A New Economic and Social Paradigm for Funding Recovery in Mental Health in the Twenty First Century

Abstract

Mental illness is a significant factor in disease related disability throughout the world. About 16% of the global burden of disease not attributable to communicable disease has been attributed to mental disorders (Prince et al 2007) with substance abuse disorders contributing to a further 4% of this burden (ibid). In Australia, “Mental Disorders” were considered to be the third major cause of health loss (behind cancer and cardiovascular disease) in 2003 but were estimated to increase at a significant rate to move ahead of cancer and become the second major cause of “health loss” by 2013 (Begg et al 2008). This burden of mental illness is particularly pronounced in the youth of Australia with disabilityadjusted life years (DALY’s) for mental illness calculated to be above 90,000 (compared to the next highest of 48,000 DALY’s due to injury) for the 15 to 24 year old age group in 2003 (Eckersley 2011). Along with the current burden of disease attributed to mental illness, there is a number of challenges facing societies in the developed and developing world that are likely to lead to an increase in mental illness. Sartorius (pers comm) has recently outlined some of these challenges. They include: weakening of community resilience mechanisms, increasing awareness of gaps and unreachable opportunities, migration of people, talents and capital with the subsequent loss of social capital in some societies, the challenges of increased urbanisation on community supports and family structures, the changing nature of privileged families in developed society with less children, longer life spans and more fragile family structures, the decrease of middle class “norms” in developed countries and the additional increase of the middle class in developing countries with potential economic and social alienation from less privileged groups, the changing role of women and the implications that this has for child care and care of the elderly and the changing paradigms of medicine itself with increasing use of technology in addition to evolving ethical issues such as euthanasia. The severity of personal disability from mental illness is pervasive. The poetry of Anne Sexton in the poem “Sickness unto Death” (1977) helps describe some of this inner experience for severe mood disorder: