The rights of people with mental disorders: WPA perspective

Abstract

The first indisputable right of a person with a mental disorder is to find in the public health system a professional who is able to understand the nature of that disorder. This statement might seem trivial, but it is not. A meta-analysis of the available evidence showed that more than half of cases of depression are not recognised by non-psychiatrist physicians. 1 Cepoiu M McCusker J Cole MG Sewitch M Belzile E Ciampi A Recognition of depression by non-psychiatric physicians—a systematic literature review and meta-analysis. J Gen Intern Med. 2008; 23: 25-36 Crossref PubMed Scopus (270) Google Scholar Indeed, depression is a good example of a common mental disorder whose diagnosis requires a lot of expertise, such as the ability to differentiate the disorder from transient states of demoralisation or grief, from various physical diseases, and from other mental disorders. A mistake in this differential diagnosis can have serious consequences. There are no laboratory or instrumental tests on which to base the diagnosis of depression (or other mental disorders), thus the clinical acumen and experience needed to make this diagnosis are more (not less) substantial than those needed to make other medical diagnoses. Furthermore, differentiation between unipolar and bipolar depression, or between depression with and without psychotic features, is not a mere academic exercise, but has pronounced therapeutic implications. Mental health and psychosocial support in humanitarian settings: linking practice and researchThis review links practice, funding, and evidence for interventions for mental health and psychosocial wellbeing in humanitarian settings. We studied practice by reviewing reports of mental health and psychosocial support activities (2007–10); funding by analysis of the financial tracking service and the creditor reporting system (2007–09); and interventions by systematic review and meta-analysis. In 160 reports, the five most commonly reported activities were basic counselling for individuals (39%); facilitation of community support of vulnerable individuals (23%); provision of child-friendly spaces (21%); support of community-initiated social support (21%); and basic counselling for groups and families (20%). Full-Text PDF Scale up of services for mental health in low-income and middle-income countriesMental disorders constitute a huge global burden of disease, and there is a large treatment gap, particularly in low-income and middle-income countries. One response to this issue has been the call to scale up mental health services. We assess progress in scaling up such services worldwide using a systematic review of literature and a survey of key national stakeholders in mental health. The large number of programmes identified suggested that successful strategies can be adopted to overcome barriers to scaling up, such as the low priority accorded to mental health, scarcity of human and financial resources, and difficulties in changing poorly organised services. Full-Text PDF Poverty and mental disorders: breaking the cycle in low-income and middle-income countriesGrowing international evidence shows that mental ill health and poverty interact in a negative cycle in low-income and middle-income countries. However, little is known about the interventions that are needed to break this cycle. We undertook two systematic reviews to assess the effect of financial poverty alleviation interventions on mental, neurological, and substance misuse disorders and the effect of mental health interventions on individual and family or carer economic status in countries with low and middle incomes. Full-Text PDF Child and adolescent mental health worldwide: evidence for actionMental health problems affect 10–20% of children and adolescents worldwide. Despite their relevance as a leading cause of health-related disability in this age group and their longlasting effects throughout life, the mental health needs of children and adolescents are neglected, especially in low-income and middle-income countries. In this report we review the evidence and the gaps in the published work in terms of prevalence, risk and protective factors, and interventions to prevent and treat childhood and adolescent mental health problems. Full-Text PDF Human resources for mental health care: current situation and strategies for actionA challenge faced by many countries is to provide adequate human resources for delivery of essential mental health interventions. The overwhelming worldwide shortage of human resources for mental health, particularly in low-income and middle-income countries, is well established. Here, we review the current state of human resources for mental health, needs, and strategies for action. At present, human resources for mental health in countries of low and middle income show a serious shortfall that is likely to grow unless effective steps are taken. Full-Text PDF Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisisThis report reviews the evidence for the types of human rights violations experienced by people with mental and psychosocial disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD). The article draws on the views, expertise, and experience of 51 people with mental and psychosocial disabilities from 18 low-income and middle-income countries as well as a review of English language literature including from UN publications, non-governmental organisation reports, press reports, and the academic literature. Full-Text PDF A renewed agenda for global mental health4 years ago, The Lancet published a Series of articles highlighting the global health crisis due to an astonishingly large treatment gap: up to nine of ten people with a mental health problem do not receive even basic care in some countries. The Series showed that this gap was not due to insufficient evidence about the effect of mental health problems or their effective treatment, but to a range of barriers operating at all levels of the health system, from global policies through to local health-care provision. Full-Text PDF