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Global Burden of Mental Illness

Global Burden of Mental Illness. Asia Maselko and Kristen Shirey 09 October 2012. How is Burden Defined? . Mortality DALYs YLD Prevalence Foot-print Cost of care Loss of productivity Loss of income Family, community, and country costs. Mortality—Leading causes 2000. WHO, 2002.

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Global Burden of Mental Illness

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  1. Global Burden of Mental Illness Asia Maselko and Kristen Shirey 09 October 2012

  2. How is Burden Defined? • Mortality • DALYs • YLD • Prevalence • Foot-print • Cost of care • Loss of productivity • Loss of income • Family, community, and country costs

  3. Mortality—Leading causes 2000 WHO, 2002

  4. DALYs—Leading causes 2000 WHO, 2002

  5. DALYs by neuropsychiatric diagnosis WHO, 2002

  6. YLDs—10 Leading Causes 1990 BMJ 2002;325:947

  7. Prevalence • 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

  8. Global burden = Global disparity • 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?

  9. Global burden = Global disparity • 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.

  10. mhGAP Approach • 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:

  11. mhGAP • 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

  12. Global burden : Global footprint Video

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