What are some of the current challenges in global mental health?
For those who care about making a difference, the global mental health sector provides a rewarding career, where your actions can lead to positive changes for individuals and communities around the world.
The World Health Organization (WHO) recognises that mental health and wellbeing and the prevention and treatment of substance abuse play an important role in promoting global development, as illustrated by the inclusion of mental health within the UN Sustainable Development Goals.
However, it is also an industry that comes with some significant challenges, especially for those in strategic and leadership roles who are responsible for the development and implementation of sustainable mental health services.
If you are passionate about making a difference within mental health care, it is crucial to develop a full understanding of key issues facing the field, within various contexts. Here we explore some of the biggest challenges facing the mental health sector today.
Rise in mental illness
It is estimated that 13% of the world’s population suffers from some kind of mental disorder, with mental health conditions causing 1 in 5 years lived with a disability. In The UK, bed occupancy rates for inpatient mental health services regularly exceed the 85% level recommended to maintain patient safety standards.
In addition, COVID-19 has had a major impact on mental health provision world-wide, exacerbating long-standing issues like the rising demand for services, lack of funding and health inequities.
The pandemic has disrupted or halted critical mental health services in 93% of countries worldwide and has led to the Royal College of Psychiatrists to predict a 'tsunami' of mental illness, with psychiatrists seeing an alarming rise in patients needing urgent and emergency care. Studies have shown that the rate of depression doubled during the pandemic.
Social isolation, financial struggles, housing insecurity, loss of coping mechanisms and reduced access to mental health services are believed to be some of the drivers behind this increase.
“COVID-19 has interrupted essential mental health services around the world just when they’re needed most. World leaders must move fast and decisively to invest more in life-saving mental health programmes - during the pandemic and beyond” says Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization.
The increased demand for mental health services is likely to be long-term, with leading public health specialists predicting that the mental health impact of the pandemic is likely to last much longer than the physical impact.
Lack of funding
Despite mental health problems being one of the main causes of the overall disease burden worldwide, the WHO reports that countries spend less than 2% of their national health budgets on mental health.
The lack of funding for mental health care has consequences that extend far wider than individual outcomes. For example, the global economy loses about $1 trillion every year in productivity due to depression and anxiety. Untreated mental, neurological and substance use disorders are estimated to contribute to economic output losses of $2.5-8.5 trillion globally; a figure which is projected to nearly double by 2030.
Lack of funding is a key challenge for mental health care professionals. Low budgets restrict the level of mental health provision countries can provide, posing significant challenges for those who design mental health care strategies and interventions.
Health inequity and inequality
Even before the COVID-19 pandemic, the majority of people around the world who needed mental health care lacked access to high-quality mental health services. Many of those unable to access treatment are located in low income countries.
In addition to geography, there are other factors that contribute to disparities in mental health care. For example, ethnic, gender and sexual minorities often suffer from poor mental health outcomes due to multiple factors, including inaccessibility of high-quality mental health care services and cultural stigma surrounding mental health care. Disparities in mental health care provision also exist within individual countries, for example, between the mental health care services received by African Americans compared to the rest of the American population.
One contributing factor to health inequity is cost; worldwide, approximately 150 million people a year face catastrophic health-care costs, while 100 million are driven below the poverty line. Another factor is the availability of mental health services; low-income countries have an average of just 0.1 psychiatrists and 0.3 psychiatric nurses per 100,000 people.
COVID-19 will likely magnify the situation; according to a report published by the Centre for Mental Health, the COVID-19 pandemic could ‘exacerbate inequalities in mental health for a generation’ unless action is taken to close the gap, especially in communities where mental health was already poor.
Stigma and discrimination
Stigma around mental illness is a major cause of discrimination and exclusion, not only impacting individuals but also impacting the prevention of mental health disorders and the provision of effective treatment and care.
Mental health stigma is a world-wide issue, however, as with care inequity, it can be a particular problem in low- and middle-income countries where people may be more likely to believe that mental, neurological and substance abuse issues are the result of personal weakness, or that those with mental health difficulties pose a danger to society. This results in a host of negative outcomes for mental health sufferers, such as harmful treatment practices, exclusion from family and society, reduced access to mental health services, poor physical health, increased deprivation and even death.
Global initiatives such as the World Banks’ Moving the Needle: Mental Health Stories from Around the World and World Mental Health Day are trying to remove the stigma that surrounds mental illness, but it is a work in progress.
According to the World Health Organization; “Many people with mental health problems choose not to engage or maintain contact with mental health services, due to stigma and discrimination. Negative treatment and care experiences are another factor contributing to failure to engage. Reforms need to achieve higher confidence in the safety and effectiveness of care. Mental health policies need to combine structural reform of services with a focus on quality, ensuring the delivery of safe, effective and acceptable treatments by a competent workforce”.
Make a positive difference in global mental health provision
If you are passionate about improving access to mental health services, our Online MSc Global Mental Health can help you.
This multi-disciplinary programme provides graduates with the knowledge and tools to create sustainable strategies that reduce the burden of mental illness, address inequalities and actively lead to positive change in mental health treatments.
To find out more, visit our programme page and request information by completing the form.
First published: 27 April 2021