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Abstract
We call for the global health community, governments, donors, multilateral agencies,
and other mental health stakeholders, such as professional bodies and consumer groups,
to scale up the coverage of services for mental disorders in all countries, but especially
in low-income and middle-income countries. We argue that a basic, evidence-based package
of services for core mental disorders should be scaled up, and that protection of
the human rights of people with mental disorders and their families should be strengthened.
Three questions are critical to the scaling-up process. What resources are needed?
How can progress towards these goals be monitored? What should be the priorities for
mental health research? To address these questions, we first estimated that the amount
needed to provide services on the necessary scale would be US$2 per person per year
in low-income countries and $3-4 in lower middle-income countries, which is modest
compared with the requirements for scaling-up of services for other major contributors
to the global burden of disease. Second, we identified a series of core and secondary
indicators to track the progress that countries make toward achievement of mental
health goals; many of these indicators are already routinely monitored in many countries.
Third, we did a priority-setting exercise to identify gaps in the evidence base in
global mental health for four categories of mental disorders. We show that funding
should be given to research that develops and assesses interventions that can be delivered
by people who are not mental health professionals, and that assesses how health systems
can scale up such interventions across all routine-care settings. We discuss strategies
to overcome the five main barriers to scaling-up of services for mental disorders;
one major strategy will be sustained advocacy by diverse stakeholders, especially
to target multilateral agencies, donors, and governments. This Series has provided
the evidence for advocacy. Now we need political will and solidarity, above all from
the global health community, to translate this evidence into action. The time to act
is now.