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Mental Health in South Asia: Ethics, Resources, Programs and Legislation pp 263–277Cite as

Roadmap for the Future: What is Needed in the Region?

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Part of the book series: International Library of Ethics, Law, and the New Medicine ((LIME,volume 58))

Abstract

South Asia is home to 20 % of world population and comprises low and middle income countries. These countries account for a large burden of mental and behavioural disorders. There is a huge treatment gap due to scarcity of available mental health resources, inequities in their distribution, and inefficiencies in their use. Advocacy efforts by international organizations, national opinion makers and users are necessary to generate sufficient political will to prioritize mental health services. All countries in the region should have mental health policy, mental health legislation and a dedicated mental health budget. All stakeholders should be involved in planning of mental health services after taking into account felt needs of the community and ground realities. Plans should be implemented in a time bound manner with periodic assessment of performance at ground level to initiate prompt corrective responses. Decentralization of mental health services and its integration with primary care will make it easily accessible to the community. There is a need for both mental health professionals and non-mental health care providers (including traditional and alternate systems of medicine among others) to support each other in providing better and broad based services. Family and community resources hold promise in delivering services and need to be explored. Training needs of diverse providers need to be addressed. Priority research aimed at finding innovative solutions should help bridge the mental health research as well as treatment gap. All levels—individual, family, community, facility, district, national, and global—have a role and responsibility if health for all is to be achieved.

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References

  • Beaglehole, R., et al. 2008. Improving the prevention and management of chronic disease in low-income and middle-income countries: A priority for primary health care. The Lancet 372:940–949.

    Article  Google Scholar 

  • Benegal, V., P. K. Chand, and I. S. Obot. 2009. Packages of care for alcohol use disorders in low- and middle-income countries. PLoS Medicine 6 (10): e1000170.

    Article  Google Scholar 

  • Chatterjee, S., et al. 2003. Evaluation of a community-based rehabilitation model for chronic schizophrenia in rural India. The British Journal of Psychiatry 182:57–62.

    Article  Google Scholar 

  • Dal Poz, M., et al. 2006. Addressing the health workforce crisis: Towards a common approach. Hum Resour Health 4 (1): 21.

    Article  Google Scholar 

  • Dhar, A. 2011. At India’s insistence, mental health included as non-communicable disease. The Hindu. http://www.hindu.com/2011/05/05/stories/2011050557552000.htm. Accessed 4 Jan 2012.

  • Eaton, J., et al. 2011. Scale up of services for mental health in low-income and middle-income countries. The Lancet 378:1592–1603.

    Article  Google Scholar 

  • Flisher, A. J., et al. 2010. Packages of care for attention-deficit hyperactivity disorder in low- and middle-income countries. PLoS Medicine 7 (2): e1000235.

    Article  Google Scholar 

  • Goel, D. 2011a. The national mental health program: problems, perspectives, possibilities. In Public mental health: An evolving field, eds. L. Swartz and L. Richter et al. New Delhi: Ministry of Health, Government of India.

    Google Scholar 

  • Goel, D. 2011b. Why mental health services in low- and middle-income countries are under-resourced, underperforming: An Indian perspective. The National Medical Journal of India 24 (2): 94–97.

    Google Scholar 

  • Goel, D., et al. 2004. Mental health 2003: The Indian scene. In Mental health: An Indian perspective (1946–2003), ed. S. P. Agarwal, 3–24. New Delhi: Directorate General of Health Services, Ministry of Health and Family Welfare, Government of India/Elsevier.

    Google Scholar 

  • Inter-agency Standing Committee. 2007. IASC guidelines on mental health and psychosocial support in emergency settings. Geneva: Inter-agency Standing Committee.

    Google Scholar 

  • Jacob, K. 2006. The diagnosis and management of depression and anxiety in primary care: The need for a different framework. Postgraduate Medical Journal 82 (974): 836–839.

    Article  Google Scholar 

  • Jacob, K. 2010. Indian psychiatry and classification of psychiatric disorders. Indian Journal of Psychiatry 52 (7): 104.

    Article  Google Scholar 

  • Jacob, K. 2011. Repackaging mental health programs in low- and middle-income countries. Indian Journal of Psychiatry 53:195.

    Article  Google Scholar 

  • Jacob, K., et al. 2007. Mental health systems in countries: Where are we now? The Lancet 370:1061–1077.

