Why a global edition of Psychiatric Times? The needs of the world's mentally ill are great; the barriers to effective treatment, extensive; and the availability of resources, limited. Still, the opportunities for international collaboration, scientific synergy and significant progress are many.
A trusted and well-read publication for mental health care professionals in the United States for more than 20 years, Psychiatric Times believes it can contribute to closing the gaps between the current global mental health situation and the provision of quality care for patients, whether in urban centers or remote villages.
The welcome increase in Internet usage throughout the world (e.g., Internet access is available in all African capital cities) permits new modes of scientific exchange. In anticipation, we have made major improvements on our Web site, such as enabling mental health care professionals worldwide to access the full-text of articles in this global edition.
We seek to facilitate global dialogues and information dissemination on issues such as mental health care policy and legislation, classification and diagnosis of mental disorders, research findings, clinical advances, treatment protocols, and prevention initiatives. All of this is being done with recognition that developing and developed countries can assist each other. Already, those in the developing countries are benefiting from the transmission of scientific technology, while those in developed countries are benefiting from knowledge of psychoactive herbal medicines used by traditional healers.
Burden of Mental Disorders
In this introduction to our first Global Watch edition, we offer glimpses of the global mental health burden, resource indicators and solution-oriented efforts.
The World Health Organization (WHO) has warned that the international burden of mental disorders is enormous and growing. As of 1990, five of the 10 leading causes of disability worldwide--measured in years lived with a disability--were psychiatric conditions: unipolar depression, schizophrenia, bipolar disorders, alcohol dependence and obsessive-compulsive disorder (Murray and Lopez, 1996). It is expected that by 2020, major depression, which is already ranked fourth among the 10, will jump to second place (Brundtland, 2001a).
More than 450 million people worldwide suffer from mental and brain disorders. This includes 121 million people with depression, 24 million with schizophrenia and 37 million with dementia (WHO, 2001). Substance use disorders are a major challenge as well, with 140 million people dependent on or abusing alcohol (Brundtland, 2001a) and an estimated 5 million people injecting illegal drugs. The high prevalence of HIV infection among intravenous drug users has accelerated the spread of HIV/AIDS.
Worldwide, nearly 1 million people commit suicide each year, and between 10 million and 20 million attempt it. The total number of youth suicides is increasing and in one-third of countries, suicide rates are higher among those under age 30 than in older age groups (Brundtland, 2001a, 2001b).
When viewed by region or country, the challenges become more specific. For example:
- In Europe, about 41 million adults are estimated to abuse or are dependent on alcohol, yet 66% receive no treatment. For some European societies, the costs of alcohol abuse and dependence have been calculated to amount to 3% of their gross domestic product (WHO/Europe, 2001).
- In China, suicide among 15- to 34-year-olds is a leading cause of death; it is the number one cause of death among young women in rural areas (WHO, 2001).
- Epidemiological studies of mental health in Latin America have shown a consistent prevalence of 18% to 25% of mental disorders in communities and up to 48% in clinical settings (Alarcon, 2003). In the year 2000, 18 million people in the region suffered financially serious setbacks (unemployment, job dismissals, eviction, homelessness) as a result of clinically significant mental disorders.
Abas M, Baingana F, Broadhead J et al. (2003), Common mental disorders and primary health care: current practice in low-income countries. Harv Rev Psychiatry 11(2):166-173.
Alarcon RD (2003), Mental health and mental health care in Latin America. World Psychiatry 2(1):54-56.
Brundtland GH (2001a), Mental health in our world: the challenges ahead. Presented at the Council for Mental Health Seminar. Oslo, Norway/Dec. 11.
Brundtland GH (2001b), Message from the director-general. In: The World Health Report 2001. Mental Health: New Understanding, New Hope. Geneva: WHO.
Jenkins R (2003), Supporting governments to adopt mental health policies. World Psychiatry 2(1):14-19.
Lavikainen J, Lahtinen E, Lehtinen V (2001), Public health approach on mental health in Europe. Helsinki, Finland: Stakes.
Murray CJ, Lopez AD, eds. (1996), The Global Burden of Disease: A Comprehensive Assessment of Mortality and Disability from Diseases, Injuries, and Risk Factors in 1990 and Projected to 2020 (Global Burden of Disease and Injury, Vol. 1). Cambridge, Mass.: Harvard School of Public Health.
Murthy RS (2003), Mental health policy: India-towards community mental health care.
Thornicroft G, Maingay S (2002), The global response to mental illness. BMJ 325(7365):608-609 [see comments].
WHO (2001), The World Health Report 2001. Mental Health: New Understanding, New Hope. Geneva: World Health Organization. Available at: www.who.int/whr2001/2001/main/en/contents.htm. Accessed Sept. 22, 2003.
WHO (2002a), Mental health: new WHO country data show resources fall short of needs. Available at: www.who.int/inf/en/pr-2002-30.html. Accessed Sept. 22, 2003.
WHO (2002b), Project Atlas: Database. Available at: www.cvdinfobase.ca/mh-atlas/main.htm. Accessed Sept. 16, 2003.
WHO/Europe (2001), Press backgrounder on the World Health Report 2001. Mental Health: New Understanding, New Hope. Available at: www.health.fgov.be/WH13/krant/krantarch2001/
kranttekstock1/011008m03who-europe.htm. Accessed June 3, 2003.