Scale up services for mental disorders: a call for action
Abstract
We call for the global health community, governments, donors, multilateral agencies, and other mental health stakeholders, such as professional bodies and consumer groups, to scale up the coverage of services for mental disorders in all countries, but especially in low-income and middle-income countries. We argue that a basic, evidence-based package of services for core mental disorders should be scaled up, and that protection of the human rights of people with mental disorders and their families should be strengthened. Three questions are critical to the scaling-up process. What resources are needed? How can progress towards these goals be monitored? What should be the priorities for mental health research? To address these questions, we first estimated that the amount needed to provide services on the necessary scale would be US$2 per person per year in low-income countries and $3-4 in lower middle-income countries, which is modest compared with the requirements for scaling-up of services for other major contributors to the global burden of disease. Second, we identified a series of core and secondary indicators to track the progress that countries make toward achievement of mental health goals; many of these indicators are already routinely monitored in many countries. Third, we did a priority-setting exercise to identify gaps in the evidence base in global mental health for four categories of mental disorders. We show that funding should be given to research that develops and assesses interventions that can be delivered by people who are not mental health professionals, and that assesses how health systems can scale up such interventions across all routine-care settings. We discuss strategies to overcome the five main barriers to scaling-up of services for mental disorders; one major strategy will be sustained advocacy by diverse stakeholders, especially to target multilateral agencies, donors, and governments. This Series has provided the evidence for advocacy. Now we need political will and solidarity, above all from the global health community, to translate this evidence into action. The time to act is now.
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Limitations in the evidence reviewed affect the strength of conclusions and generalisability, especially for scaling up services in LAMI countries.
“We note some of the limitations of the evidence included in this review that affect the strength of conclusions and generalisability of the results, particularly to efforts to scale up services for people with mental disorders in LAMI countries.45”
From Effect of psychosocial interventions on social functioning in depression and schizophrenia: meta-analysis (2013) · cites this paper as [45]
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- Authors
- ‡
- Corresponding author
- ‡
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2007-10
- Volume
- 370
- Issue
- 9594
- Pages
- 1241-1252
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2137693987
- Cited by
- 835
- References
- 5
- Citations by year
- 2026: 18 · 2025: 28 · 2024: 31 · 2023: 71 · 2022: 29 · 2021: 68 · 2020: 45 · 2019: 41 · 2018: 50 · 2017: 53 · 2016: 44 · 2015: 44 · 2014: 54 · 2013: 47 · 2012: 58
- FWCI
- 4.86
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- UNIFESP Institutional Repository (Universidade Federal de São Paulo) (submittedVersion)
- SUNScholar (Stellenbosch University) (submittedVersion)
- Funders
- United States Agency for International Development
- Australian Agency for International Development
- Topics
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Keywords
- global mental health, low- and middle-income countries, mental illness, mental health funding, mental health indicators, research prioritization, advocacy, political will
- MeSH terms
- Mental Disorders, Female, Health Priorities, Health Resources, Health Services Needs and Demand, Humans, Male, Mental Health Services, Poverty, Research, Social Welfare, Global Health
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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