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Investing in International Mental Health Aid

International Mental Health Aid
Although widely underreported in many countries, the World Health Organization’s (WHO) 2022 World Mental Health Report, identifies one in eight people in the world currently living with mental illness. Between 2000 and 2019, people living with mental disorders increased by 25%. Mental illness is a burden on both the person experiencing mental illness and on society. Those who live with mental illness deal with impacts on their education and relationships and can lead to disability. The broader economic impact of mental health disorders and illnesses includes the costs associated with individuals, communities and nations. These costs relate directly to health services, as well as the indirect costs resulting from loss of work, education and social opportunities, which lead to “stigma, discrimination and reduced life expectancy.”

Reasons to invest in international mental health aid include lowering the costs for nations and individuals and protecting peoples’ quality of life while increasing healthy years lived. In addition, mental health conditions continue to increase across the world as global threats like growing social and economic equality and public health emergencies remain prominent, according to WHO.

The Costs of Mental Illness

The global cost of mental illness was $2.5 trillion in 2010 with projections of the cost to increase to $6 trillion by 2030, according to WHO. A 2020 cost-of-illness global study found that the annual average societal cost of mental illness is between $1,180 to $18,313 per person treated. These costs include the cost of treatment and other costs like lost production and income. Depression and anxiety alone cost the global economy $1 trillion a year, yet the median of government health expenditures toward mental health globally is less than 2%. Other costs of mental illness include loss of life and opportunities.

The burden of mental health and substance use disorders is best described as a “disease burden,” which focuses on the impacts of both mortality and morbidity. Disease burden is measured by Disability Adjusted Life Years (DALYs), which measures deaths plus the years lived with the disease. The metric of one DALY equates to losing one healthy year. According to Our World in Data, in 2019 mental disorders caused 125.31 million DALYs globally. Global DALYs attributed to mental illness have increased to 4.9% in 2019. In addition to the loss of healthy years and opportunities, as of 2019, about 703,000 people lost their lives to suicide globally making the global suicide rate nine per 100,000, according to WHO.

Global Benefits of Investing in Mental Health Aid

International mental health aid reduces human suffering, advances public health and stops human rights violations experienced by those living with mental health conditions. According to WHO. improving people’s mental health also improves educational outcomes and leads to more participation and productivity in the workforce, which benefits all of society. It also improves people’s physical health, which expands people’s lifespan, ability to work and general happiness. Investment in mental health means ensuring access to quality, affordable mental health care, addressing stigma, discrimination and abuse and addressing the underlying economic and social inequalities that shape citizens’ mental health.

Investing in international mental health aid is that it leads to extra years of a healthy life, which generates productivity gains for the country that is investing in mental health care. The countries to benefit the most from investing in mental health care are lower-middle-income countries. Jamaica, a middle-income country, is an example of a country that invested in mental health care and received economic benefits. Jamaica invested $115 million into treatment for depression, anxiety and psychosis from 2015 to 2030. The benefits of this investment include an increase in psychosocial treatment from 15% to 50%, WHO reports. The economy has seen $434 million in saved money due to mental health care.

Supporting Sustainable Development Goals

According to WHO, not only is providing mental health aid beneficial to a country’s economy, but it also supports the U.N.’s Sustainable Development Goals, specifically SDG 1 to eliminate global poverty. Mental illness and poverty create a “cycle of disadvantage” because those living in poverty lack the finances to maintain basic necessities, have fewer educational and employment opportunities and are less likely to have access to quality health care. All of these stresses lead to a higher chance of experiencing a mental health condition. In addition, those experiencing severe mental health conditions are more likely to experience poverty due to increased health expenses and stigma and discrimination in the workforce, which leads to unemployment. “More than 80% of all people with mental disorders live in low- and middle-income countries,” WHO reports. These people lack access to welfare and effective treatment.

Moving Forward

In 2019, WHO began the Special Initiative for Mental Health: Universal Health Coverage for Mental Health, which works to make affordable, quality mental health care accessible in nine countries, covering 100 million people. This program focuses on the prevention of mental disorders, suicide prevention, mental health policy and legislation, mental health support in humanitarian emergencies and workforce development for mental health.

In Jordan, WHO’s Special Initiative for Mental Health is supporting the Ministry of Health’s efforts to implement Jordan’s National Mental Health Plan. This involves increasing community-based services and expanding the Caregiver Training Skills organization for families of children living with developmental disabilities. In addition, Jordan’s Special Initiative for Mental Health is supporting inpatient units in general hospitals and scaling up the implementation of the WHO regional School Mental Health program.

With more legislation, prevention, intervention and support for mental health conditions, mental health aid internationally could decrease lives lost, productivity losses and DALYs for countries, as well as increase productivity and economic gains, increase quality of life and further the SDGs.

– Arden Schraff
Photo: Flickr

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Focusing on the Living, Not the Dying

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So much of the emphasis in judging the quality of life of a country, or its progress, focuses on death. The numbers tell how many people die; how many of the dead were mothers, how many were children, the most fatal diseases, the most deaths by violence, etc. Christopher Murray, a Harvard researcher, took issue with this standard of measurement. While he agreed that death was a powerful indicator of a country’s welfare, he also saw a major oversight in using it as a yardstick. To Murray, it was important not solely to focus on the dead, who we can do nothing for, but also examine the quality of life of the living. Not only to think of how to keep people alive but also to ensure they are living well. Murray’s viewpoint was to revolutionize metrics. He spearheaded the shift from measuring mortality to the implementation of the DALY measure – Disability-Adjusted Life Year.

In simplest terms, the DALY measures the number of years a population lives with a disability, adjusting its productivity accordingly (as a major psychological or health problem will undoubtedly decrease a worker’s effectiveness), as well as measuring the impact of shorter life expectancy (often which is related to the disabilities in the DALY). ‘Disability’ in the term covers a wide arrange of conditions, among them pain, arthritis, mental illness such as depression and PTSD, disfigurement and major diseases. A highly sophisticated system, the DALY is weighted to measure the impact of conditions on younger members of a population more than older members to give a more accurate measure of impact on the economic potential of a given population (as the young are seen to have more potential than the aged because of longevity, energy, new skills, etc.).

Measuring the global burden of disease this way has yielded surprising – and often controversial – results. Yet this data is promising and exciting in that it shakes our current system and demands attention to issues that have so far been neglected. For example, depression and suicide are found to be more damaging than tuberculosis or cirrhosis, and one of the fastest-growing diseases is glaucoma. The DALY’s results have not been welcomed by all, however. When first introduced after measuring international statistics, many countries were graded much lower than on an objective mortality scale and hotly contested the results.

The importance of metric systems in foreign aid is steadily increasing: in a world where every dollar could be used in many different ways, expenditure on aid and social programs needs to be well justified, with potential for results from investment. When asked about the use of DALYs to give an accurate picture of the state of global health, Murray stated, “People walk around with a mental map that’s different for every one of us. A real map has got to be a better guide.”

– Farahnaz Mohammed

Source: Discover Magazine
Photo: Change