This is the first in a series of papers by the Lancet on global mental health. There are three sections in the paper. In the first section the question of mental health burden is addressed by looking at a 2005 WHO report which suggested a figure of about 32% for the proportion of years-lived-with disability result from neuropsychiatric disorder. There follows a closer examination of the figures. The second section looks at the interactions between mental and physical illnesses and is much more intricate. This section includes medically unexplained symptoms, cardiovascular disease, diabetes, HIV, TB, malaria, injuries, psychosexual health and maternal and child health. As the paper references 270 other papers, this section is complex but the information is clearly and effectively displayed in a table. Some of the themes that are apparent are the recipricocity of the relationship between physical and mental health, the evidence or lack of evidence for these relationships and the impact of mental illness on adherence to medication and consequently on physical health. The third section looks at the implications for policy. There are many invaluable recommendations here: Elucidating the relationship between mental and physical illness, ensuring that concurrent physical illnesses are addressed in those with mental illnesses, ensuring that psychosocial assessments are part of the assessment process for medical illnesses, developing research locally (i.e. where the bulk of the global disease burden is located), developing psychosocial interventions and raising mental health awareness amongst other recommendations. When so much work has gone into a paper such as this and where it supports the noble aims of the Global Mental Health movement, the papers in this series in my opinion transcend the publication and become something more. This paper and the others in the series will no doubt continue to inspire.
Martin Prince, Vikram Patel, Shekhar Saxena, Mario Maj, Joanna Maselko, Michael Phillips and Atif Rahman. Global Mental Health 1. No Health WIthout Mental Health. (http://www.globalmentalhealth.org/downloads/GMH%20lancet%20series%20a1(469%20KB).pdf?PHPSESSID=4ce031d972799350afdc731226520e65, accessed 15.10.08).
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