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Treating and preventing mental disorders in low-income and middle-income countries

Lancet

Depression can be treated effectively in low- and middle-income countries with low-cost antidepressants or psychological interventions such as interpersonal therapy, conclude Professor Vikram Patel, London School of Hygiene and Tropical Medicine, UK, and colleagues, authors of this third paper in The Lancet's Global Mental Health Series. The authors say that such interventions, when delivered in primary care, are as cost effective as antiretroviral drugs for HIV/AIDS.

They add that brief interventions, delivered by primary care professionals, are effective for the management of hazardous alcohol use and that low-cost antipsychotic drugs and family focused psychosocial interventions are effective for the management of schizophrenia.

They call for more research on the process and effectiveness of scaling up mental health interventions in low- and middle-income countries; however they say: "We believe that the need for more research must not be used as an excuse to delay the scaling up of mental health systems -- we recommend that policymakers should act on the available evidence to scale up effective and cost-effective treatments and preventive interventions for mental disorders."

They conclude: "Put simply, people are entitled to receive help when ill. We have identified good evidence for what that help might comprise for people with poor mental health."

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