The International Consortium on Mental Health Policy and Services: objectives, design and project implementation

Abstract

The concept of the burden of disease, introduced and estimated for a broad range of diseases in the World Bank report of 1993 illustrated that mental and neurological disorders not only entail a higher burden than cancer, but are responsible, in developed and developing countries, for more than 15% of the total burden of all diseases. As a consequence, over the past decade, mental disorders have ranked increasingly highly on the international agenda for health. However, the fact that mental health and nervous system disorders are now high on the international health agenda is by no means a guarantee that the fate of patients suffering from these disorders in developing countries will improve. In most developing countries the treatment gap for mental and neurological disorders is still unacceptably high. To address this problem, an international network of collaborating institutions in low-income countries has been set up. The establishment and the achievements of this network--the International Consortium on Mental Health Policy and Services--are reported. Sixteen institutions in developing countries collaborate (supported by a small number of scientific resource centres in industrialized nations) in projects on applied mental health systems research. Over a two-year period, the network produced the key elements of a national mental health policy; provided tools and methods for assessing a country's current mental health status (context, needs and demands, programmes, services and care and outcomes); established a global network of expertise, i.e., institutions and experts, for use by countries wishing to reform their mental health policy, services and care; and generated guidelines and examples for upgrading mental health policy with due regard to the existing mental health delivery system and demographic, cultural and economic factors.

How did we arrive at burden of disease estimates for mental and illicit drug use disorders in the Global Burden of Disease Study 2010?

“…Another major concern with GBD was that the impact of subthreshold symptoms was not captured in the DALY. Mental health symptoms that did not meet criteria for diagnosis (as per DSM/ICD nomenclature) are also associated with significant disability [52]. Previous investigation into this issue found that countries with the lowest prevalence estimates for mental disorders also have the highest proportions of cases classified as subthreshold as per DSM-IV criteria and the World Health Organization's Composite International Diagnostic Interview [53,54].…”

Challenges to reduce the ‘10/90 gap’: mental health research in Latin American and Caribbean countries

“…Although some isolated initiatives to fund health research based on mental health research priorities have been carried out, most research agencies do not generally allocate their funds according to priorities, quality or relevance of research projects (18, 27). Funding by external donors is also rarely aligned with the needs of LAMI countries (8, 9, 37, 40, 45). Although prioritizing mental health research was one of the 10 recommendations of the 2001 World Health Report (1), continuous efforts are still needed to adequately sensitize donors and policy-makers to the mental health demands of LAMI countries (1, 2, 8, 9, 11, 18, 36, 37, 43, 45, 46).…”

“…Funding by external donors is also rarely aligned with the needs of LAMI countries (8, 9, 37, 40, 45). Although prioritizing mental health research was one of the 10 recommendations of the 2001 World Health Report (1), continuous efforts are still needed to adequately sensitize donors and policy-makers to the mental health demands of LAMI countries (1, 2, 8, 9, 11, 18, 36, 37, 43, 45, 46). …”

A Model for Sustainable Development of Child Mental Health Infrastructure in the LMIC World: Vietnam as a Case Example

“…are integrated into the structure of the model discussed below. For a detailed discussion of policy issues regarding mental health capacity development in LMIC, see Gulbinat et al (2004) and World Health Organization (2007a; 2007b).…”