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Gaps in the system regarding mental health issues

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Gaps in the system regarding mental health issues

Mental disorder can cause considerable suffering and diseases and burden. To compound this
public health problem, many individuals with psychiatric disorders remain untreated although
effective treatments exist. The median treatment gap for schizophrenia, including other
non-affective psychosis, was 32.2%. For other disorders the gap was: depression, 56.3%;
dysthymia, 56.0%; bipolar disorder, 50.2%; panic disorder, 55.9%; GAD, 57.5%; and OCD,
57.3%. Alcohol abuse and dependence had the widest treatment gap at 78.1%. The mental
health care is overloading, so it is taking time to sign up for appointment, or take time to stay
for a while to enter. Sometimes there isn’t anything to offer to the patient if they need
something. Major GAPS include:
Initial evaluation for diagnosis – develop new symptoms and wait up to 3-6 months to find
out what’s happening or begin any treatment
Crisis wait 2 weeks to 6 months for an appointment, or go to the hospital
After hospitalization – released without clinic appointment, still cannot get an appointment
for up to 3 months, and risk going back into crisis while waiting
Primary care doctors can start it’s treatment, but many times mental health cases are sophisticated
and require the involvement of a specialist with a months long wait. Emergency rooms appreciate
people in crisis and may recommend hospitalization, but they don’t enjoy the treatments for the
long term psychiatric needs of people who come in, so those who aren’t hospitalized often go
home with no treatment at all. Moving from one place to another cause mental health crisis
because it takes you too much to get to know the doctor and take the appointment. After an
explosion or a melting at work or school, it can impossible to get timely assessment for safety to
return to work/school. People with chronic mental illness who fail to follow the complicated
policies in the public mental health system may be thrown out of care, and have to start over from
the beginning to get necessary treatment. Those with serious mental illness often end up in jail for
minor charges like violation when their untreated illness causes problem behavior. These gaps
have grown over time, and continue to worsen. If you’ve ever tried to find help for a loved one in
a mental health crisis, it can be a nightmare. Creative solutions are being developed in
communities:
● “Integrated” mental health services into primary care (a mental health professional – often
a counselor- is employed by a primary care group to offer counseling and advise primary
care doctors and staff on complicated mental health issues in their patients)
● Jail diversion (people with illness are placed in monitored treatment instead of
punishment when appropriate)
● Crisis clinics (assess people in crisis, and may provide short term observation as well as
start care by providing prescription medication)
● Walk-in mental health clinics (allow patients who need mental health care to start care
immediately, and then refer to regular systems of care with longer wait times)
The global mental health landscape has transformed over the past 25 years because of the
higher visibility of the burden of mental health and substance-use disorders. These disorders
comprise 7.4% of global disability-adjusted life years and 22.7% of global years lived with
disability. The main contributors worldwide are depression and dysthymia 96 % of all.
anxiety 3.5% of all and schizophrenia, substance-use disorders and bipolar disorder just over
2% of all. Alcohol and substance-use disorders come in second for most of the developing
world, more so for southern Africa drug use and Eastern Europe alcohol. The burden of
mental health and substance-use disorders is predicted to increase worldwide in coming
decades, and the steepest rise can be expected in low- and middle-income countries as a result
of rising life expectancy, population growth and under-resourced health care4. For example,
simulation models predict a 130% increase in associated health burden of alcohol and
substance misuse in sub-Saharan Africa by 2050 as a result of population growth and ageing.
World Health Organization has introduced a series of policy initiatives that articulate both
high-level aspirations and pragmatic guidance for mental health and substance-use services
delivery in LMICs. The most recent, the Global Mental Health Action Plan 2013-2020,
challenges member states, partners and the Secretariat to collectively meet ambitious goals by
the year 2020, including increasing mental health care coverage by 20% for severe mental
health illness and reducing national suicide rates by 10%. In LMICs, the socioecology of
poverty, malnutrition, political conflicts and poor health systems influence the epidemiology,
as well as the adverse outcomes, that result from substance misuse. Additional challenges
associated with comorbidity stem from its augmentation of clinical burden, through increased
risk for relapse, other infectious and medical complications, and economic hardship and
homelessness.The weight and setup of hazard related with substance-use issue and co-dreary
dysfunctional behavior appear to fluctuate over the world. Despite the fact that liquor and
narcotic issues are heightening in Europe, Africa and Asia, issues related with amphetamines
and cannabis are progressively pervasive in Asia, North America and Europe. Cocaine use is
common in North America and Europe, while abuse of indigenous psychoactive substances is
predominant in different areas, for example, the utilization of khat in parts of Africa and the
Middle East and that of coca leaves in South America. Remarkably, existing information
holes may belittle the effect of substance-use issue. The full degree of unfavorable
psychological wellness and social effects of substance-use issue, for example, liquor use
during pregnancy and fetal liquor range disorders 25 remain deficiently comprehended. On
average less than 3% of public health resources are allocated to specific mental health care in
LMICs, with even less around 1% in Africa and Asia. There is also a substantial gap in
scientific knowledge for preventing and treating mental health and substance-use disorders.
In addition, what is currently known is often not applicable to low-resource regions.
Intervention strategies to address substance-use disorders have improved over recent decades,
but have had limited success in achieving total recovery and have limited coverage in LMIC.

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