Mental Health – A neglected chronic disease

The term Neglected Tropical Disease (NTD) is used in the field of communicable diseases to denote a diverse group of communicable diseases that prevail in tropical and subtropical conditions and affect more than one billion people worldwide. Populations living in poverty, without adequate sanitation and in close contact with infectious vectors and domestic animals and livestock are those worst affected (WHO).

Noncommunicable diseases (NCDs), also known as chronic diseases, tend to be of long duration and are the result of a combination of genetic, physiological, environmental and behaviours factors.

The main types of NCDs are cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructive pulmonary disease and asthma) and diabetes.

NCDs disproportionately affect people in low – and middle-income countries where more than three quarters of global NCD deaths occur.

Over the past decade the focus has been on lowering the burden of NCDs by stressing risk factor reduction and other initiatives. The focus has been on diseases like diabetes, cancer and cardiovascular diseases. However, chronic conditions such as mental illness, violence and injuries and even fragile and vulnerable settings are a major concern globally.

According to the World Health Organization (WHO), mental health is a state of well-being in which every individual is able to realize his/her own potential, can cope with the normal stresses of life, work productively and make a contribution to his/her family and community.

Mental disorder is defined by psychiatric experts as a clinically significant behavioural or psychological syndrome with sufficient personality, mind and/or emotional disorganization that seriously impairs individual and social function with an increased risk of suffering, death, pain, disability or loss of freedom.

In many countries, health systems generally focus on traditional chronic diseases. Mental health does not get similar attention. There is a need to encourage and support national governments to move toward strengthening sustainable, cost effective, comprehensive and integrated health care systems that includes full equity through universal coverage with strategies to strengthen the system through credible evidence and research to support mental health.

Mental health services should be accessible and should be integrated into primary health care. Primary care physicians should be able to identify risk factors and should be able to initiate care of patients with mental health issues. Too often, patients’ conditions go unattended and it is only when something serious takes place that we hear about possible signs that the patients were exhibiting.

Investments must also focus on building human resource capacity within the health sector to respond to mental illness. There is the need to have a strong team of qualified mental health staff both at the primary and the secondary health care levels. Working in mental health is not the most attractive medical field and so efforts to attract, retain and adequately compensate staff should be considered.

There is the need to enhance mental health education and to have it integrated into the formal education curriculum system so that teachers, students and parents can have a greater understanding and appreciation of mental health.

As we work to address the serious gaps in the mental health system and to draw more attention to this issue, it is important that we continue to provide the best possible services.

Dr. Rosmond Adams, MD; MSc (Public Health); M.S (Bioethics) is a medical doctor and a public health specialist with training in bioethics and ethical issues in medicine, the life sciences and research. He is a lecturer of medical ethics and Research Methods.

He is the Head of Health Information, Communicable Disease and Emergency Response at the Caribbean Public Health Agency (CARPHA). He is also a member of the World Health Organization Global Coordination Mechanism on the Prevention and Control of NCDs.

(The views expressed here are that of the writer and not of any organizations). You may contact him at adamsrosmond@gmail.com