Inequities in public health spending and focus are often seen among income level, race, and different diseases. However, there are also huge discrepancies in the funding and attention of different aspects of health. Particularly, mental health is lacking. Globally, 1 in 10 people suffer from a mental illness, and yet only a mere one percent of the global health workforce works in mental health. This puts the average mental health worker allegedly responsible for 10,000 people(based on world statistics). We know that the distribution of mental health professionals is not equal around the world. For example, in the U.S., though our mental health workforce is lacking and treating mental illness continues to be a huge public health challenge for us, we still have better access and generally more advanced treatment than millions of people suffering around the world.
One of the reasons for such low accessibility is the overall lack of funding in this area. It is estimated that only $2 per capita per year is spent on mental health in low and middle-income countries. Even higher income countries are not spending nearly enough with an average rate of 42 beds per 100,000 population. With a lack of funding, few countries have any programs in place to spread awareness of care or even to accept new patients. Less than half of countries surveyed by the World Health Organization have at least two functioning mental health promotion and prevention initiatives. Of countries that do have programs in place, most are focused on combating stigmas and largely on suicide prevention. There is a huge gap in care for women with mental illness pertaining to maternity or violence.
Along with a lack of funding comes a lack of professionals entering the field. Since 2011, the number of nurses entering into mental health professions has increased, but only by a slight 35 percent. This number also does not showcase the distribution of the new professionals entering the field- most in higher income countries. Furthermore, the countries where the largest inequities are seen are often the places where people are most susceptible to mental illness. In middle and low-income countries, there are often higher incidences of violence or more disastrous effects of natural disasters, which prove to be traumatic for the people who experience and deal with the consequences of such events. Thus, mental illness can easily manifest and often go untreated.
The World Health Organization has put into effect the Comprehensive Mental Health Action Plan 2013-2020, which aims at improving leadership, providing comprehensive care services, implementing promotion and prevention strategies, and strengthening information systems, evidence, and research as each pertains to mental illness. Hopefully, as the plan gains traction, we will start to see real progress in bridging the gaps in mental health care around the world. While higher-income countries in general have the resources, it is a matter of stepping back and refocusing to make quality and sustainable investments for long term success so that developing nations follow suit. Also, once more developed nations start to improve their care, they will be able to implement similar cost-effective programs in developing countries.
– Emma Dowd