The Unseen- Mental Illness's Global Toll

The Unseen- Mental Illness's Global Toll - 27 JANUARY 2006...

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Unformatted text preview: 27 JANUARY 2006 VOL 311 SCIENCE www.sciencemag.org 458 NEWS FOCUS CREDIT: JEHAD NGA/CORBIS LONDON— When the bloody reign of the Khmer Rouge came to an end in 1979, there were no mental health workers left in Cam- bodia; they had died or disappeared. For more than a decade, says Phnom Penh psy- chiatrist Pauv Bunthoeun, only traditional healers were available to give treatment, often administering poison or beating the patient with burning incense to drive out vexing spirits. Conditions started to improve in 1994, Bunthoeun told a gathering of researchers and aid workers here. * That year, the Ministry of Health, aided by a team from the Univer- sity of Oslo, in Norway, began training a new generation of psychiatrists. Bunthoeun was one of the first through the program, which has produced all 26 of Cambodia’s psychia- trists. Bunthoeun’s hospital in Phnom Penh now sees up to 200 psychiatric outpatients a day, and in July 2005 it opened a 10-bed inpatient ward—the first and only one in a country of 12 million people. Such stories of unmet need are a com- mon refrain among mental health workers in the developing world. The imbalance is staggering. The majority of the world’s 450 million people who suffer from neu- ropsychiatric disorders live in developing countries, but the World Health Organiza- tion (WHO) estimates that fewer than 10% have access to treatment. In regions torn by war, poverty, and infectious disease, men- tal health care is often viewed as an unaf- fordable luxury. Nearly a third of the world’s nations, including many of the poorest, have no national budget for men- tal health, according to WHO. Even where budgets exist in developing countries, they average only about 1% of meager health resources. The United Nations Millennium Development Goals make no mention of mental health, nor do the Bill and Melinda Gates Foundation’s Grand Challenges in Global Health. “The mentally ill are particularly dis- advantaged among the poor,” says Benedetto Saraceno, director of WHO’s mental health department. Untreated mental illness rein- forces poverty, researchers say. Yet despite the common assumption that treatments require expensive drugs and complex ther- apy, recent trials from developing countries on three continents have demonstrated that simple, cheap interventions for common dis- orders such as depression can be effective. Other recent work suggests that incorporat- ing simple mental health interventions into anti-HIV and other public health campaigns may make them more successful. Mental health must be add- ressed like other basic needs, says Vikram Patel, a psychiatric epidemiologist at the London School of Hygiene and Tropical Medicine and a vocal advocate for this cause. “It is unethical to deny effective, fea- sible, and affordable treatment to millions of people suffering from treatable disor- ders,” he argues. The challenge, Patel and others say, is to persuade policymakers it’s a problem worth addressing.problem worth addressing....
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The Unseen- Mental Illness's Global Toll - 27 JANUARY 2006...

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