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Session 2: Mike Davies
The document discusses mental health needs and resources in low- and middle-income countries. It notes that over 450 million people worldwide have psychosocial problems like depression, substance abuse, and schizophrenia, yet less than 1% of health budgets in these countries are spent on mental health. Only about 10-20% of people with psychosocial issues receive treatment. It advocates for a community-based approach to mental healthcare, focusing on capacity building, access to treatment, social integration and empowering patient groups.
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Session 2: Mike Davies
- 1. MENTAL HEALTH INLOW- AND MIDDLE-INCOME COUNTRIES NEEDS, RESOURCES, ISSUES AND APPROACHES MIKE DAVIES OBE cbm
- 2. CBM Formerly theChristian Blind Mission or Christoffel Blindenmission Founded 104 years ago Today, providing technical and financial support to 740 disability-related programmes in 89 countries Reaching > 23 million people in 2010 Mostly funded by individual donations
- 3. NATURAL DISASTERS HAVEACCELERATED CBM’S INVOLVEMENT IN COMMUNITY MENTAL HEALTH
- 4. NEEDS 450 millionpeople worldwide have psycho-social problems , including - 150 million with depression 90 million with substance abuse disorders 25 million with schizophrenia (World Health Report 2001)
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- 7. RESOURCES Europe :One psychiatrist for 10,000 people Africa : One psychiatrist for 200,000 people IN LOW- AND MIDDLE INCOME COUNTRIES LESS THAN 1% OF THE HEALTH BUDGET IS SPENT ON MENTAL HEALTH (WHO Mental Health Atlas 2005)
- 8. MASS GRAVE -ACEH
- 9. TREATMENT RATE cbm estimates that in developing countries, between 80 and 90% of persons with psychosocial problems do not get treatment of any kind For the vast majority, no accessible or affordable treatment option exists
- 10. HOW TO BRIDGETHE GAP BETWEEN NEEDS AND RESOURCES?
- 11. NCD SUMMIT (Sept2011) Focused mainly on cancers, cardiovascular disease, chronic respiratory disease and diabetes. By 2020, depression alone will be the second ranked disease burden, after cardiovascular disease
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- 14. CBM’S RESPONSE Aparadigm shift towards community mental health work, with treatment emphasis at primary and secondary levels Multi-tiered intervention strategy focused on local capacity development, access to appropriate treatment, social integration, family counselling & support, livelihood development, advocacy to reduce stigma and prejudice, and empowerment of users and carers groups.
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- 17. DUAL MODELS Communitymental health services, concentrating exclusively on people with psychosocial problems Inclusion of persons with psychosocial problems in cross-disability, multi-intervention community-based rehabilitation (CBR) programmes
- 18. CBR guidelines January27, 2012
- 19. IN 2010 cbm … Helped 101,000 people with psychosocial problems in 31 countries Supported the work of 18 local mental health professionals Met the training costs of 44 mental health professionals
- 20. The mayor’s solution?Put him on the bus to the next town…
- 21. STRENGTHS Strong networkof partners at all levels (local, national, international) Support for users groups and self-help groups The move towards inclusive approaches Cost-effective interventions at community level
- 22. WEAKNESSES Not enough‘care for the carers’ Preventive and promotional work remains weak Partner overload Not enough time to do training Insufficient evidence that inclusive approaches work
- 23. OPPORTUNITIES Emergency reliefwork Involving community and religious leaders Advocacy to influence policy/funding support More central roles for user groups
- 24. THREATS Biomedical orientationof government systems Lack of public/private partnerships Professional resistance to community-based MH approaches Focus on 3ry care as first choice intervention Many professionals don’t want to work where they are most needed
- 25. PEOPLE WITH PSYCHOSOCIALPROBLEMS ARE INCREASINGLY INVOLVED IN PLANNING COMMUNITY MENTAL HEALTH PROGRAMMES
- 26. THE WAY FORWARDEmpowering user organisations & SHGs Promotion of positive mental health Capacity-building at all professional levels Balance between medical, social and livelihood interventions Structured monitoring & evaluation leading to systematic improvements of services Stronger advocacy with governments Staff care/burn-out prevention
- 27. QUOTES FROM A‘USER’ “ There are two critical issues in mental health today – a) the excessive medicalisation of human suffering and distress, and b) the widespread human rights abuses of people society labels as ‘mad’, ‘disturbed’ or ‘mentally ill’”
- 28. QUOTES FROM A‘USER’ “ The primary crisis in mental health is not the lack of economic resources or the need for better technologies… the crisis is a social, cultural and political one that requires changing how we think about madness, suffering and emotional pain”
- 29. QUOTES FROM A‘USER’ “ The UN Convention on the Rights of Persons with Disabilities is a clear and comprehensive blueprint … a human rights and social inclusion framework that represents a shift away from the medical model to a social model of disability. This is precisely what is needed in mental health” In 2006, David Webb completed his PhD on suicide – the first thesis of its kind by someone who has attempted suicide. David has been a board member of the World Network of Users and Survivors of Psychiatry. His book ‘Thinking About Suicide’ was published in the UK in 2010, by PCCS Books
- 30. BEFORE Chained toa tree
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- 32. THANK YOU cbm UK www.cbmuk.org.uk Tel – 1223 - 484700
- 33. GLOBAL DISEASE BURDENOf the 15 main types of disease affecting women in LOMICs, six are psychosocial – depression (ranked 1), schizophrenia (4), bipolar disorder (7), self-inflicted injury (8), panic disorder and substance abuse (WHO, Global Disease Burden, 2004)