Interventions

Interventions

Information and evidence about cost-effective interventions to provide better mental health care is available. Although most of the research (80%) has been carried out in high-income countries, there is also strong evidence from low- and middle-income countries that pharmacological and psychosocial interventions are effective ways to treat mental disorders, with the strongest evidence for depression, schizophrenia, bipolar disorder and hazardous alcohol use.

Recommendations to strengthen mental health systems around the world have been first mentioned in the World Health Report 2001, which focused on mental health:

1. Provide treatment in primary care
2. Make psychotropic drugs available
3. Give care in the community
4. Educate the public
5. Involve communities, families and consumers
6. Establish national policies, programs and legislation
7. Develop human resources
8. Link with other sectors
9. Monitor community mental health
10. Support more research

Based on the data of 12 countries, assessed by WHO-AIMS (World Health Organization Assessment Instrument for Mental Health Systems), the costs of scaling up mental health services by providing a core treatment package for schizophrenia, bipolar affective disorder, depressive episodes and hazardous alcohol use have been estimated. Structural changes in mental health systems according to the WHO recommendations have been taken into account. For most countries, this model suggests an initial period of investment of $ 0.30 – 0.50 per person per year. The total expenditure on mental health would have to rise at least 10-fold in low-income countries. In those countries, additional financial resources will be needed, while in middle- and high-income countries the main challenge will be the reallocation of resources within the health system to provide better mental health service.