1. Week one

2. Global Mental Health  Vikram Patel Clip: Video Clip: Mental Health for All, By All URL: http://www.youtube.com/watch?v=yzm4gp AKrBk

3. Global Mental Health  World Health Organisation Report- 2001 Mental Health: new understanding, new hope Raised profile of global mental health 10 recommendations: ○ Medication access ○ Care in the community ○ Involvement of families, communities, users and carers; public

4. World Health Report (2001)  Need for national policies; programmes and legislation  Inter-sectoral collaboration  Human resource development for professionals specialized in mental health  Monitoring mental health of communities  Further research required

5. Lancet series: 2007  Launch of Global Mental Health Movement: “ mental health awareness needs to be integrated into all aspects of health and social policy, health-system planning and delivery of primary and secondary general health care”

6. Global mental healthcare movement  Limited progress to date; neglected area  Relevance to other global health challenges  Inequitable and insufficienct distribution of mental health resources  Need to scale up mental health services in face of existing evidence  Need for political leadership and advocacy; financial support and training

7. Global Mental Healthcare movement  Emphasised relevance of a ‘public health’ approach  Advocacy network established  Moral critique: sufferers existing in worst moral conditions.  Stigma of mental illness – individuals marked as non-human  Mental health professionals themselves

8. Moral condition (Kleinman)  Moral critique: sufferers existing in worst moral conditions.  Stigma of mental illness – individuals marked as non-human  Mental health professionals themselves are most effective and efficient transmitters of stigma  Some positive global changes  Need for protection by the state

9. Ethical imperative  Movement for global mental health must seek to improve the moral conditions of those with chronic mental illness: past moral failure of humanity must not longer be tolerated

10. “No health without mental health’  Key message of Lancet series  Mental health and conversely mental illness is intimately linked to many other physical conditions – co-morbidity rates are high  Notable reduction in life expenctancy by at least 10 years, probably longer in LMIC

11. Global Burden of Disease  Neuropsychiatric illnesses responsible for 14% of global burden of disease  Most notable: depression (350m worldwide); alcohol use disorders  Dementia rates to triple by 2020 with demographic transition

12. Disability  Disability is significant and disproportionate: 1/3 of years lost due to disability worldwide DALY: Disability Adjusted Life Year (one year lost of healthy life)

13. Treatment Gap  The absolute difference between the true prevalence of the disorder and the treated proportion of individuals with the disorder.  Varies across conditions and countries  Worldwide: 50% for mental disorders, probably 90% in lowest resource settings