By CHRISTABEL LIGAMI

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Mental disorders are on the rise and will cost the global economy $16 trillion by 2030, a Lancet Commission report on mental health indicates.

The report shows that in many countries, people with mental disorders suffer gross human rights violations, including shackling, torture and imprisonment.

Bringing attention to these kinds of abuse and discrimination, the commission calls for a human rights-based approach to ensure that people with mental health conditions are not denied any of their fundamental human rights such as health, employment and education.

Childhood experiences

“Mental health is the foundation of human capability that makes each life worthwhile and meaningful. It is for this reason that there can be no sustainable development without attention to mental health,” said commission joint lead editor Prof Vikram Patel of the Harvard Medical School.

“Anyone who cares about poverty, education, social cohesion or economic progress should work to improve mental health, putting the vast knowledge we have on promotion, prevention and care, into action.”

Awareness

With young people facing the brunt of the burden of mental ill health, the commission places great emphasis on our experiences in childhood, which shape our mental health for the rest of our lives.

The commission has inspired a group called Young Leaders to launch a campaign to fight stigma, create a worldwide community and raise awareness, targeted at under-35s.

“We have seen a rise in mental illness in young people when, with all the knowledge we have, we should be seeing a decrease,” said Prof Helen Herrman, president of the World Psychiatric Association.

“Treatment in hospitals needs to be complemented with care in the communities to bring mental health services to the masses.”

Early research into the genetics of mental disorder showed the presence and strength of genetic factors.

Poverty reduction

Considerable overlap in genetic heritage has been identified. Humans are closely related, having emerged from Africa only relatively recently, but also remarkable variation between individuals.

Evidence shows that interventions for poverty reduction, especially in low- and middle-income countries, including conditional and unconditional cash transfers, microcredit and asset promotion programmes, have positive effects on mental health.

For example, in Kenya, the unconditional cash transfer programme for rural households that led to reductions in domestic violence, improvements in adult psychological wellbeing, and reductions in salivary cortisol; the Ugandan asset promotion programme for its part, reported improvements in the self-esteem of adolescents orphaned by Aids.

The commission recommends a shift to community-based care.

It recommends the delivery of psycho-social interventions by health workers, peers and a range of other providers, such as teachers and the clergy, as well as medical professionals working in primary care, to provide the foundation of the mental healthcare system.