Health System Hide and Seek: “Mental Health” Never Gets Found

At the end of Lecture 4 on Global Health Governance and the Political Economy of Development, Professor Karen Grepin added two figures portraying the ‘funding relative to burden of disease and funding relative to mortality.’ Neither of the figures used by World Bank, US Government, Bill and Melinda Gates Foundation, and GFATM included the condition that could potentially affect every other disease on that chart: mental illness. Alzheimer’s, chronic depressive disorders, and self-inflicted injuries are just three of the many psychological disturbances that have high DALY rates to go alongside them. From the powerpoint in Lecture 2, there was a slide with the projected changes to the global burden of disease, and leading the charts in 2030 is predicted to be ‘unipolar depressive disorders.’ The disabling effects of mental illnesses create problems for the economic, industrial, social, and development sectors of society. We are loosing members of the vulnerable communities in the prime of their productive years, slowing our development goals, reducing life expectancies, and making it more difficult to pull societies out of poverty.

One obstacle with trying to get more aid and awareness on mental health could be the fact that measuring the health status for these illnesses is not only complex, but also very difficult to create uniform criteria with such diverse and multilayered problems. An article from PRI’s The World displayed a brief yet convincing point on what may be stopping major donors and advocacy groups from focusing on mental health. They blame the issue on the United Nations and the Millennium Development Goals. These goals have given political direction for international development and policy making on important health issues, including HIV, malaria, maternal/child health, and hunger. (1) The goals have nothing on treating mental illness, making it difficult for local projects to receive funding from international partners.

“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.” (1)

If the MDGs don’t bring mental health into light, then bilateral and multilateral institutions do not have ‘mental health’ on their lists of funding areas. In September, the UN held a special summit on noncommunicable diseases, but once more, mental health was not addressed. Columbia University’s Jeffery Sachs commented for this piece:

““The reason that the MDGs do not explicitly address noncommunicable diseases such as cardiovascular or psychiatric diseases is that the MDGs focus on the gap in health status between rich and poor countries, a gap mainly accounted for by infectious diseases, malnutrition, and unsafe childbirth,” wrote Sachs. “The goals were crafted to address these large gaps rather than to solve all pressing health problems.”

Do you agree? Is mental disability and illness affecting economic competitiveness and social stability across borders?  If one of the leading voices in global health is not emphasizing a need for a focus on mental illness, what will it take to get it discovered by the world body? If no one (UN or other multinational leading organization) is saying go seek out and find help for mental health, will it stay hidden forever?

Ayesha Amin

(1) Silberner, J. (2011). “Mental Health Not Getting Enough Attention from UN.” PRI’s The World. from http://www.theworld.org/2011/09/mental-health-not-getting-enough-attention-from-un/.

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