ISSUES AND CHALLENGES

IN MENTAL HEALTH CARE

 MENTAL HEALTH
• Mental health is the level of psychological well-being or an absence of
mental illness. It is the state of someone who is "functioning at a
satisfactory level of emotional and behavioural adjustment“
 MENTAL ILLNESS
• A mental illness is a disease that causes mild to severe disturbances in
thought and/or behaviour, resulting in an inability to cope with life's
ordinary demands and routines. 
 NEED AND SIGNIFICANCE UDERSTANDING
ABOUT MENTAL ILLNESS

• With mental health issues being so widespread in the

population, it is extremely important to raise awareness, support
those around you that are suffering from a mental
health problem, and to seek help if you feel you are suffering
from any form of mental illness or mental health problem
 NEED AND SIGNIFICANCE TO KNOW ABOUT THE
CHALLENGES AND ISSUES IN MENTAL HEALTH CARE

• There are a lot of issues and challenges are facing in the field mental
health care, the knowledge about the key issues and challenges in the
mental health care will help to manage and over come those issues in an
effective manner.
 MAJOR ISSUES IN MENTAL HEALTH
FIELD
• Burden
• Stigma and discrimination
• Mental health promotion
• Prevention of harmful stress and suicide
• Treatment gap
• Cost and financing
• Empowerment
• Workforce shortages
 Burden
• Psychiatric disorders cause significant burden to individuals and society
across the world, accounting for nearly 13% of the global burden of
disease.
• Eighty percent of people with mental disorders now live in low and
middle-income countries.
• With one million deaths per year, suicide is the major reason for years of
life lost due to mental illness.
 REASONS OF BURDEN
• (1) lack of resources,
• (2) low budget for mental health in lower and middle income countries,
• (3) under-utilization of services and stigma attached to mental illnesses
 Stigma and discrimination
• the widespread stigma attached to mental health problems jeopardizes the
development and implementation of mental health policy
• Stigma is the main cause of discrimination and exclusion: it affects
people’s self-esteem,
• It disrupt their family relationships, and limits their ability to socialize and
get
housing and jobs
 Mental health promotion
• Mental health promotion needs to target the whole population,
including people with mental health problems and their carers.
• The Action Plan's overall goal is to promote mental well-
being, prevent mental disorders, provide care, enhance
recovery, promote human rights and reduce the mortality,
morbidity and disability for persons with mental disorders
 Specific ways to promote mental health
• Early childhood interventions (e.g. providing a stable environment that is sensitive to
children’s health and nutritional needs, with protection from threats, opportunities for early
learning, and interactions that are responsive, emotionally supportive and developmentally
stimulating);
• Support to children (e.g. life skills programmes, child and youth development programmes);
• Socio-economic empowerment of women (e.g. improving access to education and
microcredit schemes);
• Social support for elderly populations (e.g. befriending initiatives, community and day
centres for the aged);
• programmes targeted at vulnerable people, including minorities,
indigenous people, migrants and people affected by conflicts and disasters
(e.g. psycho-social interventions after disasters);
• mental health promotional activities in schools (e.g. programmes
involving supportive ecological changes in schools);
• mental health interventions at work (e.g. stress prevention programmes);
• housing policies (e.g. housing improvement);
• violence prevention programmes (e.g. reducing availability of alcohol and
access to arms);
• community development programmes (e.g. integrated rural development);
• poverty reduction and social protection for the poor;
• anti-discrimination laws and campaigns;
• promotion of the rights, opportunities and care of individuals with mental
disorders.
 Prevention of harmful stress and suicide
• People in many countries are exposed to harmful stress that
leads to an increase in anxiety and depression, alcohol and other
substance use disorders, violence and suicidal behaviour.
 Workforce shortages
• According to reports from the Indian Union Ministry of Health and
Family Welfare, the country needs around 13,000 psychiatrists. To achieve
an ideal ratio of psychiatrists to population is about 1: 8000 to 10,000 but
currently has just about 3,500 - which is about one psychiatrist for over 2
lakh people! With regard to other mental health professionals the ratio is
even worse - the need of Clinical Psychologists is 20,000 and there are
only 1000 available; for Psychiatric Social Workers, the requirement is
35,000, but only 900 are available, for Psychiatric Nurses, we need 30,000
and only 1500 are available.
• According to National Crime Records Bureau 2015, the entire mental
