Mental health is a hidden illnessPeople with mental disorders are some of the most neglected people in the world. In many communities, mental illness is not considered a real medical condition, but viewed as a weakness of character. Even when people with mental disorders are recognized as having a medical condition, the treatment they receive is often less than humane. Much of the stigma surrounding mental illness could be prevented by making the public aware that mental disorders are treatable.
What is mental health? Mental health is not just the absence of mental disorder. Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully and is able to make a contribution to her or his community.
How many people suffer mental health illnesses? There are nearly 54 million people around the world with severe mental health disorders such as schizophrenia and bipolar. In addition 154 million people suffer from depression. Latest figures show that nearly 1 million people commit suicide each year.
Who is most affected? Mental disorders are increasingly prevalent in developing countries. This is a result of persistent poverty driven conditions (poor education, housing, job prospects, over work), rapid socio-economic changes, conflicts in fragile states, and natural disasters.
At the same time, more than 50% of developing countries don't provide any care for persons with mental disorders in community. As a result, more than 75% of people with major depressive disorders in developing countries are inadequately treated.
What is the situation in Viet Nam? Vietnam is not an exception in the global phenomenon. The result of a national survey in 1999-2000 showed that the prevalence of 10 common mental illnesses was about 15%. In 2003 the study “Young lives” showed that the prevalence of mental disorders in primary school children was 20%. Recent smaller scale studies revealed a prevalence of between 20 and 30% in the country.
What is Viet Nam doing? The Vietnam Government has made a significant effort in mental health. The National Target Program (NTP- a top priority program) for mental health was established in 1999. It focused on building a “model for community-based mental health care”. So far the model has covered all 64 provinces and nearly 40% of communes in Vietnam. Thanks to this model people with schizophrenia and epilepsy are managed at their community and discrimination is reduced. This greatly contributes to reduction of hardship of both the patients and their families.
Are there gaps in the system? Other mental illnesses - especially depression - are not yet recognized in the model. That means people with these conditions are not provided with adequate care and treatment in the community or at health facilities. Moreover, the concept of mental disorder – the early stage of mental illness is not yet well understood. As a result, mental health problems are only regarded as issues of the health sector and the mental health programme tends to focus on clinical aspects rather than on early detection and prevention involving other sectors and the whole community.
Treatment service at hospital facilities has been improved since the establishment of the NTP for mental health. However, it is still facing many difficulties such as incompletion of the referral network, shortage of human resources and inadequate medicines and equipment. Also the cost of treating mental disorders is very high due to their chronic nature.
What is the answer? Instead of providing care in large psychiatric hospitals WHO encourages all countries to integrate mental health into primary health care, provide mental health care in general hospitals and develop community-based mental health services.
However, national mental health policies should not be solely concerned with mental health disorders they should recognize and address the broader issues which promote mental health. These would include the socio-economic and environmental factors, described above, as well as behaviours. This requires mainstreaming mental health promotion into policies and programmes in public and private sectors including education, labour, justice, transport, environment, housing, and welfare, as well as the health sector.
What is WHO doing? The World Health Organization (WHO) has been providing support to Viet Nam’s mental health programme for many years.
The technical and financial support from WHO focuses on strengthening mental health care system, improving the model for community-based mental health care and applying the integrated approach for non-communicable diseases (NCDs) including mental disorders.
WHO has helped develop national clinical guidelines and organized training courses for a large number of health care workers to better understand mental health issues.
WHO also provided support to evaluate the current community-based model. The results will help modify the model to meet with WHO recommendations on mental health care. That means other mental illnesses besides schizophrenia and epilepsy will be included into the model and interventions such as health promotion and early detection will be improved.
What is your message for this World Mental Health Day? Worldwide, mental health illnesses carry a huge burden of stigma and discrimination. But mental health and mental illness are a part of every country, culture, age group and socioeconomic condition. This year’s message is “Making Mental Health a Global Priority: Scaling up Services through Citizen Advocacy and Action”. This theme recognizes that the best way to create change is through concerted action and advocacy in each community of the world and that each of us has the power to change and the ability to achieve a different world for mental health care, treatment, and promotion. I urge you all not to be part of a problem – but a part of the solution.
FACT SHEET – MENTAL HEALTH
- Mental, neurological, and substance use disorders are common in all regions of the world, affecting every community and age group across all income categories.
- 14% of the global burden of disease is attributable to mental, neurological, and substance use disorders.
- Depression is the fourth leading cause of disease burden globally and is projected to be the second leading cause in 2030.
- Epilepsy affects about 50 million people worldwide – 80% of whom live in low-income countries.
- Worldwide, suicide is the third leading cause of death in young people.
- Harmful use of alcohol is the fifth leading risk factor for premature death and disability in the world.
- More than 75% of patients with mental, neurological, and substance use disorders in many low-income countries do not have access to treatment.
- The associated stigma and violations of human rights hasten the decline into poverty and hinder care and rehabilitation.
- Economic costs as well as non-economic criteria, such as equitable access to health care, human rights protection, and poverty reduction need to guide the process of setting priorities in mental health.
- Most countries allocate a small fraction of the resources that are needed to be able to adequately respond to mental, neurological, and substance use disorders. One in three countries does not have a specific budget for mental health.