MENTAL HEALTH AND DEVELOPMENT: - libdoc.who.int - World ...

More documents

Recommendations

Info

Box 4 Mental health interventions are cost effective 180 Thetreatmentofmentalhealthconditionsisascosteffectiveasantiretroviral treatmentforHIV/AIDS,secondarypreventionofhypertension,and glycaemiacontrolfordiabetes.Scalingupafullpackageofprimarycare interventionsforschizophrenia,bipolardisorder,depression,andhazardous alcoholuseovera10-yearperiodwouldrequireatotaladditionalinvestment ofonlyUS$0.20percapitaperyearinlow-incomecountries,andUS$0.30 percapitaperyearinlowermiddle-incomecountries,thatis,atotalfinancial outlayofupto$2perpersonand$3–4respectively. As treatment of mental health conditions is affordable and cost effective all health services established as part of the national health response, should include a mental health component. Mental health interventions should be integrated systematically, starting at primary care. To be fully effective and efficient, primary care for mental health must be complemented by secondary care, and have linkages to informal community-based services and self care. 149 Interventions should focus on support, not coercion, and should be tailored to values and priorities of individuals and their families. A recent World Health Organization and World Organization of Family Doctors report, Integrating mental health into primary care: a global perspective, identified ten principles for the successful integration of mental health into primary care (see Box 5). 149 By adopting the ten principles, countries can improve health workers’ knowledge, skills, and confidence to provide mental health interventions; improve health and social outcomes for people with mental health conditions; and substantially increase the availability of mental health interventions across the population. A range of country experiences with integrating mental health into primary care are summarized in Box 6. Integrating mental health into primary care services is vital. 36 MentalHealthandDevelopment:Targetingpeoplewithmentalhealthconditionsasavulnerablegroup WHO/Christopher Black
Box 5 Ten principles for the successful integration of mental health into primary care 149 1. Policyandplansneedtoincorporateprimarycareformentalhealth.Bothmental healthandgeneralhealthpoliciesandplansshouldemphasizementalhealth servicesatprimarycarelevel. 2. Advocacyisrequiredtoshiftattitudesandbehaviour.Timeandeffortarerequired tosensitizenationalandlocalpoliticalleadership,healthauthorities,management, andprimarycareworkersabouttheimportanceofmentalhealthintegration. 3. Adequatetrainingofprimarycareworkersisrequired.Pre-serviceand/or in-servicetrainingofprimarycareworkersonmentalhealthissuesisessential, andhealthworkersalsomustpractiseskillsandreceivespecialistsupervision overtime. 4. Primarycaretasksmustbelimitedanddoable.Decisionsaboutspecifictasks mustbetakenaftercarefulconsiderationoflocalcircumstances. 5. Specialistmentalhealthprofessionalsandfacilitiesmustbeavailabletosupport primarycare.Theintegrationofmentalhealthservicesintoprimarycaremust beaccompaniedbycomplementaryservices,particularlysecondarycare componentstowhichprimarycareworkerscanturnforreferrals,support,and supervision. 6. Patientsmusthaveaccesstoessentialpsychotropicmedicationsinprimarycare. Countriesshouldreviewandupdatelegislationandregulationstoallowprimary careworkerstoprescribeanddispensepsychotropicmedications,particularly wherementalhealthspecialistsandphysiciansarescarce,andtheyshould distributepsychotropicmedicinesdirectlytoprimarycarefacilities,ratherthan throughpsychiatrichospitals. 7. Integrationisaprocess,notanevent.Integrationtakestimeandtypicallyinvolves aseriesofdevelopmentsspanningseveralyears. 8. Amentalhealthservicecoordinatoriscrucial.Mentalhealthcoordinatorsare crucialinsteeringprogrammesaroundchallengesanddrivingforwardthe integrationprocess. 9. Collaborationwithothergovernmentnon-healthsectors,nongovernmental organizations,villageandcommunityhealthworkers,andvolunteersis required.Individualsandagenciesoutsidethepublichealthsectorcanprovide complementarysupportandhelppeoplewithmentalhealthconditionsaccess neededresourcesandintegratefullyintothecommunity. 10. Financialandhumanresourcesareneeded.Althoughprimarycareformental healthiscosteffective,financialresourcesarerequiredtoemployandtrain primaryhealthworkers,andtopurchasepsychotropicmedications. 4.Improvingdevelopmentoutcomes:principlesandactions 37
Page 1:
MENTAL HEALTH AND DEVELOPMENT: Targ
Page 4 and 5:
WHOLibraryCataloguing-in-Publ
Page 6 and 7:
Executive summary . . . . . . .
Page 8 and 9:
This report on mental health and de
Page 10 and 11:
Association for Mental Health and A
Page 12 and 13:
Supporting statements H.R.H. Prince
Page 14 and 15:
promotes a holistic approach to men
Page 16 and 17:
affect them, including development
Page 18 and 19: event drives vulnerable individuals
Page 21 and 22: Supportingstatements response to
Page 23 and 24: Supportingstatements Gerard Quin
Page 25 and 26: Supportingstatements The Ministr
Page 27 and 28: Supportingstatements The report
Page 29 and 30: Executivesummary Two development
Page 31 and 32: Executivesummary opportunities a
Page 33 and 34: 1. Pan American Health Executive
Page 35 and 36: 1.Introduction People with menta
Page 37 and 38: 1.Introduction community, to ens
Page 39 and 40: 2. People with mental health condit
Page 41 and 42: assumed to be lazy, weak, unintelli
Page 43 and 44: Box 1 Prisons - unsuitable holding
Page 45 and 46: In many countries, people cannot co
Page 47 and 48: affected have had an important voic
Page 49 and 50: Some country examples: • In Argen
Page 51 and 52: health complications. Similar scena
Page 53 and 54: Of the several thousand letters I r
Page 55 and 56: People with mental health condition
Page 57 and 58: health conditions, including diabet
Page 59 and 60: 3. Other vulnerable groups have hig
Page 61 and 62: Box 3 How does vulnerability lead t
Page 63 and 64: Some country examples: • In Austr
Page 65 and 66: 4. Improving development outcomes:
Page 67: 4.2 Specific actions Specific progr
Page 71 and 72: 4.2.2 Integrate mental health issue
Page 73 and 74: Box 8 Mental health interventions f
Page 75 and 76: Box 10 AYouthLinkclient,21
Page 77 and 78: Figure 2 Cognitive: Increase presch
Page 79 and 80: Box 12 Employment opportunities for
Page 81 and 82: 4.2.7 Strengthen human rights prote
Page 83 and 84: Box 16 Governments can also be enco
Page 85 and 86: The right to associate is important
Page 87 and 88: 5. All development stakeholders hav
Page 89 and 90: ights. Organizations representing f
Page 91 and 92: to pursue an education and ensure t
Page 93 and 94: Across a range of roles and activit
Page 95 and 96: Conclusion Conclusion Many people w
Page 97 and 98: References References 1 Reducing po
Page 99 and 100: References 46 South Central Somalia
Page 101 and 102: References 93 Alonso J et al. Popul
Page 103 and 104: References 144 Meade CS. Sexual ris
Page 105 and 106: References 192 What works! Employme
Page 108: PEOPLE WITH MENTAL HEALTH CONDITION
show all

MENTAL HEALTH AND DEVELOPMENT: - libdoc.who.int - World ...

Create successful ePaper yourself

Delete template?

Save as template?