June 09-41-2.indd - Kma.org.kw

June 2009KUWAIT MEDICAL JOURNAL 181to grow, particularly in developing countries. It isessential to prioritize, implement and fund projects onautism spectrum disorders and other mental disordersin children in developing countries.”Currently, the vast majority of children with mentalhealth needs in developing countries do not receiveany treatment or care. The immediate challenge inthese countries is generating sufficient resources forprimary health care to ensure early identificationand treatment of mental disorders among children.These disorders are included as priority conditions inWHO’s Mental Health Gap Action Programme 2008-2013, launched in 2008.“A prioritized agenda for autism and other mentaldisorders in children should generate and strengthenthe evidence base for cost-effective prevention andcontrol strategies. Scaling up of services is the realneed. This will also improve educational attainmentsand will contribute to a better informed and healthiergeneration of children.” said Dr Benedetto Saracenos,Director, Mental Health and Substance Abuse atWHO.World autism awareness day:On 18 December 2007, the United Nations GeneralAssembly adopted resolution 62/139 which declaredApril 2, as World Autism Awareness Day.Autism spectrum disorders are characterized byvarying degrees of impairment in communicationskills and social interactions and in restricted, repetitivepatterns of behaviour. The condition causes disabilitiesthat can be lifelong. Emerging evidence indicates thatearly intervention results in improved outcomes.Autism spectrum disorders and other mentaldisorders among children bring significant economichardships to families, given the lack of health resourcesoften found in developing countries. The stigmatizationand discrimination associated with these illnessesalso remain substantial obstacles to diagnosis andtreatment. The absence of autism spectrum disordersand other mental disorders among children from listsof the leading causes of death has contributed to theirlong-term neglect by both public policy-makers indeveloping countries, as well as donors.UN Convention on the Rights of the Child 1990States parties• recognize that a mentally or physically disabledchild should enjoy a full and decent life, inconditions which ensure dignity, promoteself-reliance, and facilitate the child’s activeparticipation in the community (Article 23.1);• agree that the education of the child shall bedirected to: a. the development of the child’spersonality, talents and mental and physicalabilities to their fullest potential (Article 29 1.a);• shall take all appropriate measures to promotephysical and psychological recovery and socialreintegration of a child victim...re-integrationshall take place in an environment which fostersthe health, peer-respect and dignity of the child(Article 39)Some bare facts about mental disorders:• Mental, neurological and behavioural disordersare common to all countries and cause immensesuffering. People with these disorders are oftensubjected to social isolation, poor quality of lifeand increased mortality. These disorders are thecause of staggering economic and social costs.• Hundreds of millions of people worldwide areaffected by mental, behavioural, neurological andsubstance use disorders. For example, estimatesmade by WHO in 2002 showed that 154 millionpeople globally suffer from depression and 25million people from schizophrenia; 91 millionpeople are affected by alcohol use disordersand 15 million by drug use disorders. A recentlypublished WHO report shows that 50 millionpeople suffer from epilepsy and 24 million fromAlzheimer and other dementias.• In addition to the above figures, many otherdisorders affect the nervous system or produceneurological sequelae. Projections based on aWHO study show that worldwide in 2005, 326million people suffer from migraine; 61 millionfrom cerebrovascular diseases; 18 million fromneuroinfections or neurological sequelae ofinfections. Number of people with neurologicalsequelae of nutritional disorders and neuropathies(352 million) and neurological sequelae secondaryto injuries (170 million) also add substantially tothe above burden.• About 877,000 people die by suicide every year.• One in four patients visiting a health service hasat least one mental, neurological or behaviouraldisorder but most of these disorders are neitherdiagnosed nor treated.• Mental illnesses affect and are affected by chronicconditions such as cancer, heart and cardiovasculardiseases, diabetes and HIV/AIDS. Untreated, theybring about unhealthy behaviour, non-compliancewith prescribed medical regimens, diminishedimmune functioning, and poor prognosis.• Cost-effective treatments exist for most disordersand, if correctly applied, could enable most ofthose affected to become functioning members ofsociety.• Barriers to effective treatment of mental illnessinclude lack of recognition of the seriousness ofmental illness and lack of understanding aboutthe benefits of services. Policy makers, insurance