    Article  Google Scholar 

  • Kakuma, R., et al. 2011. Human resources for mental health care: Current situation and strategies for action. The Lancet 378:1654–1663.

    Article  Google Scholar 

  • Kapur, R. 2004. The story of community mental health in India. In: Mental health: An Indian perspective, 1946–2003, eds. S. P. Agarwaal and D. S. Goel et al., 92–100. New Delhi: Published for Directorate General of Health Services Ministry of Health & Family Welfare [by] Elsevier.

    Google Scholar 

  • Lancet global mental health group. 2007. Scale up services for mental disorders: A call for action. The Lancet 370:1241–1252.

    Article  Google Scholar 

  • Lawn, J. E., et al. 2008. Alma-Ata 30 years on: Revolutionary, relevant, and time to revitalise. The Lancet 372:917–927.

    Article  Google Scholar 

  • Lund, C., et al. 2011. Poverty and mental disorders: Breaking the cycle in low-income and middle-income countries. The Lancet 378:1502–1514.

    Article  Google Scholar 

  • Mari, J., et al. 2009. Packages of care for schizophrenia in low- and middle-income countries. PLoS Medicine 6 (10): e1000165.

    Article  Google Scholar 

  • Mbuba, C. K., and C. R. Newton. 2009. Packages of care for epilepsy in low- and middle-income countries PLoS Medicine 6 (10): e1000162.

    Article  Google Scholar 

  • Mental health policy group. 2011. http://mhpolicy.org/. Accessed 4 Jan 2012.

  • Murthy, R. S. 2011. Mental health initiatives in India (1947–2010). National Medical Journal of India 24 (2): 98–107.

    Google Scholar 

  • Oxford Policy Management. 2002. Evaluation of the Prime Minister’s Lady Health Worker Programme.

    Google Scholar 

  • Painuly, N., and P. Sharan. 2008. Effectiveness of training of non-mental health care providers in mental health in low- and middle income countries: A systematic review. Primary Care Community Psychiatry 13 (2): 83–89.

    Google Scholar 

  • Patel, V., and G. Thornicroft. 2009. Packages of care for mental, neurological, and substance use disorders in low- and middle-income countries: PLoS medicine series. PLoS Medicine 6 (10): e1000160.

    Article  Google Scholar 

  • Patel, V., et al. 2009. Packages of care for depression in low- and middle-income countries. PLoS Medicine 6 (10): e1000159.

    Article  Google Scholar 

  • Prince, M. J., et al. 2009. Packages of care for dementia in low- and middle-income countries. PLoS Medicine 6 (11): e1000176 (V. Patel ed.).

    Article  Google Scholar 

  • Rohde, J., et al. 2008. 30 years after alma-ata: Has primary health care worked in countries? The Lancet 372:950–961.

    Article  Google Scholar 

  • Saraceno, B., et al. 2007. Barriers to improvement of mental health services in low-income and middle-income countries. The Lancet 370:1164–1174.

    Article  Google Scholar 

  • Saxena, S., and P. Sharan. 2003. Research for change: Supporting mental health research in India. National Medical Journal of India 16 (3): 122–125.

    Google Scholar 

  • Saxena, S., and P. Sharan. 2004. Enhancing mental health research publication from low and middle-income countries. Indian Journal of Psychiatry 46(1): 72–78.

    Google Scholar 

  • Saxena, S., and P. Sharan. 2010. Mental health resources and services. In Mental and neurological public health a global perspective, ed. V. Patel, et al., 418–430. New Delhi: Elsevier.

    Google Scholar 

  • Saxena, S., P. Sharan, and B. Saraceno. 2004. Research for change: The role of scientific journals publishing mental health research. World Psychiatry 3 (2): 66–72.

    Google Scholar 

  • Saxena, S., et al. 2006. The 10/90 divide in mental health research: Trends over a 10-year period. British Journal of Psychiatry: The Journal Of Mental Science 188:81–82.

    Article  Google Scholar 

  • Saxena, S., et al. 2007. Resources for mental health: scarcity, inequity, and inefficiency. The Lancet 370:878–889.

    Article  Google Scholar 

  • Sharan, P., et al. 2009. Mental health research priorities in low- and middle-income countries of Africa, Asia, Latin America and the Caribbean. British Journal of Psychiatry: The Journal Of Mental Science 195 (4): 354–363.

