The Burden of Mental Illness in Low and Middle Income Countries
The Burden of Mental Illness in Low and Middle Income Countries Dr Ross White Mental Health and Well-being University of Glasgow Ross.White@glasgow.ac.uk
Global Burden of Disease• The top five leading causes of disability (DALYs) for all ages were (WHO, 2005):• By 2030 unipolar depression will be the No. 1 contributor to total years lived with disability (WHO, 2005).• Mental health difficulties are set to become the leading global cause of disability.
The Mental Health GAP• 4 out of 5 people in low and middle-income countries who need services for mental, neurological and/or substance use disorders do not receive them (MH-Gap, 2008).• Globally, spending on mental health is less than $2 per person, per year. It is 25c in low income countries (WHO, 2011).• When available, the interventions in low income countries are often not evidence-based or of high quality. (MH-Gap, 2008)• Malawi has been identified as a country requiring ‘intensified support’ for mental health services (MH-Gap, 2008).• Marked disparities exist between mental health provision in low and high-income countries.
Human ResourceMedian rates of human resources per 100,000 populationworking in the mental health sector by World Bank incomegroup:
The Brain Drain• The UK, the USA, New Zealand, and Australia employ almost 9000 psychiatrists from India, the Philippines, Pakistan, Bangladesh, Nigeria, Egypt, and Sri Lanka (Kakuma et al., 2011).• Without this migration, many source countries would have more than double (in some cases five to eight times) the number of psychiatrists per 100 000 population (Kakuma et al., 2011).
MSc Global Mental Health• Provide teaching on designing and implementing culturally appropriate mental health services and policies.• A ‘training for trainers’ approach to develop future leaders and policy makers (e.g. Nurse Lecturers from Malawi).• Block method of teaching will allow students to continue to work in their country of origin.• We are keen to collaborate with the SMMHEP: – Malawian students completing the MSc programme. – Senior clinical academics at the University of Glasgow offering supervision and mentorship.
Key points• Mental health difficulties are set to become the leading cause of global disability.• Disparities exist between the provision made for mental health problems in low and high-Income countries. Human resources in low income countries are particularly scarce.• The MSc Global Mental Health will offer high quality education on the design and implementation of mental health services and policies in low and middle income countries.• We are keen for students from Malawi to complete the MSc programme.