Mental health services should be the responsibility of government
An important aspect of the healthy society is the maintenance of the sound mental health of the people. In this paper, we argue that the government needs to take responsibility for providing efficient mental health services, which would improve the overall condition of the society. Most of the mental disorders like depression and anxiety are common to both developing and developed countries.
Different factors are responsible for the emergence of mental health disorders in the developed and developing countries of the world. (Shah and Junkins, 2000). An important trend seen in developing and developed countries is that the government authorities did not give much importance to the problem of mental health disorders. In these countries, we discern the expenditure by both government and private institutions and individual patients. These different kinds of financial arrangements have impact on the ability of these nations in redressing the mental health disorders. In the poor countries, it is found that the people are asked to arrange for the finance and this means that they did not obtain finances from the government authorities. In a study, (Dixon, et.al.), it is argued that when the government did not take the financial responsibility, this did not help the people with mental health disorder. Private health insurance is not available to all the individuals and similarly, the social health insurance gives protection to only those patients with employment. This excluded many other patients who do not belong to these categories covered by the private health insurance and social health insurance. This has created disparity between those who possessed private or social health insurance and those who did not possess these policies. This has forced the excluded communities to spend from their pocket when they suffered from the problem of mental illness. This trend is particularly seen in the developing countries such as Pakistan and Nepal. This implies that the governments of these countries have not given much priority to the problem of mental health disorder which may arise from various social and economic issues that is found in the present society. Thus, the patients have been forced to spend on their own when they faced the problem of mental health disorder. (Dixon et.al. 2004) We can suggest that there is need for the governments to take more interest in redressing the financial problems faced by those people with mental health disorder and that the governments should allocate more fund for this purpose so that all the categories of the population are covered under the social security scheme.
Among the various health problems, mental health problems obtain an important place in all the countries of the world. The mental health problems lead to other social problems such as unemployment, underemployment, poverty, and so on and the governments of the developed and the developing countries need to allocate enough resources to fight against this problem. In few cases, economic resources are not available and in some other cases although economic resources are available, they are not properly distributed among the various sections of people with mental health disorders. Thus, this implies that there is no equity in the distribution of financial and other resources among different categories of the population. Mental health problems are one of the important diseases suffered by the people all over the world. Suicide is a major cause of death of large number of people. The people are forced to commit to suicide due to mental illness such as depression, anxiety, etc. Substantial numbers of people in the world suffer from various mental health disorders. (McDaid, et.al. 2004)
This implies that particularly in the low-income countries in the future years, there would be great rise in the mental health problems of the people. The governments of all the countries need to assess the severity of this problem and they should take necessary steps to avoid the future impact of mental health disorders. Due to factors such as economic backwardness, there was decreased investment in low-income countries to reduce the mental health problems. In the low-income countries the people with mental health problems try to hide their health problems because the people with such disorders are not considered with sympathy in these countries. These people with mental health disorders are excluded from other sections of population. Moreover, in some low-income countries it is not possible to obtain the relevant data regarding the policies and impact of these government policies relating to mental health problems of the people. (McDaid, et.al.)
On the one hand, there is ignorance regarding the government policies regarding the mental health problems, and, on the other, due to stigma attached to these diseases, the people are not able to utilise the resources provided by the government.
The main problem that is being faced by the people with mental disorder in both developed and underdeveloped countries is the lack of availability of the economic resources. The governments in these countries have not taken measures to equally distribute the economic resources. The government authorities did not allocate enough funds to redress the problem of mental health disorder. This has great impact on the quality of life of the individuals in these countries, as the poor people did not obtain the finances to pay their hospital bills particularly when they were forced to obtain treatment in the private hospitals. The governments need to allocate more financial resources to be distributed among the patients who suffer from this problem. With the greater amount of planning, it is possible for the government to safeguard the efficiency of the health services, there by improving the overall health of the people. The people in these countries should obtain more information regarding the policies of the government to redress the problem of mental health disorder. This has increased the problem of these people particularly in the poor countries, as these poor people simply do not possess the required financial power to obtain the treatment for mental health disorders. Although, more amount is allocated for other major health disorders, the governments allocated very less portion of their budget to deal with the problem of mental health disorder. For instance in the countries such as Mongolia and Iran, only a small percentage of the health budget is allocated for the mental health problems. In the case of Nepal, the government gave greater emphasis to reduce the problem of infant mortality, which is very high when compared to other countries. In Ethiopia, greater amount of money is spent on problems such as HIV, which implies that less amount is available for the mental health problems. (Knapp, et.al.)
