mental health


Visualizing the global burden of mental illness in women | 

Mental Illness
Flickr, porschelinn

Mental health problems have a profound impact on men and women worldwide, but the toll of these diseases weighs most heavily on women. Worldwide, depression is responsible for more healthy years lost than HIV/AIDS or malaria in women of all ages.

Globally, depression (also known as major depressive disorder, or MDD) was the top cause of disability among females in 2010 (see screen grab). Disability from depression increased by 37% in females between 1990 and 2010. Anxiety, another mental disorder, ranked sixth. In comparison, depression and anxiety were the second- and 11th-leading causes of disability in males, respectively, in 2010. Clearly, mental health is an important issue for males as well as females, but these diseases are more prominent in females. In 2010, the rate of healthy years lost from depression was 1.7 times higher in females than in males.

Top 10 causes of disability globally, females, 2010

women mental health

Looking beyond causes of disability by factoring in fatal diseases, depression continues to stand out as a leading cause of healthy years lost in females. Continue reading

Psychiatrists and African traditional healers ally on mental health | 

Protesters in Austin, Tx.
Traditional remedies on offer at a West Africa market
Carsten ten Brink

By Peter Phalen, a doctoral student in psychology at the University of Indianapolis. Phalen writes about his recent tour of mental health facilities and practitioners in several countries across West Africa.

MORIADY, GUINEA – Dr. Siaka Sangare’s psychiatric clinic is located in an idyllic suburb of central Guinea, West Africa. Palm trees tower over the well-maintained buildings. Violet long-tailed starlings flit through the trees. There are no locks on the doors. The scene more closely resembles a tropical resort than a psych ward, and you’re only charged about $1.25 per month. So why doesn’t anybody want to come here? Continue reading

Visualizing Mental Illness Worldwide | 

Guest post by Katie Leach-Kemon, a policy translation specialist from the University of Washington’s Institute for Health Metrics and Evaluation.

Mental health problems cause a surprising amount of suffering around the world. More than 450 million people are estimated to suffer from some form of mental illness. A recent podcast from The Guardian explored the extra challenges many people afflicted with mental illness face in developing countries such as harassment, stigma, and inability to earn a living.

In 2010, mental and behavioral disorders–which include conditions like depression, anxiety, schizophrenia, and drug and alcohol use disorders—caused 23% of total years lost due to disability at the global level.

Mental health issues cause the most disability in ages 15 through 39, as seen in the graph below, which is a screenshot from one of the Institute for Health Metrics and Evaluation’s data visualization tools associated with the Global Burden of Disease 2010 database.

Mental Illness GBD

Continue reading

Seattle doc makes doc film to get mental illness higher on global health agenda | 

Delaney Ruston spent a lot of her early days as a physician working in clinics for the poor and disenfranchised, like Berkeley Free Clinic and, later, Seattle’s Pike Market Medial Clinic with a few of  the area’s leading and long-time health activists Les Pittle and Joe Martin.

Delaney Ruston
Delaney Ruston

“Early on, I kept wondering why we, the medical community, usually just communicated by giving talks and writing reports,” said Delaney. Why, she wondered, did the medical community not make better use of video, especially as a form of physician-doctor communication, since it is so emotionally compelling, personal and we’re such visual animals?

That question, or more accurately her answer to it, started Delaney on a new career – as a documentary filmmaker. It was also the way in which she sought to connect with and understand her father, who had been diagnosed — after many years of it going unrecognized — with schizophrenia. Delaney’s film about her father, Unlisted, a prize-winning film acclaimed for its powerful and very personal look at mental illness.

Opening this weekend in Seattle, as part of the Seattle True International Film Festival (STIFF), is Delaney’s latest film Hidden Pictures – a documentary that features actor Glenn Close and travels around the world — from Seattle to India, China, Africa and France — to bring us up close and personal with what it’s like for families to deal with mental illness in different cultures and places.

Continue reading

It’s World Most-Neglected-Health-Problem Day | 

Flickr, by Dierk Schaefer

Neon Brain

It’s actually World Mental Health Day, and also Columbus Day.

Neither of these calendrical milestones are likely to get much public attention, unless perhaps someone can combine them for a story suggesting that Christopher Columbus only discovered the New World in 1492 thanks to his megalomania and narcissistic, obsessive-compulsive disorder.

I am not doing much this year for Columbus Day (the state of Hawaii officially refuses to celebrate it, by the way) and would like to focus most on World Mental Health Day.

Not much to celebrate really. Overall, I think it’s fair to say we’re doing a lousy job on mental health.

As I’ve reported before, mental illness is one of the leading causes of death and disability worldwide, yet it remains a very low priority on the global health agenda. Leading mental health researcher Vikram Patel has noted that mental illness kills more women than maternal mortality.

