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      The Centre for International Mental Health Approach to Mental Health System Development

      research-article
      , MBBS, BMedSc, DPM, FRANZCP
      Harvard Review of Psychiatry
      Informa Healthcare
      development, leadership, mental health systems, scaling up

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          Abstract

          Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to developmental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka. ( harv rev psychiatry 2012;20:37–46.)

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          Most cited references45

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          Mental health systems in countries: where are we now?

          More than 85% of the world's population lives in 153 low-income and middle-income countries (LAMICs). Although country-level information on mental health systems has recently become available, it still has substantial gaps and inconsistencies. Most of these countries allocate very scarce financial resources and have grossly inadequate manpower and infrastructure for mental health. Many LAMICs also lack mental health policy and legislation to direct their mental health programmes and services, which is of particular concern in Africa and South East Asia. Different components of mental health systems seem to vary greatly, even in the same-income categories, with some countries having developed their mental health system despite their low-income levels. These examples need careful scrutiny to derive useful lessons. Furthermore, mental health resources in countries seem to be related as much to measures of general health as to economic and developmental indicators, arguing for improved prioritisation for mental health even in low-resource settings. Increased emphasis on mental health, improved resources, and enhanced monitoring of the situation in countries is called for to advance global mental health.
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            Human rights violations of people with mental and psychosocial disabilities: an unresolved global crisis.

            This report reviews the evidence for the types of human rights violations experienced by people with mental and psychosocial disabilities in low-income and middle-income countries as well as strategies to prevent these violations and promote human rights in line with the UN Convention on the Rights of Persons with Disabilities (CRPD). The article draws on the views, expertise, and experience of 51 people with mental and psychosocial disabilities from 18 low-income and middle-income countries as well as a review of English language literature including from UN publications, non-governmental organisation reports, press reports, and the academic literature. Copyright © 2011 Elsevier Ltd. All rights reserved.
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              A renewed agenda for global mental health.

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                Author and article information

                Journal
                Harv Rev Psychiatry
                Harv Rev Psychiatry
                uhrp
                Harvard Review of Psychiatry
                Informa Healthcare
                1067-3229
                1465-7309
                Jan-Feb 2012
                15 February 2012
                : 20
                : 1
                : 37-46
                Affiliations
                From the Centre for International Mental Health, Melbourne School of Population Health, University of Melbourne
                Author notes
                Correspondence: Dr. Harry Minas, University of Melbourne—Centre for International Mental Health, 207 Bouverie St., Carlton, Victoria 3053, Australia. Email: h.minas@ 123456unimelb.edu.au
                Article
                10.3109/10673229.2012.649090
                3335086
                22335181
                e0d4cc8a-f9ae-4acb-88e5-4645367af021
                © 2012 President and Fellows of Harvard College

                This is an open access article distributed under the Supplemental Terms and Conditions for iOpenAccess articles published in Informa Healthcare journals , which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 June 2011
                : 30 October 2011
                : 27 September 2011
                Categories
                Perspectives

                Clinical Psychology & Psychiatry
                scaling up,development,mental health systems,leadership
                Clinical Psychology & Psychiatry
                scaling up, development, mental health systems, leadership

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