Nick Kristof really hit the nail on the head in his Sunday column in the New York Times “First Up, Mental Illness. Next Topic Is Up to You,” where he called out mental illness as one of the major issues systematically neglected to be given the seriousness and attention it deserves.
Controversy has surrounded the latest publication of the Diagnostic and Statistical Manual (DSM) of mental health disorders, in part because of concerns that the guideline pathologizes many behaviors that some people might consider normal, theoretically increasing the opportunity to prescribe pharmaceuticals for non-pathological behavior. But beyond the field of psychiatry, there are increasing concerns that “medicalization” may be doing more harm than good for patients (especially where tests and therapies have marginal benefit but potentially great risks), and may be influenced by profit motives and desires to define disease so expansively as to intrude on normal living to a stifling degree. A recent comprehensive study of medical panels’ decisions about expanding disease definitions shed some light on this debate, and revealed some concerning findings… In 2009, the Institute of Medicine published a landmark report entitled “Conflict of interest in medical research, education, and practice”. In the report, the IOM found “widespread relationships with industry have created significant risks that individual and institutional financial interests may unduly influence professionals’ judgments” in medicine. Subsequent recommendations from the IOM revealed that a major area of concern was the writing of medical guidelines that physicians around the country (and, indeed, around the world) typically use to decide when to screen patients for diseases, how to define a disease, and when and how to treat such diseases.
Image Credit: Marcie Casas, Flickr At the launch of the Turning the World Upside Down website earlier this year Paul Farmer, from Harvard University, spoke of the ‘fetishisation of the quantifiable’ in global health. That is not to say the quantifiable outcomes are not important, but instead to highlight that there is a lot to learn from the experience of researchers, clinicians and policy makers beyond the measurable. This is a key motivation of PLOS Medicine’s Global Mental Health Practice series, which aims to emphasize the importance of “practice-based evidence,” by placing value on the experiences and impact of interventions in real-world settings as evidence for implementation. In this week’s PLOS Medicine we publish a new case study, as part of the series, by Oye Gureje from the University of Ibadan, Nigeria and colleagues who describe their experience of contextualizing and adapting the World Health Organization’s Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) for Nigeria. The guide is designed to help scale up the coverage of mental health services in low resource settings by providing guidance for non-specialists to provide mental health services.
VOA News: Study in CAR Links Mental Health and Malnutrition “Data collected at a hospital in the Central African Republic suggest that many parents of malnourished children have symptoms of post-traumatic stress disorder, according to the international aid group Action Against Hunger…” (Long, 4/22).
Huffington Post: The True Price of Mental Health and the Low-Cost Solution Olivia Davies, development officer at BasicNeeds “[There is] a distinct lack of funding or recognition for the vast problem of mental illness and epilepsy in low- and middle-income countries. This is a travesty, really, considering that of the 450 million people suffering from…More
GlobalPost: The lingering wounds of Liberia’s 14-year civil war “In Nimba County, northeastern Liberia, the most visible signs of the country’s 14-year civil war are finally fading. … But the deepest wounds of the conflict are difficult to see and slower to heal. They are the psychological scars of war, and even after a decade…More
Flickr, porschelinn Mental health problems have a profound impact on men and women worldwide, but the toll of these diseases weighs most heavily on women. Worldwide, depression is responsible for more healthy years lost than HIV/AIDS or malaria in women of all ages. Globally, depression (also known as major depressive disorder, or MDD) was the … Continue reading →
The Guardian: Female refugees from Syria ‘blighted by gynecological illness and stress’ “Syrian women who have fled to Lebanon are suffering severe stress and health problems including a high rate of preterm births and complications among those who are pregnant, according to a study. … Some of their health problems are linked to conflict-related stress,…More
Background: Australia’s health workforce is facing significant challenges now and into the future. Health Workforce Australia (HWA) was established by the Council of Australian Governments as the national agency to progress health workforce reform to address the challenges of providing a skilled, innovative and flexible health workforce in Australia. HWA developed Australia’s first major, long-term national workforce projections for doctors, nurses and midwives over a planning horizon to 2025 (called Health Workforce 2025; HW 2025), which provided a national platform for developing policies to help ensure Australia’s health workforce meets the community’s needs. Methods: A review of existing workforce planning methodologies, in concert with the project brief and an examination of data availability, identified that the best fit-for-purpose workforce planning methodology was the stock and flow model for estimating workforce supply and the utilisation method for estimating workforce demand. Scenario modelling was conducted to explore the implications of possible alternative futures, and to demonstrate the sensitivity of the model to various input parameters.