Learning lessons in mental health care from around the world

8 August 2011

Originally posted in the HSJ blog Leadership in Mental Health, 25 July, 2011

Earlier in July, the journal Nature published a worldwide “call for urgent action” in research into mental health. The article, Grand challenges in global mental health, is based on an international review of “the priorities for research in the next 10 years that will make an impact on the lives of people living with [mental health, substance use and neurological] disorders”.

It is, inevitably, an ambitious undertaking that illustrates above all the burden of ill health worldwide that is linked to the wide range of mental health problems. Depression alone costs some 65 million disability-adjusted life years (DALYs) while alcohol misuse accounts for 23 million and schizophrenia nearly 17 million.

The article is also a reminder that mental health conditions receive a much smaller share of research funds than their prevalence and their impact on people’s lives would merit. The total fund of research into mental health conditions is simply not enough to tackle the level of need that exists.

As a result, the authors set out their 25 top priorities for research into mental health, sorted into six groups. While some of the priorities were specific to the developing world, most are applicable to the UK and address some of the biggest challenges we face in improving mental health across society and in improving the lives of people affected by mental illness.

Some of the most important priorities focus on prevention and early intervention. They include reducing the ‘duration of untreated illness’ which we know for many conditions has a major bearing on both the speed and success of recovery, and tackling key determinants of poor mental health such as child poverty and abuse.

Other priorities focus on improved responses to the needs of people with mental ill health, such as better screening in primary care and improved community care. And there are major workforce issues such as improving mental health knowledge among all health professionals and increasing the role of lay health workers in providing effective treatments.

Global “grand challenges” can seem a long way from the real world of mental health care and support. Yet while they should be first and foremost a reminder of the pressing need for more research funding for mental health, they do point to some of the biggest issues we all face now in improving the quality of care people get in a time of scarcity of resources.

They also serve as a reminder that countries around the world can all learn from each other. While mental health care in the UK is widely regarded as being among the best in the world, we can still learn from the efforts of services in developing nations that are working in much more straitened circumstances, often without the elaborate exclusion criteria that we apply to people and the silos in which we work.



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