Sally Mathiesen, Ph.D., LCSW
What is mental health? The World Health Organization launched Project Atlas in 2000 to respond to the large gaps in the collection and dissemination of information about mental health service delivery in countries around the world. “It replaces impressions and opinions with facts and figures” (WHO, 2011, p.7). The main findings of the WHO (2011) project are as follows:
RESOURCES TO TREAT AND PREVENT MENTAL DISORDERS REMAIN INSUFFICIENT
Globally, spending on mental health is less than two US dollars per person, per year and less than 25 cents in low income countries. Almost half of the world’s population lives in a country where, on average, there is one psychiatrist or less to serve 200,000 people.
RESOURCES FOR MENTAL HEALTH ARE INEQUITABLY DISTRIBUTED
Only 36% of people living in low income countries are covered by mental health legislation. In contrast, the corresponding rate for high income countries is 92%. Dedicated mental health legislation can help to legally reinforce the goals of policies and plans in line with international human rights and practice standards.
Outpatient mental health facilities are 58 times more prevalent in high income compared with low income countries. User / consumer organizations are present in 83% of high income countries in comparison to 49% of low income countries.
RESOURCES FOR MENTAL HEALTH ARE INEFFICIENTLY UTILIZED
Globally, 63% of psychiatric beds are located in mental hospitals, and 67% of mental health spending is directed towards these institutions.
INSTITUTIONAL CARE FOR MENTAL DISORDERS MAY BE SLOWLY DECREASING WORLDWIDE
Though resources remain concentrated in mental hospitals, a modest decrease in mental hospital beds was found from 2005 to 2011 at the global level and in almost every income and regional group. “There is no health without mental health,” (WHO, 2007).
Mental health, then, is more than the absence of mental disorders. It is the foundation for well-being and effective functioning for individual and community. Mental health is determined by socio-economic and environmental factors. Greater vulnerability to mental health disorders for disadvantaged people may be related to factors such as: insecurity and hopelessness, rapid social change, risks of violence, and physical ill health (WHO, 2007).
Mental health is linked to behavior. Substance abuse, violence, abuse of women and children, HIV/AIDs, depression, anxiety are more prevalent and difficult to cope with when combined with high unemployment, low income, limited education, stressful work conditions, gender discrimination, social exclusion, unhealthy lifestyle, and human rights violations (WHO, 2007).
WHO defines mental health as: “A state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community” (WHO, 2007).
The Universal Declaration of Human Rights states that “All human beings are born free and equal in dignity and rights.” But human beings are flawed in their actions toward each other. Human rights violations for those with mental disorders have been documented around the world. As social workers, we have the opportunity to work with people from all over the globe, whether we are in the United States or working internationally. Using the data gathered by sources such as the World Health Organization will be of great importance as we move forward in attempting to understand cultural variations and provide equal opportunity for mental health for all people.
Note: This article is based on a module in development for the Global Commission, Council on Social Work Education (CSWE) that will be available to all CSWE Affiliated MSW Programs.
References
World Health Organization (2011). Mental Health Atlas of 2011. Geneva, Switzerland.
WHO MH Gap Project (2008). http://whqlibdoc.who.int/publications/2010/9789241548069_eng.pdf
WHO Atlas of 2005. http://www.who.int/mental_health/evidence/Atlas_training_final.pdf
WHO Resource book on mental health, human rights and legislation (2005). http://www.who.int/mental_health/policy/who_rb_mnh_hr_leg_ FINAL_11_07_05.pdf
Dr. Mathiesen is professor at the School of Social Work, SDSU. She teaches courses in social work practice, research, and mental health.