Transcript Global Burden of Mental Illness

Asia Maselko and Kristen Shirey
09 October 2012
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 Mortality
 DALYs
 YLD
 Prevalence
 Foot-print
 Cost of care
 Loss of productivity
 Loss of income
 Family, community,
and country costs
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Disease
%
Ischemic heart disease
13.4
Cerebrovascular disease
9.5
Lower respiratory infections 6.4
HIV/AIDS
4.2
COPD
4.2
Diarrhoeal diseases
4.1
Perinatal conditions
4.0
Tuberculosis
2.8
Lung cancer
2.3
Road traffic accidents
2.2
WHO, 2002
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Disease
%
Lower respiratory infections 6.7
HIV/AIDS
6.2
Perinatal conditions
6.2
Diarrhoeal diseases
5.0
Depression
4.1
Ischaemic heart disease
4.1
Cerebrovascular disease
3.5
Malaria
3.1
Road traffic accidents
2.8
COPD
2.7
WHO, 2002
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WHO, 2002
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Disease
%
Depression
10.7
Iron-deficiency anaemia
4.7
Falls
4.6
Alcohol use
3.3
Chronic Obstructive
Pulmonary Disease
3.1
Bipolar disorder
3.0
Congenital anomalies
2.9
Osteoarthritis
2.8
Schizophrenia
2.6
Obsessive-compulsive
disorder
BMJ 2002;325:947
2.2
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 WHO Mental Health Survey Initiative
 26 countries (6 are classified as less-developed*)
 100,000+ respondents
 Results
 12-month prevalence of any disorder 4.3-26.4%
 12-month prevalence of moderate-severe disorder 1-16%
 Leading spectrum disorders
 Anxiety (2.4-18.2%)
 Mood (0.8-9.6%)
 Substance use (0.1-6.4%)
 Challenges?
* Mexico, Colombia, Nigeria, Lebanon, China, Ukraine
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 15% of those with mental
illness in low-income
countries receive the
treatment they need
 54% of those with mental
illness in high-income
countries receive the
treatment they need
 The gap is large, but is
treatment good anywhere?
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 Mental Health Gap Action Programme (mhGAP)
 Aims at scaling up services for mental, neurological and
substance use disorders for countries especially with
low- and middle-income. The programme asserts that
with proper care, psychosocial assistance and
medication, tens of millions could be treated for
depression, schizophrenia, and epilepsy, prevented from
suicide and begin to lead normal lives– even where
resources are scarce.
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 In addition to recommendations for policy,
infrastructure development, and financing, published
implementation/treatment guide for primary care
providers in resource-limited settings
 Guide is 121 pages, includes modules on treatment of
the eight priority conditions as well as bipolar disorder
and other significant emotional or medically
unexplained complaints
 Each module provides basic algorithms for feasible
assessment and treatment of the conditions…
example:
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 WHO identified 8 priority mental, neurological, and
substance use conditions:
 Depression
 Schizophrenia and other psychotic disorders
 Suicide
 Epilepsy
 Dementia
 Disorders due to alcohol use
 Disorders due to illicit drug use
 Mental disorders in children
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Video
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