This show that on the one hand, there are fewer amounts of financial resources available in the underdeveloped countries, and, on the other, they are not able to allocate greater financial resources for the problem of mental health. When the people in the poor countries did not obtain the financial resources to cure their mental health problems, they were compelled to ignore these problems and they did not afford to take any treatment for their diseases. This has contributed to increase in the problem of the people with the mental health disorder particularly in the middle and the low-income countries.
However, the governments in the few developed countries such as United Kingdom have taken steps to redress the problems concerning mental health disorder. For instance, the government of UK has decided to provide few guidelines regarding the policy of the government concerning the mental health disorder. These guidelines and information regarding the government action regarding mental health disorders are found in the “National Service Framework for Mental Health”.(1999).
The government document suggest that the government has few objectives of mental health policies such as mental health promotion, primary care and providing information regarding services, providing needful services to the people with mental health disorder and preventing the suicides. (1999,5). These are the principal aims of the policy of the government. Attempt is made by the government authorities to achieve these objectives. The government has taken measures to solve the mental health problems of people belonging to the age group of below 65 years. The government takes care of their financial burden, which may occur due to the mental health problem suffered by the people who are below 65 years of age. However, the document does not give information regarding the problems of the people who are aged more than 65 years. The government allocated $700 million to provide services to people with this problem. (1999, 7).
Thus, money has been allocated to provide mental health services in the different regions of United Kingdom. The government authorities also monitored the performance of the mental health services of the government through performance indicators. The government has recognised that few sections of population are particularly exposed to the mental health disorder. These different categories are poor people, unemployed, children, ethnic minorities, black population, prisoners, those who consume drugs, abused people, victims of domestic violence and others.(1999, 14) Thus, an attempt is made by the government to provide mental health services to these different communities. The attempt of the government is to improve the psychological health of the local population so that they would contribute to the overall growth of the society. (1999, 15). The government has taken many measures to solve the mental health problems in the schools to assure the psychological health of the students. (1999, 21).
These informations indicate that the governments in the developed countries have comprehended the problem of mental health disorders and they have taken measures to confront these problems. Enough funds are allocated to provide solution to the people suffering from the mental health disorders. This also suggests the differences between high-income countries and low-income countries in the approach of the governments towards the problems of mental health disorders. The low-income countries should emulate the example of the high-income countries in providing efficient mental health services.
The above government document, although gives some information regarding the policy measures of the government regarding this important problem, the data shows that the governments of the European countries did not allot enough funds. This indicates that the European governments have ignored the causes and consequences of mental health disorders. In these countries there has been the cases of abuse of human rights, which is done both directly and indirectly. Thus, it is argued by David McDaid that, “…more than any other health issue, therefore, mental health requires an effective coordinated multisectoral approach to both the development of policies and the delivery of services”. (McDaid, 2005, 2)
The European countries need to invest huge amount of money to redress the problems of mental health disorders, as it is estimated that the European countries need to invest 3-4% of the GNP to take measures in order to counter the mental health problems. Thus, by using few statistical techniques, the economic expenditure to confront mental disorders has been estimated. This estimate differs from one country to the other in the region of Europe. Huge amounts of money is required to deal with mental illness found among the women, and other mental disorders such as depression, schizophrenia, neurotic disorders such as stress, and, so on. Depression has emerged as the most severe of all the mental health disorders. Depression led to other consequences such as loss of employment, ultimately leading to poverty. (McDaid,2005, 3)
These details indicate the seriousness of the mental disorder and the potential negative impact of these problems on the people. Thus, the government needs to be clear regarding its proposed policy to reduce the problems of mental disorder. The policy of the government should be to first identify the cause of the mental illness and it should state its objectives and the strategies of implementing its action plan. Without proper planning and implementation it is not possible to achieve the desired result. The legislation also plays an important role in safeguarding the human rights. The legislations enacted by the government plays an important role in significantly reducing the factors leading to mental disorders. (McDaid, 2005, 5) Thus, it is possible for the government to provide an ideal atmosphere for the development of sound mental health, which contributes to the progress of the society of any country.