    Article  Google Scholar 

  • Sood, M., and P. Sharan. 2011. A pragmatic approach to integrating mental health in undergraduate training: The AIIMS experience and work in progress. National Medical Journal of India 24 (2): 108–110.

    Google Scholar 

  • Thornicroft, G., et al. 2010. WPA guidance on steps, obstacles and mistakes to avoid in the implementation of community mental health care. World Psychiatry: Official Journal of the World Psychiatric Association 9 (2): 67–77.

    Google Scholar 

  • Tomlinson, M., et al. 2009. Setting priorities for global mental health research. Bulletin of the World Health Organization, 87 (6): 438–446.

    Article  Google Scholar 

  • Trivedi, J. K., and A. Q. Jilani. 2011. Pathway of psychiatric care. Indian Journal of Psychiatry 53 (2): 97–98.

    Article  Google Scholar 

  • United Nations Statistics Division. 2011. Standard Country and Area Codes Classifications (M49). http://millenniumindicators.un.org/unsd/methods/m49/m49regin.htm. Accessed 3 Dec 2011.

  • Walley, J., et al. 2008. Primary health care: making alma-ata a reality. The Lancet 372:1001–1007.

    Article  Google Scholar 

  • WHO. 2001. The world health report: 2001: Mental health: New understanding, new hope. Geneva: WHO.

    Google Scholar 

  • WHO. 2007. The optimal mix of services for mental health. Information sheet 2. In Mental health policy, planning & service development. http://www.who.int/mental_health/policy/services/en/index.html. Accessed 3 Jan 2012.

  • WHO. 2008. mhGAP: Mental health gap action programme: Scaling up care for mental, neurological and substance use disorders. Geneva: WHO.

    Google Scholar 

  • WHO. 2009a. Improving health systems and services for mental health. Geneva: World Health Organization.

    Google Scholar 

  • WHO. 2009b. Mental health systems in selected low- and middle-income countries: A WHO-AIMS crossnational analysis. Geneva: WHO.

    Google Scholar 

  • WHO. 2010a. Best practices: Mental health service development. Mental health policy, planning & service development. http://www.who.int/mental_health/policy/services/en/index.html. Accessed 3 Jan 2012.

  • WHO. 2010b. mhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings: Mental health gap action programme (mhGAP). Geneva: World Health Organization.

    Google Scholar 

  • WHO. 2011a. Mental health atlas 2011. Geneva: WHO.

    Google Scholar 

  • WHO. 2011b. WHO Model Lists of Essential Medicines. 17th edition. 2011. http://www.who.int/medicines/publications/essentialmedicines/en/. Accessed 3 Jan 2012.

  • WHO, WONCA. 2008. Integrating mental health into primary care: A global perspective. Geneva: World Health Organization and World Organization of Family Doctors.

    Google Scholar 

  • WHO/UNESCO/ILO/IDDC. 2010. Community based rehabilitation guidelines; supplementary booklet; mental health and CBR (P3–20). Geneva: World Health Organization.

    Google Scholar 

  • Wig, N. 2004. Vision 2020: Roadmap for the future-II. Mainstreaming mental health. In Mental health: An Indian perspective, 1946–2003, ed. S. P. Agarwal, et al. 341–343. New Delhi: Published for Directorate General of Health Services Ministry of Health & Family Welfare [by] Elsevier.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry, AIIMS, New Delhi, 110029, India

    Prof. Pratap Sharan

  2. Department of Psychiatry, NIMHANS, Bengaluru, 560029, India

    T. Sivakumar

Authors
  1. Prof. Pratap Sharan
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  2. T. Sivakumar
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Corresponding author

Correspondence to Pratap Sharan .

Editor information

Editors and Affiliations

  1. King George's Medical University, Shahmeena Road, Chowk, Lucknow, Uttar Pradesh, India

    Jitendra Kumar Trivedi

  2. King George's Medical University, Uttar Pradesh, India

    Adarsh Tripathi

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Sharan, P., Sivakumar, T. (2015). Roadmap for the Future: What is Needed in the Region?. In: Trivedi, J., Tripathi, A. (eds) Mental Health in South Asia: Ethics, Resources, Programs and Legislation. International Library of Ethics, Law, and the New Medicine, vol 58. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-9017-8_15

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