The World Health Organization is calling for a radical change in the treatment of mental health disorders, saying existing care systems are largely ineffective and often abusive. 

Nearly a billion people were living with a mental disorder in 2019. That number has grown, with new data showing conditions such as depression and anxiety increasing by more than 26 percent in the first year of the coronavirus pandemic.

The World Health Organization recently released its largest review of world mental health since the turn of the century. The report finds 14 percent, or one in seven adolescents, is suffering from a mental disorder. It says suicides account for one in 100 deaths, with 58 percent occurring before age 50.

Head of the WHO’s mental health unit, Mark Van Ommeren, says mental disorders are the leading cause of disability. He says depression and anxiety alone cost the world economy nearly $1 trillion a year in lost productivity. Despite the enormous socio-economic consequences, he says many people with mental health problems do not seek help for a variety of reasons.

“They fear the stigma of seeking help could be one reason. Another reason can be that they do not trust the services that are available because there has not been enough investment in it,” Van Ommeren said. “Third, it could be that they do not recognize the problem because their knowledge about mental health problems is limited.”

The WHO says only a small fraction of people in need have access to effective, affordable and quality mental health care. It says the gap between developed and developing countries is huge, noting 70 percent of people with psychosis are treated in richer countries, compared to 12 percent in poorer countries.

Van Ommeren says the current mental health care system is broken and must change. He says governments invest around two out of three dollars for mental health in large custodial psychiatric hospitals. He says that money would be better spent  on community-based mental health facilities because they are more accessible.

“It is less likely that there are human rights violations … the atmosphere in large hospitals easily becomes that the hospitals warehouse people with very severe problems,” Van Ommeren said. “In community settings with open doors, it is much less likely. Also, in community settings, many more people can easily be treated. The hospital has so much stigma around it that many people would never seek care there.”

The WHO says countries can provide better, more affordable treatment by strengthening community health services. It recommends integrating treatment into primary health care, in schools and in prisons. It says mental health should be covered by insurance plans.

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