Wednesday, October 3, 2007

No health without mental health

The Lancet has recently published a paper entitled "No health without mental health." It's worth a look, I'll be putting it up on Blackboard under the Psychiatry and Society label.

The abstract in full:

"About 14% of the global burden of disease has been attributed to neuropsychiatric disorders, mostly due to the chronically disabling nature of depression and other common mental disorders, alcohol-use and substance-use disorders, and psychoses. Such estimates have drawn attention to the importance of mental disorders for public
health. However, because they stress the separate contributions of mental and physical disorders to disability and mortality, they might have entrenched the alienation of mental health from mainstream eff orts to improve health and
reduce poverty. The burden of mental disorders is likely to have been underestimated because of inadequate appreciation of the connectedness between mental illness and other health conditions. Because these interactions are protean, there can be no health without mental health. Mental disorders increase risk for communicable and non-communicable diseases, and contribute to unintentional and intentional injury. Conversely, many health conditions increase the risk for mental disorder, and comorbidity complicates help-seeking, diagnosis, and treatment, and influences prognosis. Health services are not provided equitably to people with mental disorders, and the quality of care for both mental and physical health conditions for these people could be improved. We need to develop and
evaluate psychosocial interventions that can be integrated into management of communicable and non-communicable diseases. Health-care systems should be strengthened to improve delivery of mental health care, by focusing on
existing programmes and activities, such as those which address the prevention and treatment of HIV, tuberculosis, and malaria; gender-based violence; antenatal care; integrated management of childhood illnesses and child nutrition;
and innovative management of chronic disease. An explicit mental health budget might need to be allocated for such activities. Mental health aff ects progress towards the achievement of several Millennium Development Goals, such as
promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS. Mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning, and delivery of primary and secondary general health care."

Something of particular interest:

"The population-attributable fraction (which is the proportion of cases of disability that would not have occurred in the
absence of mental disorders) could be as high as 0∙69,which suggests that failing health and consequent disability
could be the most important contributory cause for late-life

In other words, 69% of disability - even that ostensibly not related to mental illness - is due to mental health.

1 comment:

Niall Crumlish said...

Hi Seamus

As I mentioned I will be touching on this on Thursday - I was on the site to put a link up but I see you beat me to it. Great paper, if huge.

Amazing figure, that PAF of 0.69.

See you Thursday.