My friend and colleague Joanne Silberner recently reported on this disparity — between the global burden of this disease and the low attention it gets — on PRI’s The World, after a visit she paid to a clinic in Uganda. Said Silberner:

The World Health Organization estimates that more than 450 million people suffer from mental disorders, and a new report by the World Economic Forum figures the annual global costs of mental and neurological illnesses at $2.5 trillion. That is three times the economic cost of heart disease.

Here are some of the stories today about World Mental Health Day:

The Independent World Mental Health Day: Time to Invest

Voice of America Treatment for Mental Health Underfunded, Inadequate

Huffington Post World Mental Health Day — A revolution needed

UN News Centre UN Secretary General Ban Ki-moon urges more resources for mental health

Actualitie news Afrique WHO highlights global under-investment in mental health

The gist of most of the news stories is that we aren’t spending enough on mental health and so many experts and leaders are calling for more money.

Talk is cheap, of course, and these are tough economic times. Donations are down for the global AIDS response. I recently attended a UN meeting focused on chronic diseases where advocates called for expanding the global health agenda to better respond to problems like diabetes, heart disease and cancer. There’s a push to expand the number of slices despite a shrinking pie.

Many argue we need to increase the size of the pie, that investment in global health provides many times more in return. In lieu of that happening, perhaps the best chance for mental health issues — as well as other neglected diseases — of receiving more attention and resources is if the experts can finally agree on how best to set priorities in the global health agenda.

One would think it should be based largely on the burden of disease as well as the socioeconomic and health benefits of reducing that burden. We’re not there yet, partly because some problems are easier to solve than others, despite the disease burden, and partly because achieving that cost-benefit analysis I mentioned is also easier said than done.

Still, many say the gross neglect of mental health is perhaps the strongest evidence of our misplaced priorities.

PRI’s Joanne Silberner on Mental illness in Uganda | 

Joanne Silberner

Uganda works to improve mental health care

Health journalist Joanne Silberner, former health policy correspondent based at NPR’s flagship in DC and now (lucky for us) based here in Seattle at the University of Washington, has done an excellent report on the lack of mental illness care in Uganda for PRI’s The World.

I’ve done a few stories here about the mental health in the global health context, noting it is both a massive contributor to the burden of disease yet gets almost no attention when it comes to the global health agenda.

As Silberner reports, the first in a PRI series she’s doing on mental health in the developing world, improved acess to work training for the mentally ill is perhaps just as important as improving and expanding access to treatment: Continue reading

Why is mental illness so low on the global health agenda? | 

Flickr, by Dierk Schaefer

Seattle recently hosted a big international meeting in which many of the world’s leaders in the fight to improve health met to parse data, debate statistical methods and struggle toward consensus aimed at informing the global health agenda.

Given this focus on data, are the biggest contributors to the global burden of disease also getting the most attention and resources?

Consider two major causes of death and disability worldwide — maternal mortality and mental illness.

Today, the international community, or at least the global health community, has made reducing the number of maternal deaths and complications in childbirth worldwide a top priority. The Gates Foundation has made this a primary mission of its global health program. This priority, which really targets both mothers and children, represents two of the UN’s eight Millennium Development Goals.

Maternal health is wisely regarded as a critical, high-value goal for global health because of the important (and not always measurable) magnified benefits to a family and community that come from focusing on women’s reproductive health and the health of newborns.

Yet, surprisingly, mental illness actually kills and maims more young mothers worldwide.

Continue reading

NPR: Using lay therapists to deal with mental illness in India | 

Flickr, by Dierk Schaefer

Neon Brain

In the global health arena, mental health care is typically considered — or not considered at all, more accurately — as infeasible for poor communities compared to the more pressing disease burdens of physical illness like AIDS, tuberculosis, malaria, pneumonia, malnutrition and the like.

But as I’ve written here before, the burden of mental illness in the developing world is massive and many experts are exploring innovative ways to bring mental health care to poor communities.

For example, NPR’s Joanne Silberner reports on the use of lay people doing mental health therapy in India. Silberner’s report is based on a new study in the Lancet that found people suffering from anxiety or depression can be assisted by therapists with minimal training. Says Silberner:

In India, there is only one psychiatrist for every 400,000 people, according to the Indian government. The Lancet study involved about 2,600 people in the state of Goa with common mental illnesses such as anxiety or depression. About half were assigned case managers who had taken a two-month training course in mental health counseling.

For another example, take a look at my post “The most neglected disease in global health” about a pair of local experts training locals to treat PTSD in Iraq, Congo and Cambodia for another example.