The reviewed article is the fourth in the global mental health series ‘Mental health systems in countries: where are we now?’ by Professor K Jacob and colleagues. The aim of this paper is to identify where countries are at present in terms of their mental health resources. The authors examined the correlations between several economic and mental health resource indicators and also hand-searched three journals for mental health resource profiles on countries.
The authors found that 80% of the 191 countries they looked at had a mental health policy and that most of the countries that didn’t have a mental health policy were low or middle-income countries. There are then a series of tables with economic and mental-health resource data. There is lots of interesting data here. For instance there are a number of countries which have no psychiatrists or psychiatric nurses at all. Still others such as Uruguay have as many as 22 psychiatrists per 100,000 of the population. 70% of countries in Africa were identified as spending less than 1% of their health budget on mental health whilst 60% of European countries spent more than 5%. These differences raise interesting questions. Why should the proportion of spending be less in lower income countries and what factors influence the spending.
The authors then correlate economic and mental health data explaining their assumptions in the process. Here the authors attempt to answer the question of what factors influence the proportion of the health budget that is allocated to mental health. They found that only 14% of the variability was accounted for by ‘population, economic, health-related resource indicators and neuropsychiatric burden’.
The authors give three case studies in Brazil, India and South Africa of mental health policies which have been developed. The authors highlight the lack of a relationship between neuropsychiatric burden and proportion of health budget allocated to mental health care in some low and middle-income countries as an area to be addressed.
This paper contains a lot of detailed information on the current state of mental health resources globally as well as relevant economic and other indicators for countries. An important finding here was the relatively lower proportion of health budget that is spent on mental health in low and middle income countries and a need to ensure that neuropsychiatric burden influences relevant policies.
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