We know that mental illness is a global problem, not just restricted to developed nations. Statistics show that the suicide rate in the United States is up 18% since 2000, while in the rest of the world it has been falling. In its article about this trendThe Economist gives an analysis of why and what more can be done (see below). But this is a superficial analysis. The issue needs a much more in-depth study of the disparities which exist in access to and quality of care, including in the United States. Here the British medical journal The Lancet has stepped in. Long engaged in issues of global health concerns, it has announced a new initiative Countdown Global Mental Health. It is an ambitious project, which will be years in the implementation, but it brings more crucial research to bear on this major health issue. Below are excerpts from their announcement.
Last year’s Lancet Commission on Global Mental Health and Sustainable Development reframed mental health as a dimension, emphasising mental health promotion and prevention of mental disorders for the entire population, alongside quality treatment and care for those who have a mental health condition. The Commission also proposed mental health as a global public good and recommended a rights-based approach to protect people at risk of poor mental health and to protect the dignity of people with mental health problems. The Commission recommended strengthening of monitoring and accountability for global mental health.
The Commission identified three domains that should be considered for Countdown Global Mental Health. These domains are mental health determinants (eg, demographic, economic), mental health system and service components (eg, financing, workforce capacity), and mental health outcomes and risk protection (eg, social and financial risk protection). These domains are aligned with the dimensional concept of mental health within the framework of sustainable development, and go beyond crude indicators such as suicide rate . . . .The Countdown will give particular attention to mental health treatment coverage as an essential component of universal health coverage. . . .
“Quality of services and satisfaction with care will be an integral part of monitoring. The Countdown group will expand on the work of WHO and the Lancet Commission to determine the measurement and accountability framework, including the set of indicators that follow criteria such as feasibility, reliability, and usefulness. Data on the selected set of indicators will be collected from all countries using, as far as possible, existing global and national sources. Analysis will include aggregating the indicators, exploring correlations and clusters, and, ultimately, developing an index for comparability across countries and time.
“As the global community begins to mobilise resources towards addressing the goals of promoting mental health, preventing mental disorders, and providing quality care for people with mental health conditions, there is an urgent imperative for a comprehensive and transparent monitoring mechanism to catalyse global and national action and hold diverse actors accountable.
“Countdown Global Mental Health seeks to realise this aspiration.

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