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Review Article

Mental health for nations

Pages 342-374 | Received 30 Jun 2016, Accepted 06 Jul 2016, Published online: 15 Aug 2016
 

Abstract

Mental ill health is a universal phenomenon: that is, it is seen across all cultures and societies, even though the presentation may be culture-specific and affected by cultural norms and more. Governments have a moral and ethical duty to develop mental health services which are accessible, appropriate, and non-discriminatory. Equity in funding mental health services is critical. As globally services and their quality vary dramatically, one should be proposing and agreeing on minimum standards of care. In this paper the basic components and minimum standards of care are described. It is imperative that services are non-discriminatory. It is important that governments work with psychiatrists, other mental health professionals, and individuals with mental illness, their families, and carers to plan, develop, and deliver services with adequate funding. Employers and psychological first aid must also be remembered. Services must be geographically accessible. In this endeavour primary care services have a major role to play. Training and clinical decision-making must be part of the change in service delivery. It is imperative that every effort is made to keep the population mentally as well as physically healthy, and people who develop mental illness must have access to evidence-based treatment at the earliest possible opportunity.

Acknowledgements

Several people have contributed to my thinking and this piece directly and indirectly. Members of the Centre for Mental Health law led by Dr Soumitra Pathare, Albert Persaud, Professors Kamaldeep Bhui, Graham Thornicroft, Norman Sartorius, Louis Appleby, and Alastair Burns, among others. I have taken the liberty of using some of the material published elsewhere and am grateful for its use. Thanks are also due to Ralph Footring and Andrea Livingstone for their help in pulling various themes together in this paper.

Disclosure statement

The author reports no conflicts of interest. The author alone is responsible for the content and writing of the paper.

Funding

World Psychiatric Association (WPA) funded the global survey on discrimination against people with mental illness. This article is based on the findings of that survey.

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