The world health report of 2001 recognised the need to deal with the problem of mental health. This report recommended that the governments should take the actions such as providing treatment in primary care, making psychotropic drugs available, providing care in the community, educating the public, involving communities, families and consumers, establishing national policies, programmes and legislations, developing human resources, linking with other sectors, monitoring community mental health, and providing funding for further research. (Murthy et.al, 2001, xi-xii).
This document has realised the importance of changing the policies of the government towards the people with mental disorder. The governments need to increase their funding concerning the mental health. The mental disorders should be considered as a part of the other health problems. There should not be any discrimination between people with mental health illness and other people who suffer from other diseases. The developing countries need to increase the number of trained specialised staff in mental health. It is found that in most of the developing countries there is lack of specialised staff who can treat the mental illness. The government needs to monitor community mental health and the government should use the performance indicators to assess the performance of the actions of the government. These performance indicators can be published in the form of the reports so that the governments and the public can be aware of the various policies and the consequences of these policies relating to the mental well being. (Murthy, 2001, xi-xii).
The governments of the various countries can use these guidelines given by the World Health Report 2001. The implementation of these guidelines by the respective countries will go a long way in redressing the various problems related to mental health. International institutions such as World Health Organization have given importance to solving the problem of mental health disorders.
The countries in the region of Central and Eastern Europe have allocated very less amount of fund for the mental health of the people. In these countries the psychiatric hospital and social care homes provided the mental health care services. However, these European countries did not invest in the community based mental health services, which was an important recommendation of the World Health Report of 2001. This indicates that in these countries there is a need to implement the action plan suggested by the World Health Report of 2001 in order to effectively face the problem of mental health disorders among the people. By proving efficient health services it is possible to protect the human rights of the people who suffer from mental health problems. Community care services would lead to improving the quality of life of individuals in any society. There is a need to maintain the balance between different methods of providing health care. Particularly one should maintain this balance between institutionalised service and community-based care. There is need to introduce certain innovations to achieve the objectives of the countries to fight against the problems related to mental health. Although, community-based care does not reduce the economic cost, they will lead to greater efficiency in providing health care services. (McDaid and Thornicraft, 2005)
Different governments in the various European countries have pursued various methods of funding which differs from one country to the other. However, in spite of the realisation of the acuteness of the problem of mental health disorders in these countries, the mental health projects are allocated less amount of money, which has not improved the status of mental health of individuals in these countries. Different problems prevail in these countries which hinder the progress of the clear mental health policies. In order to achieve the goals, stated in some policy documents, the governments of the European and also other countries need to arrange for more funding, which is imperative to cure the overall problem of mental health disorders. The governments need to initiate measures to remove the stigma that is attached to the people with mental illness which has prevented these people from openly debating and discussing their problems with other members in the society. It is found that the funding in the European countries has been inefficient and inequitable which means the government authorities have not provided efficient mental health services and there is no equal distribution of economic resources among different categories of people, who suffer from mental illness. In some relatively low-income countries in Europe, the people have been forced to pay from their pockets in order to cure their mental diseases. (McDaid et.al, 2005)
It is possible to arrange for more efficient funding through strengthening the information base, by giving more importance to needs based resource allocation, by earmarking funds for mental illness communities, and, by coordinating funds. (McDaid, et. al., 2005, 12-13)
With the increase in the number of cases relating to mental illness as reported in the different countries, there emerged the concept of the burden of the mental disorder, which can be considered as the social and economic cost. The government, through its various policy measures, can reduce the problems of mental illness and also these policies could contribute the development of human capital, which can emerge as a valuable asset to the country. It is found that in “…both developed and developing countries the majority of persons with mental disorders are untreated.” (Whiteford, et al., 2001, 9)
It is also suggested that the key to redressing the problem of mental health disorders is the proper utilisation of mental health care facilities. In the developing countries the primary health care centres mostly provide such service while in the developed countries they are provided by both primary and secondary sectors. (Whiteford et.al, 9)
Important international organizations such as World Health Organization and other agencies have realised the importance of concentrating more on the problem of mental health disorders. The governments of developed and particularly developing countries need to give more priority to reduce the mental illness among the large number of people.
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Knapp, Martin, Michelle Funk, Claire Curran, Martin Prince, Margarent Grigg, David McDaid, “Mental health in low- and middle-income countries: economic barriers to better practice and policy”. Submitted.
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McDaid, David, Adam Oliver, Martin Knapp, and Michelle Funk. (2004) “Minding Mental Health: Towards An Equitable Approach”. Submitted.
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