A patient at a psychiatric hospital in Addis Ababa
Mental health disorders affect a significant number of people in developing countries, but the sector does not receive enough resources for treatment and services, say experts.
This is the conclusion of a WHO study comparing mental health services in 17 low-, middle- and high-income countries — including China, Colombia, Lebanon, Mexico, Nigeria and South Africa — published in The Lancet last week (7 September).
Guilherme Borges — from Mexico's National Institute of Psychiatry and one of the study's authors — says that in Mexico mental disorders, such as depression or alcohol and drug abuse, rank highly in terms of the number of people affected. But the area does not receive comparable attention in terms of healthcare delivery.
Other low- and middle-income countries have similar problems.
"In Nigeria there is a significant lack of interest by the policymakers in mental health. It doesn't receive as much attention as infectious diseases," says Oye Gureje, another of the study authors and head of the Department of Psychiatry at Nigeria's University College Hospital in Ibadan.
The study found that the proportion of people receiving services related to the percentage of gross domestic product (GDP) spent on healthcare.
Low- and middle-income countries generally spend less than one per cent of already small health budgets on mental health services.
The exception was South Africa, which spends a larger proportion of its GDP on healthcare and had higher rates of mental health treatment than the other developing countries in the study.
People with serious mental illness — such as bipolar disorder — were found to suffer the most, with inadequate access to treatment, and a lack of adequate follow-up care.
And in China, in contrast to the other countries surveyed, people with severe mental disorders were actually less likely to receive care.
Gureje says that in Nigeria, "There is a low status given to training for taking care of people with mental health problems, so many people with common mental health problems may not be recognised."
He believes the problem can be tackled by reorganising the health system and better allocating mental health resources so that those most in need receive treatment.
The authors write that comparison studies such as this — along with future, more detailed studies — will be valuable in guiding policymakers in developing countries to redesign mental health policies and the funding and delivery of healthcare.
Reference: The Lancet 370, 841 (2007)
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