[NYAPRS Enews] NYT: Aid Groups Aim to Put Mental Health on World Agenda

[Thomas Templeton]

NYAPRS Note: The World Health Organization (WHO) and the World Bank are assembling a coalition of doctors, aid groups, and government officials to prioritize mental health as a global concern. For all of the infrastructure problems and service gaps in the U.S., many parts of the world have nothing in the way of mental health care.
Moreover, in a study published by The Lancet, an international research team determined that for every dollar of investment spent on programs to treat depression and anxiety worldwide, a $3-$5 return would be expected in addition to a more healthy life. This likely economic advantage is appealing to many decision-makers around the world who might otherwise be skeptical of such an investment.

Aid Groups Aim to Put Mental Health on World Agenda
By Benedict Carey New York Times April 12, 2016

Good mental health care is scarce in many parts of the United States, but it is nonexistent in most of the world. In developing countries, the ratio of mental health professionals to citizens is about one in a million — and that vast majority of people with treatable conditions like anxiety and depression are left to their own devices, or to the ministrations of local folk healers.

This week, the World Bank and the World Health Organization are convening hundreds of doctors, aid groups and government officials to start an ambitious effort to move mental health to the forefront of the international development agenda.

“The situation with mental health today is like H.I.V.­AIDS two decades ago,” Tim Evans, the senior director of health, nutrition and population at the World Bank Group, said Tuesday in a call with reporters. “We are kick­starting a similar movement for mental health, putting it squarely on the global agenda.”

The conference in Washington coincides with the publication on Tuesday of the first global estimate of potential returns on investing in treatment programs for depression and anxiety, the most common mental disorders, which are now epidemic in conflict zones and refugee communities.

In a review of data from 36 countries, including poor nations in Africa and Asia as well as affluent countries in Europe and elsewhere, an international research team calculated that every dollar of investment in such programs would bring a return of $3 to $5 in recovered economic contributions and years of healthy life. The study appears in the journal The Lancet Psychiatry.

“About 30 percent of total disability costs are due to mental health disorders — this is huge number,” said Dr. Shekhar Saxena, director of the mental health and substance abuse department at the World Health Organization and one of the study’s co­authors.

An expert not involved in the research said the analysis used state­of­the-art methods and was persuasive, given how little is known about interventions in developing countries in particular.

“For a decision maker at the Ministry of Finance, these numbers would be a low­risk, high­gain investment,” said the expert, Kjell Arne Johansson, an associate professor of global public health and primary care at the University of Bergen in Norway.

Dr. Johansson added, however, that because there were “few health economic evaluations of this kind available,” it was difficult to compare the expected returns on investment in other types of prevention and treatment programs.

Mental health has traditionally languished near the bottom of the international health agenda, as well as nations’ health spending. But international aid groups have sponsored dozens of interventions for anxiety and depression in developing countries: for example, training mental health workers in Liberia in the wake of the Ebola outbreak and the civil war there; and setting up screening and treatment services for women in Rwanda victimized by sexual or gender­based abuse.

In the analysis, the research team used a standardized tool called OneHealth to calculate treatment costs and outcomes in the 36 countries from 2016 to 2030.

Assuming a 5 percent improvement in health and restored productivity, the research team calculated that an investment of $147 billion in treatment or these common mood disorders would result in some $400 billion in returns, said Dan Chisholm a health economist at W.H.O. and another coauthor of the study.

http://www.nytimes.com/2016/04/13/health/world-bank-who-mental-health-depression.html?_r=0

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