribution, and inefficiencies in their use, the authors conclude: "Innovative, concerted, and sustained efforts are needed to remove these obstacles and achieve better mental health."