ABSTRACT
Mental disorders are a major contributor to the burden of disease in all regions of the world, with about 14% of the global burden attributable to neuropsychiatric disorders (Prince, Patel, Saxena, Mai, Maselko, Phillips, & Rahman, 2007). Even in sub-Saharan Africa, where communicable diseases are common, mental disorders account for nearly 10% of the total burden of disease (Lopez, Mathers, Ezzati, Jamison, & Murray, 2006). The health systems in many low- and middle-income countries (LMICs) face a scarcity of financial resources and qualified staff – a situation that is often compounded by a lack of commitment from public health policymakers and inefficient use of resources (Rahman, 2005). As a result, at least 40 to 70% of individuals never receive any kind of care (Rahman, 2005). In this chapter, we first briefly outline the context of mental health in LMICs, with a particular focus on the Millennium Development Goals (MDGs), and discuss the issue of mental health and poverty. We then present a description and analysis of a number of promising interventions implemented in LMICs that are providing important data in terms of delivery and potential scale-up of mental health interventions. Finally, we discuss the concept of task shifting and present a case for family-based interventions as key efforts to improve population mental health.
