W3-T3 The Societal Burden of Mental Ill Health

Question 1

what are global burdens of mental health according to WHO

Answer 1

– the leading cause of disability across the world
– WHO use DALY as an index of disability
– the most disabling mental disorder is depression
– Dementia will come to an ever larger source of disability
– Schizophrenia and bipolar disorder are important – have a greater impact on the health budget
– the burden of the disease varies across countries

Question 2

why Wittchen and Jacobi estimation went up between 2006 and 2011

Answer 2

they widened the age and scope of disorders

—> one-year period prevalence of 38.2 per cent. This takes into account childhood disorders, personality disorders, and dementia.

Question 3

define economic impact of mental health disorder

Answer 3

– treatment and care cost
– social security cost
– cost due to lost productivity
– hidden cost in term of pain and suffering
– cost experienced by carers

Question 4

NIMH reported the global cost of mental health at nearly 2.5T and is projected to increase over 3T by 2030. define what it means.

Answer 4

– entire global health spending in 2009 was 5.1T
– annual GDP for the low-income country is less than 1T
– entire US overseas development aid over past 20 years <2T

Question 5

how prevalence are measured

Answer 5

estimate the prevalence of the disorder
weight disorders by disability (possibly with gradings for the severity of a particular disorder)
take account the impact of premature mortality

Question 6

How DALY is calculated

Answer 6

years lived with disablitity (prevalence x weight disorder by disability) + year of lost life

YLD + YLL

Question 7

what are the major disorders in Europe according to Wittchen

Answer 7

unipolar disorder
dementias
schizophrenia
bipolar disorder

Question 8

according to WHO, what are the top 3 DALY that related to neuropsychiatric disorder

Answer 8

1. Major depression
2. bipolar disorder
3. schizophrenia
4. Alzheimer/dementia

Question 9

what can be concluded from Wittchen et al. (2011) studies

Answer 9

– a disorder of the brain is the major distributor of the total EU disease burden

– there are tremendous diagnosis-specific differences - even less serious disorders are associated with a substantial degree of disability

– Depression is already the most important single contributor o the total disease burden

– confirm the existence of substantially different disability differences between females and males.

Question 10

the Global Burden Disease (GBD) data is important because

Answer 10

– helps policymakers understand the impact of mental disorders at a population level
– shows up that mental disorders constitute the most important category of non-communicate disease in terms of burden of disease
– provides an argument for investment in mental health research and mental health services

Question 11

define what World Economic Forum concludes in 2011

Answer 11

– Economic policymakers naturally concerned with economic growth
– evidence presented in the report indicates that it would be illogical and irresponsible to care about economic growth and simultaneously ignore NCD (non-communicable diseases)
– Inaction will likely be far more costly than intervention

–> Mental health disorders are the most significant NCDs
–> This is a ‘call to arms’ for investment in the provision, services, and research into intervention
–> further research, to make that intervention more effective and more cost-effective.

Question 12

what do we have to do in the face of the combination of individual suffering and societal burden

Answer 12

research agenda, a policy agenda, a practice agenda

Question 13

what are the grand challenges in global mental health

Answer 13

to identify the root causes of disorders, risk factors, and protective factors,
advance prevention and implementation of early interventions for disorders,
improve treatments and expand access to care,
raise awareness of the global burden of disorder– and that’s essentially a political
issue-
build human resource capacity, (so having people who can actually deliver effectively
interventions), and
transform the health system and policy responses

Question 14

The way forward according to Frank.

Answer 14

simple interventions can have a very positive impact on mental health outcomes – increasing
access to the psychological therapies model, which promises psychological therapy for all.

people experience severe and enduring mental health problems — don’t respond well to simple interventions

Despite the policy emphasis towards prevention and early intervention – little evidence that it works

Further research into “potentially modifiable risk factor” is needed