Skip to main content Accessibility help
×
×
Home

Mental health service availability and delivery at the global level: an analysis by countries’ income level from WHO's Mental Health Atlas 2014

  • A. Lora (a1), F. Hanna (a2) and D. Chisholm (a2)

Abstract

Aims.

The World Health Organization (WHO)’s Mental Health Atlas series has established itself as the single most comprehensive and most widely used source of information on the global mental health situation. The data derived from the latest Mental Health Atlas survey carried out in 2014 describes the availability and delivery of mental health services in the WHO's Member States, focussing on differences by country's income level.

Methods.

The data contained in this paper are mainly derived from questions relating to mental health service availability and uptake, as well as on financial and human resources for mental health. Results are presented as median values and analysed by World Bank income group. Interquartile ranges are also provided as measures of statistical dispersion.

Results.

In total, 171 out of WHO's 194 Member States were able to at least partially complete the Atlas questionnaire. The results highlight a wide gap between high and low-medium income countries in a number of areas: for example, high-income countries have 20 times more beds in community-based inpatient units and 30 times more admissions; the rate of patients cared by outpatient facilities is 40 times higher; and there are 66 times more community outpatient contacts and 15 times more mental health staff at outpatient level. Overall resources for mental health are not distributed efficiently: globally about 60% of financial resources and over two-thirds of all available mental health staff are concentrated in mental hospitals, which serve only a small proportion of patients. Results indicate that outpatient care is the only effective means of increasing the coverage for mental disorders and is expanding, but it is strongly influenced by country income level. Two elements of the network of mental health facilities are particularly scarce in low- and middle-income countries: day treatment facilities and community residential facilities.

Conclusions.

The WHO Mental Health Atlas 2014 survey provides basic mental health information at the level of WHO's Member States, concerning mental health resources and activities. Atlas promotes the use of information, usually underestimated not only in low- and middle-income countries but also in high-income countries. Information is needed not only for monitoring the scaling up of the mental health system at country level, but also for improving transparency and accountability for users, families and the public.

Copyright

Corresponding author

*Address for correspondence: A. Lora, Department of Mental Health, Lecco Hospital, Lecco, Italy. (Email: antoniolora55@gmail.com)

References

Hide All
Institute of Medicine (2006). Improving the Quality of Health Care for Mental and Substance Conditions. National Academy Press: Washington, D.C.
Lora, A, Lesage, A, Pathare, S, Levav, I (2016). Information for mental health systems an instrument for policy-making and system service quality. Epidemiology and Psychiatric Sciences 26, 112.
Organization for Economic Co-operation and Development (2014). Focus on health – Making Mental Health Count. Retrieved 31 December 2016 from http://www.oecd.org/els/health-systems/Focus-on-Health-Making-Mental-Health-Count.pdf.
Pincus, HA, Spaeth-Rublee, B, Watkins, KE (2011). The case for measuring quality in mental health and substance abuse care. Health Affairs 30, 730736.
Ryan, G, De Silva, M, Terver, JS, Ochi, OP, Eaton, J (2015). Information systems for global mental health. Lancet Psychiatry 2, 372373.
Saxena, S, Thornicroft, G, Knapp, M, Whiteford, H (2007). Resources for mental health: scarcity, inequity, and inefficiency. Lancet 370, 878889.
Thornicroft, G, Tansella, M (1999). The Mental Health Matrix: A Manual to Improve Services. University Press: Cambridge.
World Health Organization (2000). Design and Implementation of Health Information Systems. WHO: Geneva.
World Health Organization (2001 a). The World Health Report 2001 – Mental Health: New Understanding, New Hope. WHO: Geneva.
World Health Organization (2001 b). Atlas: Mental Health Resources in the World 2001. WHO: Geneva.
World Health Organization (2003). Improving Data Quality: a Guide for Developing Countries. WHO: Geneva.
World Health Organization (2005 a). Atlas: Mental Health Atlas 2005. WHO: Geneva.
World Health Organization (2005 b). Mental Health Information System. WHO: Geneva.
World Health Organization (2010). Monitoring the Building Blocks of Health Systems: A Handbook of Indicators and their Measurement Strategies. WHO: Geneva.
World Health Organization (2011). Country Health Information Systems: A Review of the Current Situation and Trends. WHO: Geneva.
World Health Organization (2013). Mental Health Action Plan. Retrieved 28 January 2017 from http://www.who.int/mental_health/publications/action_plan/en/.
World Health Organization (2015). Atlas: Mental Health Atlas, 2014. WHO: Geneva.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology and Psychiatric Sciences
  • ISSN: 2045-7960
  • EISSN: 2045-7979
  • URL: /core/journals/epidemiology-and-psychiatric-sciences
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed