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July

Global Mental Health Challenges for the next decade

The Grand Challenges in Global Mental Health have been announced in the journal Nature today, setting out the priorities for the next 10 years of global research into mental, neurobiological and substance-use (MNS) disorders.

The 40 mental health challenges have been agreed upon by over 400 researchers, including colleagues from Institute of Psychiatry at King’s, clinicians and patient advocates worldwide, and aim to pinpoint the unique research priorities that in the next decade, can lead to substantial improvements in the lives of people living with neuropsychiatric illnesses.

Children receive particular attention in the challenges. The authors highlight the need for more research into the role of prenatal exposures, and in developing interventions to reduce the long-term negative impact of low childhood socio-economic status on cognitive ability.

The mental health challenges emphasize the need for global cooperation in reducing the overall burden of health conditions and reducing mental health inequalities within and between countries. They draw attention the importance of shared access to data, expertise and capacity-building opportunities.

Professor Shitij Kapur, Dean of the IoP at King’s and member of the Scientific Advisory Board for the Grand Challenges in Global Mental Health Initiative, says: ‘This report is unique as not only has it had input from 60 different countries, but it covers the entire spectrum of MNS disorders and it has looked across the entire lifespan. Prevention and cure in mental health is a bold ambition however we are now at a time when it is truly meaningful to talk about prevention. Sufficient strides have been made in MNS research that in the near future prevention through early intervention can be a reality in focussed areas.’

Conditions within the remit of the initiative include schizophrenia, depression, epilepsy, dementia, alcohol dependence and other MNS disorders which constitute 13% of the global burden of disease, surpassing cardiovascular disease and cancer. Whilst the disease burden is high, treatment and preventative interventions for MNS disorders are few. This reflects the limited understanding of the brain and disease mechanisms, but also the lack of global investment in fundamental research into MNS disorders relative to the disease burden.

Graham Thornicroft, Professor of Community Psychiatry IoP at King’s, who also contributed to the report said: ‘We have a real problem with access to treatment for MNS compared to physical disorders - in high income countries 94% of those with diabetes access and receive treatment; for depression it is 29%. For low and middle income countries it is even worse with 77% of those with diabetes receiving treatment but only 8% of those with depression getting help. Stigma, discrimination and fear of rejection play a big part in these statistics however with anti-stigma campaigns such as Time to Change and bringing patients to the centre of research such as the Service User Research Enterprise at the IoP, we can move towards the mental health community speaking with one voice and combating this. 

'This report is a remarkable and exciting turning point in mental health. With life-expectancy rates for those with MNS being 15-20 years less than those without, I would like a future where people will seek treatment for MNS without fear of stigma and discrimination which we will only achieve if we have funding for research to reflect the level of disease burden MNS creates.’

Professor Kapur concludes: ‘The grand challenge is not just for us as researchers but for this country and the world as a whole. We need more mental health training for medical students and to encourage more medical students to take up psychiatry - health professionals must be given the appropriate training to recognise signs early on.’

The Grand Challenges in Global Mental Health Initiative is led by the U.S. National Institute of Mental Health and the Global Alliance for Chronic Disease, in partnership with the Wellcome Trust, the McLaughlin-Rotman Centre for Global Health, and the London School of Hygiene and Tropical Medicine.

For more information on the Global Mental Health Challenges: http://grandchallengesgmh.nimh.nih.gov

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