WHO Director-General's speech at the launch of the World Health Report
It is a great pleasure for me to address you on the occasion of the Launch of the World Health Report 2001, Mental Health: New Understanding, New Hope.
We are launching this report against a background of widespread horror, insecurity and grief around the world. The recent attacks in USA have brought home to many people in the industrialized world a sense of emergency and fear which millions in other parts of the world only are too familiar with.
Fear - whether as a result of cruelty, of violence, or of disease, undermines trust among people - and between groups and communities that need to function together. It undermines the safety and predictability we all need to grow, develop and prosper. It undermines our very belief that people are good - not evil, the belief that is essential if we are to give meaning to what we do. It undermines our freedom to engage with others to improve our societies.
We are proud of the thousands of doctors, paramedics, nurses and psychologists where-ever they are, who are working ceaselessly to ease suffering and heal wounds - on the bodies of those injured, and inside the minds of many as they cope with the horror. Their dedication and stamina is an inspiration to us all.
There has been much focus on trauma and stress - from witnessing or being victim of violence or from being close to victims. Strong reactions to violence, to displacement are natural and healthy. But at the same time we need to acknowledge that some of the people who are directly exposed to such events will suffer long-term mental effects.
At the same time, mental good health is what enables us all to be optimistic, to move on and to continue the struggle to create a meaningful and worthwhile life even during difficult times. The recent events have reaffirmed and strengthened the circle of caring - between people and within communities.
Our global community is being tested as never before.
We must continue to work together to tackle the great problems that affect the future of humanity, and sustain the impetus for freedom and democracy so that all people can live and grow together
Let us be clear: Poverty is the most significant determinant of suffering and grief in today's world. We must carry forward the fight against global poverty with all the energy we can muster. We know that poor people are bound to remain poor if they lack physical and human security. This means that freedom from terror, violence and disease are critical foundations for poverty reduction, human well-being and a secure future for our world.
This is the context I want you to have in mind when you look at the report we are launching today.
With this Report and related activities we hope to break the vicious cycle of neglect and lack of funding and to raise awareness of mental health issues at the highest level of decision and policy making. This Report marks a significant step on the road to understanding mental illness and combating the stigma and discrimination that surrounds it.
Mental illness is not a personal failure. If there is failure, it is in the way we have responded to people with mental and neurological disorders. I hope this report will help dispel long-held prejudices and mark the beginning of a new era in the field of mental health care.
Now more people than ever know that physical and mental health are inextricably linked to each other and to the well-being of individuals.
The global toll of mental illness and neurological disorders is staggering. Neuropsychiatric disorders account for 31% of the disability in the world - and they affect rich and poor nations and individuals alike.
Four-hundred and fifty million people currently have a mental or neurological disorder. One-hundred and twenty-one million people suffer from depression and 50 million from epilepsy. Every year, one million people commit suicide and 10-20 million attempt suicide.
Because people do not get the care they need, mental and neurological disorders impose a range of costs on individuals, households, employers, and society as a whole, ranging from the cost of care to the cost of lost productivity.
A great deal of this suffering is unnecessary.
We know, for instance, that 60% of those suffering from major depression can fully recover if treated. However, in both developed and developing countries, less than 25% of those affected receive treatment for a variety of reasons including stigma, discrimination, scarce resources, lack of skills in primary health care and deficient public health policies.
This is unacceptable.
Solutions that are based on solid scientific evidence are available and affordable. Through recent advances in neuroscience, neuroimaging, genetics and behavioural sciences, we know more about brain functioning and behaviour than ever before. This in turn has led to breakthroughs in therapy and medication.
This new understanding of mental and neurological disorders and how to treat them effectively means new hope for sufferers, families and communities.
This Report deals with seven common disorders; disorders that are often debilitating: depressive disorders, schizophrenia, mental retardation, disorders of childhood and adolescence, drug and alcohol dependence, Alzheimer’s disease and epilepsy.
Chapter one introduces the reader to a new understanding of mental health and argues the case for the importance of mental health as an integral part of overall health.
Chapter two presents the size of the burden of mental ill health and explains the existing treatment gap.
Chapter three outlines the tools we have to solve mental health problems. It outlines the importance of prevention and early intervention. It shows how effective use of drugs can reduce the need for separate care and involuntary arrangements. It argues the need to move from institutionalized care to community care.
Chapter four outlines the need for reform of mental health policies and service provision. It explains how policies, priorities and often legal changes need to be made to make effective action on the ground possible. It argues that governments have the ultimate responsibility for improving mental health in their countries, and that they must take on the role as the stewards of the reform process.
Chapter five contains ten recommendations for country action. It also sets out three scenarios for how low, middle and high resource countries can act on each of the ten recommendations to get results.
These recommendations are to:
- Provide treatment for mental disorders within primary care
- Make psychotropic medicines available
- Give care in the community. (Replace large custodial hospitals by community care facilities backed by general hospital psychiatric beds and home care support)
- Educate the public. (Launch public awareness campaigns to overcome stigma and discrimination)
- Involve communities, families and consumers in decision-making on policies and services
- Establish national policies, programmes and legislation
- Develop human resources. (Train mental health professionals)
- Link mental health with other social sectors
- Monitor community mental health, and
- Support more research
Let me just stress that this year's World Health Report is not a stand-alone product. The theme of this year's World Health Day celebration was mental health and the slogan was "Stop Exclusion! Dare to Care!"
This message is being heard. We are already beginning to see change.
WHO has made it a priority to assist countries in a variety of ways to ensure that those who suffer can receive the care, treatment and acceptance that they so desperately need.
Our engagement does not end with the end of this year which we have dedicated to mental health. I would like to use this opportunity to announce that we have developed a new "Global Action Programme" or "GAP" This is no coincidence. Indeed, this five year programme will focus on helping countries closing the treatment gap. It represents a comprehensive strategy for closing the gap between effective and available mental health services - or in other words, for translating the ten recommendations of the World Health Report 2001 into action.