health workforce, comprising clinical psychiatrists, psychologists,
psychiatric social workers and psychiatric nurses, stands at 7,000, while
the actual requirement is around 55,000.
• Thus, there is huge gap between demand and supply.
 Treatment gap
• A vast gap exists between the need for treatment and the services
available.
• To compound this public health problem, many individuals
with psychiatric disorders remain untreated although
effective treatments exist.
• Alcohol abuse and dependence had the widest treatment gap at 78.1%.
 Cost and financing
• Mental health disorders cost national economies billions of dollars in
terms of expenditure and loss of productivity.
• Human and economic costs also fall on people with mental health
disorders and their families, whose lives can be severely affected.
 Quality of care and variation in practice
• There should be access to basic mental health care for everyone who needs it.
• This means that mental health care should be affordable, equitable, geographically
accessible, available on a voluntary basis and of adequate quality.
• In many countries, services for people with mental disorders remain minimal and
do not measure up to these principles.
• In a context where resources are inadequate and mental health is emerging as a
new priority, concern for quality may seem premature. Quality may seem more of
an issue for well-established, well-resourced systems than for ones that are just
becoming established
 Empowerment
• Poor advocacy and a lack of financial support for service users’ and
carers’ organization
• The absence of the voices of users and carers from the process reflects the
stigma of mental health problems, and can reinforce negative attitudes.
CHALLENGES
 EMPOWERMENT
• In a mental health context, empowerment refers to the level
of choice, influence and control that users of mental
health services can exercise over events in their lives.
• The key to empowerment is the removal of formal or informal barriers
and the transformation of power relations between individuals,
communities, services and governments.
 Innovation and solidarity
• Countries should be open to and invest in innovation and change, and
search for new ways to tackle familiar problems.
Examples
• Integrating mental health into primary care
• Increasing clinical care capacity by training no specialized health workers
 Knowledge
• More research is urgently needed, however, to evaluate interventions for
their cost–effectiveness and to identify what works.
• there is also a need to apply the considerable knowledge that already
exists.
• Action can be taken on the basis of “good enough” information about
what works, rather than waiting for perfect data to appear
 Learning
• Needed to the dissemination of knowledge and the development of
evidence-based mental health care.
• Mental health services need to become learning organizations, open to
new ideas and new ways of delivering care and support.
 Intersectoral policy and practice
• Health ministries are behind the Declaration and Action Plan, but other
government ministries need to lend their support if change is to occur.
 Sustainability
• Sustainability in mental health is the ability to provide high value care
now and in the future in the face of environmental, economic and social
constraints.
• Prevent mental illness, build social capital and promote individual, social
and community resilience and mental wellbeing.
Ways To Manage Mental Health Issues And
Challenges
• Promote mental well-being for all
• Tackle stigma and discrimination
• Prevent mental health problems and suicide
• Ensure access to good primary care for mental health problems
• Offer effective care in community-based services for people with
severe mental health problems.
• Establish partnerships across sectors
• Create a sufficient and competent workforce
• Establish good mental health information
• Provide fair and adequate funding
 KEY TERMS
• Burden
• Stigma and discrimination
• Mental health promotion
• Prevention of harmful stress and suicide
• Treatment gap
• Cost and financing
• Empowerment
• Workforce shortages
• Empowerment
• Innovation and solidarity
• Knowledge
• Learning
• Intersectoral policy and practice
• Sustainability
 References
• http://www.euro.who.int/__data/assets/pdf_file/0008/96452/E87301.pdf
• https://www.health.gov.nl.ca/health/wellnesshealthyliving/
mentalhealthpromotion.html
• www.euro.who.int/__data/assets/pdf_file/0020/113834/E93430.pdf
• https://www.crcresearch.org/news/our.../statement-sustainability-mental-health
• https://www.mentalhealthamerica.net/recognizing-warning-signs
• https://timesofindia.indiatimes.com/life-style/health-fitness/health-news/we-need-
more-mental-health-care-professionals-in-india/articleshow/66146320.cms
• https://www.who.int/mental_health/policy/services/
3_context_WEB_07.pdf
• https://www.who.int/news-room/fact-sheets/detail/mental-health-
strengthening-our-response