Mental health services: the African gap
| DOI | https://doi.org/10.1108/JPMH-09-2013-0059 |
| Date | 09 September 2014 |
| Published date | 09 September 2014 |
| Pages | 132-141 |
| Author | Claire Wilson,Mohammad Taghi Yasamy,Jodi Morris,Atieh Novin,Khalid Saeed,Sebastiana D. Nkomo |
| Subject Matter | Health & social care,Mental health,Public mental health |
Mental health services: the African gap
Claire Wilson, Mohammad Taghi Yasamy, Jodi Morris, Atieh Novin, Khalid Saeed and
Sebastiana D. Nkomo
Dr Claire Wilson is an Honorary
Clinical Fellow, based at
Faculty of Medicine, University
of Glasgow, Glasgow, UK.
Dr Mohammad Taghi Yasamy
is a Medical Officer, based at
Department of Mental Health,
World Health Organization
(WHO), Geneva, Switzerland.
Dr Jodi Morris is an Adjunct
Professor, based at
Department of Psychology,
Irving K Barber School of Arts
and Sciences, University of
British Columbia Okanagan,
Kelowna, Canada.
Dr Atieh Novin is a Medical
Student, based at College of
Medicine, Drexel University
College of Medicine,
Philadelphia,
Pennsylvania, USA.
Dr Khalid Saeed is a Regional
Advisor: Mental Health and
Substance Abuse, based at
Department of
Non-Communicable Diseases
and Mental Health, World
Health Organization,
Cairo, Egypt.
Dr Sebastiana D. Nkomo
is based at Department of
Non-Communicable Diseases,
African Regional Office of the
World Health Organisation
(WHO), Brazzaville,
Republic of Congo.
Abstract
Purpose – Neuropsychiatric disorders account for a substantial proportion of disease burden and disability
in Africa. Despite this, mental health systems are under-resourced in Africa, as in most parts of the world,
creating a “treatment gap”and denying the African population the right to mental health achieved through
access to mental health services. The paper aims to discuss these issues.
Design/methodology/approach – The mental health systems of African countries were compared with
figures for all low- and middle-income countries (LAMICS) using data from the World Health Organization
Assessment Instrument for Mental Health Systems. Comparable global figures were also availablefor some
indicators from the WHO’s World Mental Health Atlas 2011.
Findings – Selected indicators of mental health systems are presented for 14 African countries and shows
that they are lower as compared to figures for all other LAMICS and also global figures. The treatment gap
for mental disorders is much higher in Africa than comparable global figures. For example, the treatment gap
for mood disorders has been estimated from 95 to 100 per cent for some African countries.
Originality/value – There is an imbalance between need and service provision in the area of mentalhealth
across the world but particularly in Africa. Despite this, there are a greater number of outpatient than
inpatient services in Africa which provides an opportunity for development of community-based services.
There are also many encouraging examples of effective approaches to reducing the burden of
neuropsychiatic disease in Africa.
Keywords Mental health, Africa, Treatment gap
Paper type Research paper
Introduction
Neuropsychiatric disorders account for a substantial proportion of disease burden and
disability.They are the leadingcauses of disability worldwide,accounting for around one-third of
years lost due to disability among adults aged 15 years and over. Globally, neuropsychiatric
disorders account for 13 per cent of the global burden of disease (World Health Organization
(WHO), 2008a, b).
Despite this, mental health systems are under-resourced in most parts of the world.
Many countries do not have a specified budget for mental health and in those that do,
25 per cent report spending o1 per cent of the health budget on mental health (Saxena et al.,
2006). As a result, many of the world’s population with mental disorders are left unsupported,
creating a “treatment gap”. More than 80 per cent of patients with mental, neurological and
substance use disorders in many low-income countries do not have access to treatment
(Demyttenaere et al., 2004).
This “treatment gap” is especially prominent in Africa, where control of the causes of early
death, such as infectious diseases tend to be prioritized over more chronic, disabling conditions
such as neuropsychiatric disorders. Yet the global burden of neuropsychiatric conditions is
significant in Africa too. In an area of the world where natural disasters, conflict and other forms
of social unrest are frequent occurrences, post-traumatic stress disorder and more complex
psychological trauma prevail. The overall proportion of the global burden of disease in Africa
attributable to neuropsychiatric conditions is 6 per cent (WHO, 2008a, b) and by 2010 major
Data used are from the World
Health Organisation’s Assessment
Instrument for Mental Health
Systems (WHO-AIMS) and WHO’s
World Mental Health Atlas 2011.
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VOL. 13 NO. 3 2014, pp. 132-141, CEmerald Group Publishing Limited, ISSN 1746-5729 DOI 10.1108/JPMH-09-2013-0059
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