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Countries spend too little on mental health: WHO

LONDON, Apr 23 (Reuters Health) - The World Health Organisation (WHO) on
Tuesday held a mirror up to the way countries deal with mental illness, and
found many sorely lacking in terms of spending and provision of quality care.

More than 450 million people worldwide have mental or neurological
disorders, accounting for about 12% of the global burden of premature death
and disability, WHO notes.

But its newly published "Country Profiles on Mental Health" show that one
in three countries spend less than 1% of their national health budgets on
treating these conditions.

The profiles, which will be continuously updated, are intended to help
countries compare their mental health programmes with recommendations WHO
outlined in its World Health Report last year, Dr. Shekhar Saxena, one of
the agency's coordinators for mental health, told Reuters Health.

"In this publication we are giving specific country data," Saxena said.

"We are saying what countries have and don't have; what they need to do
immediately to translate WHO recommendations into action."

WHO thinks that, in an ideal world, between 5% and 10% of the total health
budget should be spent on mental health, Saxena said.

In reality, 40% of countries have no mental health policies and 25% have no
legislation in the field.

Countries like China, Iran, Nigeria, Thailand and Turkey have no specific
legislation for mental health.

And Western nations are in many cases no better than their developing
counterparts, reinforcing the idea that all countries, rich and poor, need
to make mental health a bigger priority, WHO states.

"The main point is that the comparatively rich countries shouldn't be
complacent as the situation there is far from ideal," Saxena said.

"The burden is high, community interventions are available and accessible
if you implement them, but still countries are lagging behind in terms of
expenditure and improving modalities of care."

Specifically, WHO would like to see countries moving more of their mental
health treatment out of asylums and into community care facilities.

"It is widely accepted that community care is more effective as well as
more humane than inpatient stays in mental hospitals," the agency said in a
statement.

"Surprisingly, a large number of economically developed countries with
extensive mental health infrastructure still have a large proportion of
their psychiatric patient beds in mental hospitals."

Globally, about 65% of psychiatric beds are in mental hospitals.

In Africa, the Eastern Mediterranean and South-East Asia, community care is
almost non-existent.

It is absent in one in three countries in other regions, the new profiles
show.

There is also a distinct shortage of mental health professionals in much of
the world, the UN agency says.

"More than 680 million people, the majority of whom are in Africa and Asia,
have access to less than one psychiatrist per million population.

"This is the case in large countries with populations over 100 million,
like Bangladesh and Nigeria," according to the statement.

The point of the new data is not to create a league table of countries,
pointing the finger at those who are the worst offenders, Saxena said.

"Rather, we are making this report available, not only in printed form but
online, so that it can be useful to policy and planning.

"It is actual concrete help; a baseline status report for countries to see
where they are and how they improve."

The atlas is available at http://mh-atlas.ic.gc.ca/.

Copyright 2002 Reuters Limited. All rights reserved.
http://www.reutershealth.com/archive/2002/04/23/eline/links/20020423elin031.
html

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