Campaign to recognise dangers of mental illness

An international alliance of specialists in mental health is launching a campaign today to shift the focus of the world's attention from disorders of the body to disorders of the mind.

Some 30 per cent of the world's population suffer some form of mental disorder each year, yet at least two-thirds receive inadequate or no treatment, even in countries with the best resources, such as the UK.

Mental illness outranks cancer and heart disease as a cause of chronic ill health – mainly due to the disabling nature of depression and alcohol or drug problems – yet it attracts a fraction of the resources of these more fashionable conditions.

In a series of articles published in The Lancet, experts from the World Health Organisation, the London School of Hygiene and the Institute of Psychiatry in the UK appeal to governments and medical organisations around the world to increase funding for mental health and make it a central theme of their wider health strategy.

As much as 14 per cent of the global disease burden is attributable to mental illness according to estimates by WHO in 2005, yet the condition is marked by stigma and neglect. Almost a quarter (23 per cent) of the global burden of disability is due to mental problems, compared with 21 per cent for heart disease and stroke and 11 per cent for cancer.

Professor Martin Prince of the Institute of Psychiatry said even those high figures were likely to be an underestimate because the impact of mental health on physical health went unrecognised.

The most obvious fatal impact of depression was when it led sufferers to take their own lives with 800,000 suicides each year around the world, nine out of ten of whom suffered a serious mental problem in the weeks leading up to their deaths.

But depression carried an increased risk of death for other reasons, such as by contributing to a less healthy lifestyle with more smoking and less exercise.

Stigma also played a part in denying mental patients treatment for physical illness. An Australian study found mental patients with heart disease were less than half as likely to receive surgery for their condition and were 80 per cent more likely to die from it than unaffected patients.

"We have missed these links [between mental and physical health]. Without them we fail to capture the full impact of mental illness," Professor Prince said.

Almost a third of countries worldwide have no budget for mental health and one fifth of those that have spend less than 1 per cent of their total health budget on it, compared with 10 per cent in the UK. Shekhar Saxena of WHO said inequities in provision were rampant.

"High income countries have up to 200 times more psychiatrists, psychiatric nurses and psychologists. Low income countries are losing resources – in two years' time the situation will be even worse," he said.

Too often, countries were training more psychiatrists and investing in expensive mental hospitals and beds when the money would be better spent on psychiatric nurses and community care, he said.

Professor Vikram Patel of the London School of Hygiene said there was robust evidence to show that scaling up services in countries where they were most sparse was cost-effective. Over 10 years the cost was estimated at $2 (£1) a person in low income countries and $3-$4 in middle income countries.

Richard Horton, editor of The Lancet said there had been "a critical failure of leadership" by Western countries.