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King's contributes to WHO Intervention Guidelines

08 October 2010

The World Health Organization (WHO) has launched new mental health Gap Action Programme (mhGAP) Intervention Guidelines on the management of depression, alcohol use disorders, epilepsy and other common mental disorders in the primary health-care settings in low and middle income countries, with important contributions from Professors Graham Thornicroft, Martin Prince and Colin Drummond, Institute of Psychiatry at King's and Centre for Global Mental Health King's Health Partners.

Millions of people with common, but untreated, mental, neurological and substance use disorders can now benefit from new simplified diagnosis and treatment guidelines drawn up by 200 specialists from around the world.    The Intervention Guidelines extend competence in diagnosis and management to non-mental health specialists including doctors, nurses and other health providers. These evidence-based guidelines are presented as flow charts to simplify the process of providing care in the primary health-care setting.

Dr Margaret Chan, Director-General of the World Health Organization  said 'In a key achievement, the Intervention Guidelines transform a world of expertise and clinical experience, contributed by hundreds of experts, into less than 100 pages of clinical wisdom and succinct practical advice.'

Professor Thornicroft, who chaired the Guideline Development Group with Dr Shekhar Saxena, Director, Mental Health and Substance Abuse Department WHO, said 'These are the first World Health Organisation mental health guidelines for practitioners in low income countries and are a very important step forward to improve care for people with mental disorders worldwide. Using these guidelines, we can now say to governments across the world that diagnosing and treating people with mental disorders is possible and affordable if there is the political will and the collaboration of all stakeholders.' 

Almost 95 million people with depression do not receive any treatment or care

The WHO estimates that more than 75% of people with mental, neurological and substance use disorders - including nearly 95 million people with depression and more than 25 million people with epilepsy - living in developing countries do not receive any treatment or care. Placing the ability to diagnose and treat them into the primary health care system will significantly increase the number of people who can access care.

Expensive technologies are not required to improve mental health services

'Improvement in mental health services doesn't require sophisticated and expensive technologies. What is required is increasing the capacity of the primary health care system for delivery of an integrated package of care', said Dr Ala Alwan, Assistant Director-General for Noncommunicable Diseases and Mental Health at WHO.

An estimated one in four people globally will experience a mental health condition in their lifetime. People with mental, neurological and substance use disorders are often stigmatized and subject to neglect and abuse. The resources available are insufficient, inequitably distributed and inefficiently used. In the majority of countries, less than 2% of health funds are spent on mental health. As a result, a large majority of people with these disorders receive no care at all.

Implementing the guidelines

WHO in collaboration with partners will provide technical support to countries to implement the guidelines and has already initiated the programme for scaling up care in six countries; Ethiopia, Jordan, Nigeria, Panama, Sierra Leone and Solomon Islands.

How the programme will help people

 'The programme will lead to nurses in Ethiopia recognizing people suffering with depression in their day to day work and providing psychosocial assistance. Similarly, doctors in Jordan and medical assistants in Nigeria will be able to treat children with epilepsy', said Dr Shekhar Saxena, Director of the Department of Mental Health and Substance Abuse at WHO. Both these conditions are commonly encountered in primary care, but neither identified nor treated due to lack of knowledge and skills of the health care providers. 

The Intervention Guidelines will help scale up care for mental, neurological and substance use disorders - which is the aim of WHO mental health Gap Action Programme (mhGAP). Multiple partners including Member States, UN agencies, research institutes, universities, multilateral agencies, foundations, WHO Collaborating Centres and NGOs under the (mental health Gap Action Programme (mhGAP) Forum have agreed to assist WHO in advocating for improving mental health care and services in developing countries.    WHO through its mhGAP programme, calls on governments, donors and mental health stakeholders to rapidly increase funding and basic mental health services to close the huge treatment gap.

For further information on the mhGAP Intervention Guidelines for mental, neurological and substance use disorders in non-specialized health settings published by WHO can be found here: 

For information about the King's College London Health Service and Population Research Department click here:

For information about the King's Health Partners Centre for Global Mental Health, here: http:///

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