Session 2: Carol Brayne
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Global mental health is a significant public health issue, with around 450 million people worldwide suffering from neuropsychiatric conditions. Depression is one of the leading causes of disability worldwide. Large international studies like the 10/66 study have helped measure the prevalence of mental disorders across different countries and cultures, finding that conditions like dementia and depression are highly prevalent and associated with substantial disability. However, there remain many barriers to improving mental health globally, including insufficient funding, stigma, and lack of trained healthcare workers. Advocacy is needed to promote human rights and reduce treatment gaps for mental disorders.
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Session 2: Carol Brayne
- 1. Global mental health & public health Carol Brayne Matthew Prina Cambridge Institute of Public Health
- 2. The Cambridge Institute of Public Health (CIPH) A federation and platform to foster and support public health research, training & service
- 6. Mental Health & Mortality WHO 2010
- 7. Depression leading cause of burden of disease by 2030? WHO 2004
- 10. Measuring the prevalence of mental disorders example – later life
- 11. Ageing population across the world
- 15. 10/66 sites
- 16. Dementia *Standardised for age, sex, and education. Prince et al. Lancet. 2008 August 9; 372(9637): 464–474.
- 17. Prevalence of depression Guerra et al. (submitted)
- 18. Needs for care
- 19. Need for care ‘much of the time’ independently attributable to different health conditions Condition Prevalence Adjusted Prevalence ratio PAF Major Depression 1.5% 2.0 2 % 3 or more physical illnesses 9.9% 1.9 23% Stroke 7.8% 2.5 10/66 Dementia 10.8% 17.8 65%
- 22. Overcoming Barriers to Mental Health in Health
- 23. Insufficient funding (% health expenditure) Prina et al. (In preparation)
- 24. Treatment gaps for mental disorders - world Kohn et al. WHO Bulletin 2004
- 26. ‘ The Movement for Global Mental Health aims to improve services for people with mental disorders worldwide. In so doing, two principles are fundamental: first, the action should be informed by the best available scientific evidence; and, second, it should be in accordance with principles of human rights ’ http://www.globalmentalhealth.org
Editor's Notes
- Current aims to foster and support public health research training and service
- 1 DALY = the loss of the equivalent of one year of full health Enables comparison of impact of disorders that cause early death but little disability (eg. drowning or measles) with those that do not cause death but do cause disability (e.g. cataract causing blindness) It combines YLL (years of life lost) due to deaths and YLD (years lived with disability) for equivalent healthy years of life lost through living in states of less than full health for cases of disease and injury incident
- The prevalence of 10/66 dementia varied between 5·6% and 11·7% by site, whereas that of DSM-IV dementia was much lower ( 0.4% - 6.4 ). However, the false positive rate, which varied between 1% and 10% across regions and levels of education, might be one factor accounting for the higher prevalence of 10/66 dementia.
- A high proportion of people needed care in particular in the Latin American sites.
- population attributable fractions = represent the proportion of needing much care which could be avoided if depression, physical illnesses or dementia could be removed as a problem from these populations. And it is two thirds in the case of dementia.
- What was found was that on the basis of empirical research, dementia was overwhelmingly the most important independent contributor to disability for elderly people in countries with low and middle incomes. And given the societal costs associated with disability, which are enormous, chronic diseases of the brain and mind deserve increased prioritisation.