Mental disorders around the globe remain low-priority, yet they concern so many people worldwide. The suffering that is
caused by mental illness impacts the persons affected and their families as well as numerous aspects of life. In its Mental
Health Action Plan as well as elsewhere, the WHO describes a variety of steps that should be taken worldwide, next to those
that have been pointed out by actors in the field for years in publications. More must be done in the field of mental health.
One important aspect in this context is stigmatization. We need differentiated statements, not arguments like the one that
it is the fault of the affected persons themselves. It has been known for a long time that we need transdisciplinary collaboration
at the national and international level, e.g. among the persons affected, their advocacy organizations, the decisionmakers,
and international organizations. Declarations will not do by themselves; they must be put into practice. Reports
without binding commitments serve no purpose. What is needed is diversified expert competence, adequate educational
facilities. On a worldwide average only a few per cent of health budgets are invested in mental health. Sustained investments
from public and other funds are indispensable.
Mental disorders around the globe are often invisible and
remain a low priority, as discussed by Baxter et al. 2013.
Actors and responsibilities like Jim Yong Kim, President of
the World Bank and Margaret Chan, Director-General of the
World Health Organization (WHO) announced that the mental
health purpose has to been taken out of the shadow, has to
become a priority, has to become a Global Development Priority. However, how to achieve these goals?
Systematic review of bibliographic databases, analyzes and
extracts of key publications, inclusion of more than 320 publications.
The present publication includes 83 publications/presentations
containing data and/or statements that are based
on scientific studies, surveys, considerations, analyses etc.,
Epidemiology/ prevalence: Many years ago the Global Burden
of Disease (GBD) study published that neuro-psychiatric disorders
account for more than 25% of all health loss due to
disability, or one in four over lifetime, more than eight times
greater than that attributed to heart disease and 20-fold
greater than to cancer.
Worldwide around 10-20% of children and young adolescents
experience mental disorders. Half of all mental illnesses
begin by the age of 14 years and three-quarters by mid-20s. Attention deficits, cognitive disturbances, lack of motivation,
and negative mood are typical manifestations.
Globally, about 350 million people are affected by depression, in general more women are affected than men. About 60
million people worldwide are affected by bipolar affective
disorder, about 21 million are affected by schizophrenia and
other psychoses. Estimated over 47 million people worldwide
have dementia with the majority of sufferers living in low- and
middle-income countries.
Correlations: More than 20% of adults aged 60 and over suffer
from a mental or neurological disorder, excluding headache
disorders with recognition that many of the broad complexities
of the frequent chronicity of mental disorders have an
interplay and correlation with other chronic multimorbid diseases.
A mental illness can contribute substantially to increased
chronic disease morbidity and mortality, e.g. with chronic
diseases like with Type 2 diabetes. Patients with chronic
medical illnesses can have two- to threefold higher rates of
major depression compared with age- and gender-matched
primary care patients and e.g. modifiable health risk behaviors,
like inadequate vegetable consumption, inadequate fruit
consumption, smoking, physical inactivity, and alcohol risk.
Gender effects in the prevalence of common mental disorders
(like anxiety disorders) is evident. Steel et al. documented
that women having e.g. higher statistical rates of mood
(7.3%:4.0%) and anxiety (8.7%:4.3%) disorders during the
previous 12 months and men have higher rates of substance
use disorders (2.0%:7.5%), with a similar pattern for lifetime
prevalence.
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