Mental Health Integrated into Primary Care
The World Health Organisation (WHO) and The World Organisation of Family Doctors (Wonca) today released a joint report that aims to offer help to hundreds of millions of people who are affected by mental disorders but cannot receive the care and treatment they need.
The report "Integrating mental health in primary care - a global perspective" shows through detailed examples of best practices from 12 nations that, even though the current provision of mental health in primary care is still globally insufficient and unsatisfactory, integration can be successfully achieved in a variety of socio-economic contexts.
The report also outlines 10 broad principles to guide countries in their efforts to successfully integrate mental health into primary care. These principles have been derived from an in-depth analysis of the best practices, and range from clear policy directions and resource allocation at national level through to local-level commitment and capacity building on the ground.
Though mental disorders represent 13% of the total burden of disease, the gap between the number of people affected and the number receiving care and treatment, even for severe conditions, remains enormous. Data presented in the report show that up to 75% to 86% of people with severe mental disorders in low- and middle-income countries, and 30% to 50% in high-income countries, had received no treatment in the prior 12 months.
"Many people present to primary care with a mental disorder but in many countries their problem is not recognised and treated," said Dr Ala Alwan, Assistant Director General for Non Communicable Diseases and Mental Health at WHO's headquarters in Geneva. 'Untreated mental health problems cause suffering for individuals, can increase the risk of suicide, and impair family and social relations and overall productivity at work."
One of the key recommendations of the report is to train primary care workers to help them better identify and respond to patients with mental disorders. Professor Chris van Weel, President of Wonca, remarked: 'We need education and training on mental health care for all students and health professionals preparing to work in family medicine and other areas of primary health care".
However, the effects of training are nearly always short-lived if health workers do not practise newly learnt skills and receive specialist supervision over time. Another key recommendation from the report is therefore to set up a system of supervision and ongoing support for primary care workers for integration to be successful.
Countries are already benefiting from the lessons and recommendations documented in the report.