Mental Health: New WHO country data show resources fall short of needs
23 April 2002 - New World Health Organization (WHO) data on the state of mental health resources in individual countries around the world demonstrate the huge gap between what is needed and what is available to take care of the massive burden of mental, neurological and behavioural disorders, which according to the latest estimates stands at 12.3% of the total disease burden.
The new data, collected from government sources, have been published by WHO in Atlas: Country Profiles on Mental Health Resources. They are also available on the Internet at http://mh-atlas.ic.gc.ca/ .
One of the surprising findings is that wealthy countries are not always rich in the quantity and quality of mental health resources. These findings further reinforce the recommendations of the World Health Report 2001, that all countries, large and small, rich and poor, need to give a much higher priority to mental health and take urgent steps to enhance their mental health services.
Forty per cent of countries have no mental health policies and 25% have no legislation in the field of mental health. Many large countries, including China, Iran, Nigeria, Thailand and Turkey, have no specific legislation for mental health, though some are in the process of developing legislation. Of the countries reporting, about one-third spend less than 1% of their federal health budget on mental health-related activities. Community care facilities have yet to be developed in about half of the countries in the African, Eastern Mediterranean and South-East Asia Regions. In other Regions, these facilities are absent in at least one-third of the countries. Of the total number of psychiatric beds in the world about 65% are still in mental hospitals.
It is widely accepted that community care is more effective as well as more humane then inpatient stays in mental hospitals. Surprisingly, a large number of economically developed countries with extensive mental health infrastructure still have a large proportion of their psychiatric patient beds in mental hospitals.Whereas Ireland, Israel, Netherlands and Spain have 80-95% of the total psychiatric beds located in mental hospitals; this figure for France, Germany and Japan is 60-75% and for Australia, Canada and USA is around 40%.
The availability of mental health professionals in large areas of the world is extremely poor. More than 680 million people, the majority of whom are in Africa and Asia, have access to less than one psychiatrist per million population. This is the case in large countries with populations over 100 million, like Bangladesh and Nigeria.
This data, available on the internet, will facilitate action by policy-makers and researchers and will empower public health institutions, non-governmental organizations and consumer associations in their advocacy efforts.