Global Mental Health Resources and Services: A WHO Survey of 184 Countries

Abstract

Data derived from the World Health Organization's (WHO) Mental Health Atlas Project 2011 are presented. These data provide the latest estimates on available resources for the treatment and prevention of neuropsychiatric disorders covering 98 percent of the world's population. Resources are defined in terms of governance, financing, mental health care delivery, human resources, essential medicines, and information systems. The Atlas project was initiated to guide policy and planning efforts in order to meet the large and growing burden of neuropsychiatric disorders worldwide. Results indicate that 60 percent of countries have a dedicated mental health policy; 71 percent possess a mental health plan; and 59 percent report having dedicated mental health legislation. Median mental health expenditures per capita are US$ 1.63, with large variation among income groups, ranging from US$ 0.20 in low income countries to US$ 44.84 in high income countries. Globally, 67 percent of financial resources are directed towards mental hospitals. The global median number of facilities per 100,000 population were; 0.61 outpatient facilities, 0.05 day treatment facilities, 0.01 community residential facilities, and 0.04 mental hospitals. There are 7.04 psychiatric beds per 100,000 population in mental hospitals in comparison to 1.4 psychiatric beds per 100,000 population in general hospitals. Higher income countries typically report more facilities and higher admission/ utilization rates. Three quarters of patients admitted to mental hospitals remain there less than one year. There is a clear pattern whereby greater rates of human resources are observed in higher income countries. Globally, nurses represented the

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“…However, outside these areas, mental health services were often unavailable, inaccessible or too expensive for patients and their families who are required to pay for medications if they are available (Morris et al. ). In line with the millennium development goals, Sub‐Saharan Africa governments need to take concrete steps to address the under‐resourcing of mental health care, poverty and income inequality as these are major barriers to accessing necessary treatment for people in this region (Lund et al.…”

“…, World Health Organization ) with the result that many low‐ and middle‐income countries experience chronic shortages of qualified mental health clinicians (Morris et al. ; World Health Organization ). Zimbabwe has a population of 13 million and only seven psychiatrists, all of whom work in Harare, the capital.…”

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“…The policy largely conveys government’s commitments organized in a set of values, principles, objectives and areas for action to improve the mental health of a population [4]. Based on the findings of the documents review, South Africa has a new Mental Health Policy and Strategic Plan (2013–2020) [16].…”

“…Mental health plans are essential for guiding the activities that have to be implemented to meet policy objectives and typically include vital elements such as budgets and time frames [4]. South Africa has a Mental Health Action Plan [16] which provides a roadmap for the implementation of the mental policy.…”

“…In 2010, about 10% of the global burden of disease is attributed to neuropsychiatric disorders, mostly due to the high prevalence and chronicity of the more commonly occurring mental disorders [3]. Despite the growing burden of mental illness, mental health services remain a low priority in most low and middle income countries (LMICs), where greater attention is given to the control and eradication of infectious diseases as well as to conditions associated with reproductive, maternal and child health [1, 4]. This may be understandable, due to the high mortalities and morbidities that are directly associated with these priority conditions, [1, 4, 5] but it translates into neglect and a lack of access to care, for the increasing population with mental health conditions in LMICs.…”