Parity of care in mental health: scale of the challenge

World Mental Health Day is being held on the 10th October. The theme for 2021 is ‘Mental Health in an Unequal World’. Join in with the discussions around the world to address practical ways to tackle these inequalities in mental health care.A disproportionate lack of investment in mental health care, relative to the overall health budgets, and deficiencies in the quality of care contribute to a mental health treatment gap.1

It is very important that the inequality in the value placed on mental health, in relation to physical health, is addressed.2 This will involve improving the quality and monitoring of mental health care practices, allocating sufficient time and resources to mental health education and care, and improving access to effective and safe treatment for mental health disorders.2

Less than 2% of the world’s health expenditure goes towards mental health4

 

Why is parity of care needed for mental health?

In 2019, 970 million people had a mental health disorder globally.3 Of all years lived with disability, mental health disorders now account for 1 in 5.4 The financial consequence of this burden will be an estimated cost to the global economy of 16 trillion US dollars between 2011 and 2030.5 Given its prevalence and burden, mental health care should be a priority in healthcare investment.6

Despite improvements in mental health care funding since 2007,7 investment in this sector is far outweighed by other health care burdens – for instance, in 2013, the global development assistance for HIV/AIDS was $144 per DALY (disability-adjusted life year), but only $0.85 per DALY for mental health.8

 

Ending mental health disparity

More mental health professionals are needed – the global median number of mental health care workers is 9 per 100 000 people (ranging from 1.6 in low-income countries to 72 in high-income countries)11

Improving parity of care in mental health must take a universal yet proportional approach.9 Through identifying risk factors, promoting protective factors, and integrating mental health services into core healthcare, mental health can be managed at a population level.6,10 Increasing investment in the mental health sector, in care provision and research, would reap benefits across societies and economies, by improving engagement and productivity.

Healthcare workers at all stages of treatment, from general care to mental health specialists, can apply evidence-based interventions in a range of healthcare contexts.6 By advocating for improved referral pathways and in-clinic resources, as well as encouraging wider access to a range of healthcare facilities, from hospitals to community-based settings, more people can receive the treatment they need.6

Through developing a better understanding of the gaps in care, healthcare practitioners can contribute to changes in daily clinical practice and parity of care policies. Thereby, helping to break down barriers to care and facilitating greater access to mental health care for all.

Globally, less than 2% of physicians and nurses received training to recognise and treat patients with severe and common mental disorders during the last year11

 

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Our correspondent’s highlights from the symposium are meant as a fair representation of the scientific content presented. The views and opinions expressed on this page do not necessarily reflect those of Lundbeck.

References

1. World Federation for Mental Health. 2021 World Mental Health Global Awareness Campaign – World Mental Health Day Theme. 19 March 2021. Available at: https://wfmh.global/2021-world-mental-health-global-awareness-campaign-world-mental-health-day-theme/, accessed 31 May 2021.

2. Royal College of Psychiatrists. Occasional Paper 88. 2013.

3. GBD 2019 Diseases and Injuries Collaborators. Lancet 2020; 396 (10258): 1204–1222.

4. World Health Organization. Mental health burden. Available at: https://www.who.int/health-topics/mental-health#tab=tab_2, accessed 23 June 2021.

5. Bloom DE, et al. The global economic burden of non-communicable diseases. Geneva: World Economic Forum, 2011. Available at: http://www3.weforum.org/docs/WEF_Harvard_HE_GlobalEconomicBurdenNonCommunicableDiseases_2011.pdf, accessed 21 June 2021.

6. Patel V, et al. Lancet 2018; 392 (10157): 1553–1598.

7. Gilbert BJ, et al. PLoS Med 2015; 12 (6): e1001834.

8. Charlson F, et al. PLoS One 2017; 12 (1): e0169384.

9. World Health Organization and Calouste Gulbenkian Foundation. Social determinants of mental health. Geneva: World Health Organization, 2014.

10. Campion J, Fitch C. Guidance for Commissioning Public Mental Health Services. Joint Commissioning Panel for Mental Health, 2015.

11. World Health Organization. Mental Health Atlas 2017. Geneva: World Health Organization, 2018. Licence: CC BY-NC-SA 3.0 IGO.

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