- Recognize the public relevance of mental disorders worldwide
- Understand indicators of the frequency, the impact and the use of services in relation to mental disorders
- Stimulate the search for additional information and knowledge about solutions needed to diminish the global burden of mental disorders
As health care spending continues to rise, treatment resource allocation decisions will need to be based increasingly on information about the prevalence and societal burden of illness. Interest in societal burden has increased dramatically over the past decade based on this recognition and as part of a larger movement to rationalize the allocation of treatment resources and maximize benefit in relation to cost. Much of the current interest in mental disorders among health policy makers is based on the fact that these disorders have consistently been found in studies of disease burden to be both among the most burdensome health problems in the world1 and also to be among the disorders with the lowest ratio of investments in treatment to disease burdens.2
A number of factors account for the high burden of mental disorders. They are commonly occurring, often begin at an early age, often are quite persistent throughout the life course, and often have substantial adverse effects on functioning. The low investments in treatment are more difficult to explain but presumably are due at least partly to failure of health policymakers to recognize the high prevalence and burden of mental disorders.
Data are here presented from the World Health Organization (WHO) World Mental Health (WMH) surveys initiative.3 This initiative was launched to diminish the information gap regarding the high prevalence and burden of mental disorders, with the specific objectives of assessing the prevalence, severity, and comparative societal burden of mental disorders throughout the world. Although the WMH is still a work in progress, enough useful information has been produced to warrant a review of data produced by WMH up to now on the global epidemiology of common mental disorders.
WMH includes a series of geographically representative mental health surveys carried out in all major regions of the world. A key aim of the surveys is to help countries that would not otherwise have the expertise or infrastructure to implement high-quality community epidemiologic surveys that can be used for health policy planning purposes by providing centralized instrument development, training, and data analysis (www.hcp.med.harvard.edu/wmh). Twenty-eight countries have so far completed WMH surveys. The vast majority of these surveys are nationally representative, although a few are representative of only a single region (e.g., the São Paolo metropolitan area in Brazil) or regions (e.g., six metropolitan areas in Japan). The details about sampling in the countries that have been analyzed for the present analyses are shown in Table 17-1.
Table 17-1. Sampling Characteristics by Country Income Level: The WMH Surveys.a