Life after 2015: Keep Mental Health in Mind

Crystal NgI could use a vacation.

Don’t worry, boss! I’m not overly stressed, but everyone can benefit from an occasional break. In fact, many countries mandate that workers receive a minimum number of vacation days per year. The idea is that time off can contribute to maintaining or even improving worker productivity and satisfaction. Yet a recent Atlantic piece points out that mandatory vacation time does not necessarily correspond to workers’ satisfaction.

That makes sense—time off from work doesn’t mean time off from other life stressors. The potential impact of negative stress and mental illness on worker productivity, and therefore the economy, has been used as an argument for why countries should implement mental health programs. The stigma associated with mental illness in most cultures is well-documented, but linking mental illness to economics has given discussions a new urgency. Mental and behavioral disorders constitute almost one-fourth of all years lived with disability worldwide.

So why is mental health still the neglected cousin of global health efforts? Mental health didn’t even appear in the Millennium Development Goals, despite its pervasive effects on education and women’s health (among other areas). However, there are encouraging signs that the post-2015 development agenda may correct this oversight.

An April 2013 global consultation on health noted that improving mental health should be included in the post-2015 health priorities. Much of the post-2015 talk related to mental health has centered around aging. According to a report by the UN System Task Team on the Post-2015 Development Agenda, one in three people in developed countries and one in five in developing countries (per current classifications) will be over 60 years old by 2050. The number of people living with dementia is expected to double by 2030 and more than triple by 2050. Mental health initiatives also need to focus on more than just dementia. In low- and middle-income countries, an estimated 76%-85% of people with severe mental disorders do not receive treatment.

There are not enough mental health workers worldwide to meet the needs of the global population. Nearly half the world’s population lives in countries where there is an average of only one psychiatrist per 200,000 or more people—and often concentrated in urban areas. In May 2013, the World Health Assembly adopted the World Health Organization’s Comprehensive Mental Health Action Plan for 2013-2020, which recommends integrating mental health into general health workers’ competencies and training specialized mental health workers. When implementing this action plan, countries should also actively involve community-based and informal caregivers, social service workers, and interdisciplinary teams. Training is key not only to build mental health workers’ skills and knowledge of evidence-based protocols, but also to ensure that they respect patients’ rights and dignity.

The scale of global mental health issues demands that governments and communities strengthen their mental health systems to ensure that they are not leaving behind already vulnerable populations. Coinciding with World Alzheimer’s Month, we’ll find out if our minds will finally be treated as importantly as our bodies when the UN General Assembly meets this month to discuss the post-2015 development framework. I’ll be watching the outcomes closely—after all, vacation can wait, but the mental health of millions can’t.

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Photo courtesy of Crystal Ng