Global mental health resources and services: A WHO survey of 184 countries

Abstract

Data derived from the World Health Organization's (WHO) Mental Health Atlas Project 2011 are presented. These data provide the latest estimates on available resources for the treatment and prevention of neuropsychiatric disorders covering 98 percent of the world's population. Resources are defined in terms of governance, financing, mental health care delivery, human resources, essential medicines, and information systems. The Atlas project was initiated to guide policy and planning efforts in order to meet the large and growing burden of neuropsychiatric disorders worldwide. Results indicate that 60 percent of countries have a dedicated mental health policy; 71 percent possess a mental health plan; and 59 percent report having dedicated mental health legislation. Median mental health expenditures per capita are US$ 1.63, with large variation among income groups, ranging from US$ 0.20 in low income countries to US$ 44.84 in high income countries. Globally, 67 percent of financial resources are directed towards mental hospitals. The global median number of facilities per 100,000 population were; 0.61 outpatient facilities, 0.05 day treatment facilities, 0.01 community residential facilities, and 0.04 mental hospitals. There are 7.04 psychiatric beds per 100,000 population in mental hospitals in comparison to 1.4 psychiatric beds per 100,000 population in general hospitals. Higher income countries typically report more facilities and higher admission/utilization rates. Three quarters of patients admitted to mental hospitals remain there less than one year. There is a clear pattern whereby greater rates of human resources are observed in higher income countries. Globally, nurses represented the most prevalent professional group working in the mental health sector. User and family associations are present in about two thirds of the countries, with greater representation in higher income countries. Results from Mental Health Atlas 2011 reinforce the urgent need to scale up resources within countries to meet the high and growing burden of mental disorders.