BARRIERS IN THE MIND: PROMOTING AN ECONOMIC CASE FOR MENTAL HEALTH IN LOW AND MIDDLE INCOME COUNTRIES - Bariere mentale: promovarea unui model economic pentru sanatate mintala in tarile cu venituri mici si mijlocii

DAVID MCDAID¹², MARTIN KNAPP¹´³,  SHOBA RAJA4

 

Abstract

In recent years, policy makers in high-income countries have placed an increasing emphasis on the value of maintaining good mental health, recognizing the contribution that this makes to quality of life, whilst ever more mindful of the socio-economic consequences of poor mental health. The picture in many other parts of the world is much less encouraging; policy attention and resources are still directed largely at communicable diseases. We reflect on some of the challenges faced in these countries and outline the role that economic evidence could play in strengthening the policy case for investment in mental health. Clearly this should include assessment of the economic impact of strategies implemented outside, as well as within the health sector. The ways in which mental health services are delivered is also of critical importance. Non-governmental organizations (NGOs) have long been shown to be key stakeholders in the funding, coordination and delivery of these services in high-income countries. Their role in low- and middle-income countries, where infrastructure and policy focus on mental health are more limited, can be even more vital in overcoming some of the barriers to the development of mental health policy and practice.

Keywords: Mental health policy, economics, service development, non-governmental organizations

 

Rezumat         


In ultimii ani, lumea politica din tarile puternic dezvoltate a pus un puternic accent pe importanta mentinerii sanatattii mintale, recunoscând contributia acesteia la o mai buna calitate a vietii, între timp crescând si  atentia asupra consecintelor socio-economice ale tulburarilor mintale. Situatia din multe alte parti ale lumii este descurajatoare; atentia si resursele sunt îndreptate în mare parte catre bolile contagioase. Reflectând asupra provocarilor aparute în  aceste tari, subliniem rolul pe care tactica economica îl poate juca în consolidarea planului de investitii în sanatatea mintala. In mod evident acesta ar trebui sa includa evaluarea impactului economic al strategiilor implementate, atât în afara cât si în interiorul sistemului de sanatate. De asemenea de o importanta vitala sunt si caile prin care serviciile de sanatate mintala sunt distribuite. În tarile dezvoltate, organizatiile non-guvernamentale (ONG-urile) s-au dovedit de mult a fi principalii mandatari în finantarea, coordonarea si distribuirea acestor servicii. Rolul lor în tarile cu venituri mici si mijlocii, unde infrastructura si atentia asupra serviciilor de sanatate mintala este limitata, poate fi chiar mai important în depasirea unor bariere de dezvoltare a politicii si practicii sanatatii mintale. 

Cuvinte cheie: politica sanatatii mintale, dezvoltarea serviciilor, organizatii non-guvernamentale.

(World psychiatry 2008;7:79-86)

 

¹ Personal Social Service Research unit and ² European Observatory on Health Systems Policies, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK

³ Center for the Economics of Mental Health, King's College London, Institute of Psychiatry, London, UK

4 Basic Needs, Banaswadi, Bangalore, India

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