Showing papers by "Benedetto Saraceno published in 2001"

Mental health and primary care

Abstract: The World Health Organization (WHO) has dedicated World Health Day on April 7, 2001, to mental health. Two themes that are important aspects of mental health and specific to mental illness form the basis of the WHO mental health campaign: “Stop exclusion — Dare to care.” The first element of

World Health Day, 7 April 2001.

Abstract: Across the world, mental health has entered an historic era. Over the past 50 years, demographic factors such as population growth and ageing, poverty, urbanization and `modernization' of rural communities have increased the burden of mental problems. As we enter the 21st century, ®ve of the 10 leading causes of disability worldwide are mental disorders. The rapid rise of non-communicable diseases (NCDs) represents one of the major challenges to global development: it is estimated that by 2020 over 70% of the global burden of disease will be caused by NCDs, and neuropsychiatric disorders will account for 14% of all disease burden. As such, mental and neurological disorders represent a major source of disability and lost productivity (1). The World Health Organization recognizes this juncture, and has de®ned Mental Health as a top priority for its global strategy to improve health. The Director of WHO, Dr Gro Harlem Brundtland has selected mental health as the topic for two of the 2001 major events: the World Health Report and World Health Day (7 April). This is an unequivocal statement of the commitment of the WHO leadership to mental health. Over the course of 2001, there will be an increasing effort to use the World Health Day and the World Health Report to capture the attention of the public as well as governments. Many challenges exist in improving mental health, worldwide. Cost-effective treatments are available for our most serious disorders, but most people who need these services do not receive them. Persistent and troubling barriers to receiving care remain: stigma and discrimination, which inhibit seeking help; public attitudes driven by fear and misinformation still dominate public discourse. All service delivery systems are being challenged to do more, often without signi®cant new resources, and they are being held accountable for their performance. The way systems are organized and ®nanced may also serve to obstruct access by limiting coverage for mental health or by requiring impossibly expensive user payments. WHO has developed a strategy that responds to these diverse challenges. In many places, policies need to be developed or modernized to improve their responsiveness to the people they serve. In other areas, creative and innovative programmes already exist and need to be empowered (as in many developing countries where outstanding and innovative practices are in place but need to be supported). Indeed, we should recognize the important lessons that the South of the world could teach to the North, in areas such as community work, integrated primary health care, and family and consumer involvement. Similarly, the North could contribute fundamentally in the areas of neuroscience, genetics, pharmacology and research methodology. The challenges to researchers in developing countries and the speci®c needs of vulnerable groups in today's world have been discussed in this journal by Norman Sartorius in 1998 (2) and Gro Harlem Brundtland in 2000 (3) respectively. WHO will focus its action on assisting countries in mental health policy formulation, which should include human rights protection and in development and dissemination of evidencebased interventions with special emphasis on substance dependence, depression, suicide prevention, schizophrenia, epilepsy and dementia. Through its regional and country of®ces, WHO is seeking the collaboration of governments, international and local NGOs and research institutions. At WHO we stand ready to do our part in providing global leadership to ensure that this opportunity is maximized. The slogan of WHO World Health Day 2001 captures this imperative: `Stop exclusion, dare to care'.