Bridging the Treatment Gap for People with Mental Illness

Abstract

In 2010, mental and substance use disorders accounted for around 7·4% of all DALYs (disability-adjusted life years) worldwide. Mental illness has become a contributing cause of disability claims in many developed countries. Despite many undesired effects and costs to the nation, it is estimated that between 76% and 85% of people with serious mental disorders receive no treatment for their disorder in low-income and middle-income nations. For high-income nations, the corresponding estimates range between 35% and 50%. Treatment is hindered by several factors: attitudinal barriers, including stigma associated with receiving treatment; inadequate resources devoted to mental health sector; spread of the low wage non-standard employment, accentuating financial barriers to treatment; inadequate emphasis on early treatment and psychiatric diagnosis for children and adolescents; lack of integration of mental health into primary care facilities; disproportionate emphasis on psychiatric institutions compared to cost-effective community-based services; and information-related barriers, including non-existent population-based surveys and poor surveillance systems in many countries. The present work examines the progress and challenges in implementing evidence-based strategies and interventions for bridging the treatment gap.