Public Mental Health

Abstract

Globally, mental disorder and self-harm accounts for 22.0% disease burden (as measured by years of healthy life lost to disability). Even this figure underestimates the large burden which is due to a combination of high prevalence, most lifetime mental disorder arising before adulthood, and mental disorder having a wide range of impacts. These impacts include higher rates of health risk behaviour, physical illness (non-communicable and communicable) as well as reduced life expectancy, educational and employment outcomes. Annual global economic cost of mental illness was estimated to be $2493 billion in 2010 and projected to grow to $6046 billion by 2030. A range of cost-effective evidence-based interventions exist to treat mental disorder, prevent associated impacts, prevent mental disorder from arising and promote mental wellbeing including for those recovering from mental disorder. Many such interventions also result in early net economic savings which can be calculated at national, regional and local levels. However, coverage of public mental health interventions is poor: Only a minority of people with mental disorder receive treatment even in high-income countries with far less coverage in low- and middle-income countries. Even lower coverage occurs for interventions to prevent associated impacts such as premature mortality, prevent mental disorder from arising or promote mental wellbeing. The public mental health intervention gap has a broad range of impacts and associated economic costs. Public mental health practice takes a population approach to mental health and facilitates improved provision, outcomes and coordination of public mental health interventions to sustainably reduce burden of mental disorder and promote population mental health. Assessment of the size, impact and cost of the national, regional or local public mental health intervention gap supports improved coordination with other sectors, strategic planning, advocacy for resourcing and improved coverage of interventions. Public mental health capacity can also be enhanced through education and training, settings based approaches, use of technology, implementation of mental health policy, legislation and adopting a human rights approach to access. Public mental health practice facilitates better integration between different sectors and appropriate resourcing which can be supported by estimating the local impacts of improved coverage of public mental health provision including associated economic savings.