Introduction
Mental and behavioural disorders are universal public health problems, and about 450 million people suffer from mental disorders. One person in four will develop one or more mental or behavioural disorders during their lifetime, and about 873000 people die by suicide every year. Five of the ten leading causes of disability worldwide are psychiatric conditions, including depression, alcohol use, schizophrenia and compulsive disorder. In the European Union, around 58 000 people die each year as a result of suicide or self-inflicted injury, and most suicide deaths are linked to mental illness, in particular, depression. Of the ten countries with the highest rates of suicide in the world, nine are in the European region. Mental health problems represent not only an immense psychological, social and economic burden to society, but also increase the risk of physical illnesses. Mental disorders affect and are affected by chronic conditions such as cancer heart and cardiovascular diseases diabetes and
HIV/AIDS. Individuals with mental disorders are often subjected to social isolation, poor quality of life and increased mortality.
Untreated. mental disorders bring about unhealthy behaviour.. non-compliance with prescribed medical regimens, diminished immune functioning and poor prognosis. These disorders are the. cause of staggering economic and social costs
The World Health report outlines a new understanding and provides new nope an
a comprehensive review of what is known about the burden of mental disorders and the principnal contributing factors. It examines the scope of prevention and the availability of, and obstacles to, treatment. It provides a critical review of service provision and planning and concludes with a set of far-reaching recommendations that can be adapted to every country according to its resources and needs. In England, mental ill-health is so common that at any one time around one in six people of working age have a mental health problem, most often anxiety or depression. One person in 250 will have a psychotic illness, such as schizophrenia or bipolar affective disorder (manic depression).
In 2000, the Office for National Statistics (ONS) carried out a survey of psychiatric morbidity of people aged 16 to 74 years living in private households in Great Britain, and found that about one in six adults aged between 16 and 74 living in individual households had a neurotic disorder (depression, anxiety, mixed anxiety and depression disorder ,phobia , obsessive disorder or panic disorder).
A new report The Neglected Majority indicated that one fifth of individuals who have depression in England need help that their general practitioners cannot give. The report calls for a new type of intermediate mental health care for this group.
Intermediate mental health care is a way of bridging the gap between primary and specialist services. The National Service Framework focuses on the mental health needs of working-age adults up to 65. This National Service Framework sets out standards in five areas; each criterion is supported by the evidence and knowledge base, by service models, and by examples of good practice.
Standard 1 addresses mental health promotion and combats the discrimination and social exclusion
associated with a mental health problems.
Standards 2 and 3 cover primary care and access to services for anyone who may have a mental health problem.
standards 4 and 5 encompass the care of people with severe mental illness
Standard 6 relates to individuals who care for people with mental health problems
Standard 7 draws together the action necessary to achieve the target to reduce suicides.
These standards will be challenging for all mental health services and those delivering service provision in primary care and specialist settings to individuals with a dual diagnosis.
About 90% of mental health care is provided solely by primary care, making mental health consultations, second only to those for respiritory infections.The importance of primary care in addressing mental health problems and the delivery of primary care psychiatric and neurological health services is discussed in Standard 2 of the national service framework for mental health.