From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

Mills, China

doi:10.1111/dech.12397

Cited by 50 publications

(35 citation statements)

References 62 publications

(70 reference statements)

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“…Recently, mental health was included in the UN Sustainable Development Goals, and for the first time in history, it has been recognized as a health priority within the global development agenda [ 28 ]. This recognition is believed to have had a positive influence on mental health care systems development in member countries [ 29 ]. By being part of the global development agenda, mental health is expected to receive more attention and thus more resources and increased monitoring, particularly in low-income countries like Bangladesh.…”

Section: Discussionmentioning

confidence: 99%

Pathways to care of patients with mental health problems in Bangladesh

Nuri

Sarker

Ahmed

et al. 2018

Int J Ment Health Syst

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BackgroundHealth systems in Bangladesh are not fully organized to provide optimal care services to patients with mental health problems. There is both a lack of resources and a disproportional distribution of the available resources. To design an equitable health system and plan interventions to improve access to care, a better understanding of mental health care-seeking behavior and care pathways are crucial.MethodsA facility-based cross-sectional study was conducted using a mixed-method design at the National Institute of Mental Health (NIMH), in Bangladesh. A total of 40 patients (or their attendants) visiting the outpatient department of NIMH were selected by purposive sampling.ResultsAs their first contact point for care services, 27.5% of the patients consulted a psychiatric care provider, 30% went to non-medical provider, and the majority, 42.5%, went to non-psychiatric medical care providers. Only 32.5% of the patients had been advised to go to NIMH by a private physician, hospital personnel or psychiatrist. Among all individual categories of providers, private psychiatrists were the most frequent caregivers (n = 12), followed by traditional healers (n = 9). A total of 70% of the patients had chosen a provider within 20 km. In three out of four of the cases, the family had decided on the first provider. From the start of the symptoms the median delay in the first contact with any provider was 6 months, and in reaching any psychiatric care provider was 1 year. The most common reasons for a delay in seeking care were a lack of knowledge about mental health problems, a lack of information about the place for appropriate care, and not considering the problem as serious enough to seek care. Each of those reasons were mentioned by one in every four respondents.ConclusionsThe majority of the patients with mental health problems in Bangladesh access various categories of providers before reaching a psychiatric care provider, and use a diverse range of pathways and loops, which results in a delay or missing appropriate care. We hope that our findings are useful for planning interventions to improve access to mental health care in general, in Bangladesh, and improving referral policies and structures in particular.

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Section: Discussionmentioning

confidence: 99%

Pathways to care of patients with mental health problems in Bangladesh

Nuri

Sarker

Ahmed

et al. 2018

Int J Ment Health Syst

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“…It is also noteworthy that the movement to globalize mental health was formed across political and economic organizations (i.e., WHO, World Bank, International Monetary Fund), resulting in an uneasy alliance among psychiatry, public health, and international development (48,49). There is increasing concern that the data reinvigorating the GMHM (e.g., disease burden estimates of depression) have been distorted by commercial interests and psychiatry's capture of this 4 https://www.who.int/mental_health/mhgap/en/.…”

Section: Mind the Gap: Renewed Global Emphasis On Scaling Up The Diagmentioning

confidence: 99%

Drivers of and Solutions for the Overuse of Antidepressant Medication in Pediatric Populations

et al. 2020

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Children in the United States and internationally are increasingly being diagnosed with depression and related psychiatric conditions and a recent study found that antidepressant (ADM) use in children and adolescents rose substantially in youth cohorts in five Western countries from 2005 to 2012. However, there has been ongoing controversy over the effectiveness and safety of ADM use in children, including concerns about ADM increasing suicidality and self-harm. In addition to the increase in the diagnosis of depression, commercially driven off-label prescriptions have been cited as a significant reason for high rates of pediatric ADM prescribing. In this commentary, we discuss two drivers of the overuse of ADM, both of which are products of an increasingly medicalized approach to mental health: 1) the demand for mental health and depression screening in youth, despite the lack of evidence to support it, and 2) the renewed momentum of the Global Mental Health Movement and concomitant calls to "scale up" the diagnosis and treatment of mental illness. Using the lens of institutional corruption, we identify the ways in which both guild and financial conflicts of interest create obstacles to rational prescribing practices in pediatric populations and offer suggestions for reform.

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“…14). Similarly, the UN Sustainable Development Goals (2015), which for the first time mention mental health (Mills 2018), emphasise development of new and enabling ICTs (1.4) to bridge the digital divide and develop knowledge societies (WHO, 2013, p. 15).…”

Section: Introductionmentioning

confidence: 99%

The construction of mental health as a technological problem in India

Mills

Hilberg

2018

Critical Public Health

Self Cite

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This paper points to an underexplored relationship of reinforcement between processes of quantification and digitization in the construction of mental health as amenable to technological intervention, in India. Increasingly, technology is used to collect mental health data, to diagnose mental health problems, and as a route of mental health intervention and clinical management. At the same time, mental health has become recognized as a new public health priority in India, and within national and global public health agendas. We explore two sites of the technological problematisation of mental health in India: a large-scale survey calculating prevalence, and a smartphone app to manage stress. We show how digital technology is deployed both to frame a 'need' for, and to implement, mental health interventions. We then trace the epistemologies and colonial histories of 'psy' technologies, which question assumptions of digital empowerment and of top-down 'western' imposition. Our findings show that in India such technologies work both to discipline and liberate users. The paper aims to encourage global debate inclusive of those positioned inside and outside of the 'black box' of mental health technology and data production, and to contribute to shaping a future research agenda that analyzes quantification and digitization as key drivers in global advocacy to make mental health count.

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From ‘Invisible Problem’ to Global Priority: The Inclusion of Mental Health in the Sustainable Development Goals

Cited by 50 publications

References 62 publications

Pathways to care of patients with mental health problems in Bangladesh

Pathways to care of patients with mental health problems in Bangladesh

Drivers of and Solutions for the Overuse of Antidepressant Medication in Pediatric Populations

The construction of mental health as a technological problem in India

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