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Public mental health 

Public mental health
Public mental health

Benedetto Saraceno

, Melvyn Freeman

, and Michelle Funk

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date: 26 January 2022

Mental health is an integral part of health. Consequently, public mental health is critical to achieving better health in populations. The prevalence of mental disorder is substantial with around 450 million people worldwide suffering from neuropsychiatric conditions. Suicide is among the leading causes of death in 15–45-year-olds. Moreover, mental disorder makes a considerable independent contribution to the burden of disease worldwide—accounting for 13 per cent of the global burden of disease. By 2030, it is estimated that unipolar depression will be the second-highest cause of disability-adjusted life years (DALYs) lost. Globally, the majority of people who need mental health care do not receive it. This ‘service gap’ is far highest in middle- and low-income countries. There are, however, cost-effective treatments available, and it has been estimated that the benefits of a basic specified package of treatment could lead to a reduction of 2000–3000 DALYs lost per million population. Inadequate and inappropriate mental health systems and services are a major cause of poor mental health outcomes. Decentralization of services and integration of mental health into general health care are critical to improve mental health status in populations. In middle- and low-income countries, additional trained personnel and facilities are required, especially in general health care. Though there are multiple determinants of mental disorder, social and economic factors are fundamental. Poverty, gender discrimination and violence/war are amongst the most important of these. Understanding social determinants is important for planning services; to initiate prevention and promotion; for advocacy and for the information of sectors outside of health that need to assist in improving mental health—such as social development, labour, education, and housing. Finding appropriate and adequate promotive and preventive interventions in mental health is increasing but remains an important area of growth. Given the inextricable connections between mental and physical health, and the importance of mental disorder as a health problem in its own right, this chapter shows that public mental health is central to improved global health.

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