Scaling up mental health care in resource-poor settings

The Global Burden of Disease shows that about one-third of long-term disability is attributable to neuropsychiatric disorders, of which depressive disorders account for one-third. The World Health Organization (WHO) has pledged its full and unrestricted commitment to this vital public health issue. The Lancet Series on Global Mental Health in 2007 sounded a call for action to 'scale up' mental health care in the world. The WHO responded and launched its mental health Gap Action Programme (mhGAP) the following year with the objective of scaling up care for mental, neurological and substance use (MNS) disorders. Scaling up refers both to the objective of increasing access to evidence-based, sustainable services, as well as to the attainment process itself, including mobilising political will, assessing needs and resources, developing human resources, increasing the availability of essential medicines and monitoring and evaluating progress. This will form a crucial roadmap for WHO's programme for reducing the global burden of MNS disorders in the years ahead. The programme relies on increasing the capacity of the existing health-care system in delivering evidence-based care within the community using the primary health-care system.