International

Campaign on Mental Illness

An international alliance of specialists in mental health is launching a campaign today to shift the focus of the world's attention from disorders of the body to disorders of the mind.

Some 30 per cent of the world’s population suffer some form of mental disorder each year, yet at least two–thirds receive inadequate or no treatment, even in countries with the best resources, such as the UK.

Mental illness outranks cancer and heart disease as a cause of chronic ill health – mainly due to the disabling nature of depression and alcohol or drug problems – yet it attracts a fraction of the resources of these more fashionable conditions.

In a series of articles published in The Lancet, experts from the World Health Organisation, the London School of Hygiene and the Institute of Psychiatry in the UK appeal to governments and medical organisations around the world to increase funding for mental health and make it a central theme of their wider health strategy.

As much as 14 per cent of the global disease burden is attributable to mental illness according to estimates by WHO in 2005, yet the condition is marked by stigma and neglect. Almost a quarter (23 per cent) of the global burden of disability is due to mental problems, compared with 21 per cent for heart disease and stroke and 11 per cent for cancer.

Professor Martin Prince of the Institute of Psychiatry said even those high figures were likely to be an underestimate because the impact of mental health on physical health went unrecognised.

The most obvious fatal impact of depression was when it led sufferers to take their own lives with 800,000 suicides each year around the world, nine out of ten of whom suffered a serious mental problem in the weeks leading up to their deaths.

But depression carried an increased risk of death for other reasons, such as by contributing to a less healthy lifestyle with more smoking and less exercise.

Stigma also played a part in denying mental patients treatment for physical illness. An Australian study found mental patients with heart disease were less than half as likely to receive surgery for their condition and were 80 per cent more likely to die from it than unaffected patients.

“We have missed these links [between mental and physical health]. Without them we fail to capture the full impact of mental illness, ” Professor Prince said.

Almost a third of countries worldwide have no budget for mental health and one fifth of those that have spend less than 1 per cent of their total health budget on it, compared with 10 per cent in the UK. Shekhar Saxena of WHO said inequities in provision were rampant.

“High income countries have up to 200 times more psychiatrists, psychiatric nurses and psychologists. Low income countries are losing resources – in two years' time the situation will be even worse,” he said.

Too often, countries were training more psychiatrists and investing in expensive mental hospitals and beds when the money would be better spent on psychiatric nurses and community care, he said.

Too often, countries were training more psychiatrists and investing in expensive mental hospitals and beds when the money would be better spent on psychiatric nurses and community care, he said.

Professor Vikram Patel of the London School of Hygiene said there was robust evidence to show that scaling up services in countries where they were most sparse was cost-effective. Over 10 years the cost was estimated at $2 (£1) a person in low income countries and $3–$4 in middle income countries.

Richard Horton, editor of The Lancet said there had been “a critical failure of leadership” by Western countries.

Source: Jeremy Laurance, Campaign to recognise dangers of mental illness. The Independent on Sunday, London, 4 September 2007.

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TV Show: Coming Down the Mountain

What’s the solution to an annoying little brother? Push him off a mountain, that’s what! In Coming Down the Mountain (BBC1, Sunday), 15–year–old David is depressed. His brother Ben’s got Down’s syndrome, which is annoying because it means he has to look after Ben and take him home after school instead of getting a girlfriend. And who’s going to go out with him anyway, with a brother like Ben? But then, in spite of the odds being stacked up highly against him, David goes and gets himself a girlfriend. A really hot one, too – Gail, who’s a bit like Amy Winehouse’s little sister, with some of Amy’s attitude and habits. Suddenly, things aren't so shabby after all.

But then it gets bad again –really bad. David’s family move – from north London, to Matlock! Wherever the hell that is. It’s all because of Ben, of course – there’s a special school in Matlock. Everything’s because of Ben.

And if that wasn't enough, hot Gail goes and dumps David too, for the guy in the tattoo shop. A boyfriend with a Down’s syndrome brother, that’s a big ask, but just about doable. One with a Down’s syndrome brother who lives in Matlock? No thanks, you're all right.

So heartbroken David is stuck in Matlock with his Down’s syndrome brother, about whom the whole world revolves, and on top of that he’s being beaten up at his new school for being gay, even though he isn't. Things aren't good at all.

There’s only one thing for it: kill Ben. So they set off for North Wales, David and Ben, and suddenly it’s a bit like Rain Man, except they're kids. And they're in Wales, not America. So not that much like Rain Man at all, except that they're on the road, and one of them has a learning disability. They go up Snowdon, the difficult way, and at the top David throws Ben off – payback for ruining his life. But Ben doesn't end up dead at the bottom as he’s supposed to, but on a ledge a little way down, scratched and bruised, but undeniably alive.

After that, things get much better. David and Ben start getting on much better. David meets Alice, who’s also hot and a bit wild. And she’s nice to Ben, too. Hey, maybe having a Down’s syndrome brother can help you get girls! Even Ben gets a girlfriend. And things at home are much better too. David, who, I forgot to mention, is keen on art as well as fratricide, stops drawing skulls and stuff, and starts to draw cows and trees. The end. I hope I'm not making it sound silly, because it’s very good – original, interesting, brave drama. It has all that you'd want from a film with a moody 15–year–old at its core – cigs, snogging on the stairs, serious strops, sparklers. And a bunch of stuff that doesn't begin with an “s”: vodka, no–one–understands–me rages, love, letters, fumbling.

But it has more, because of Ben. Written by Mark “Dog in the Night Time” Haddon, Coming Down the Mountain deals with Down’s syndrome warmly and wittily, rather than worthily. And it centres on an often overlooked aspect of it - the devastating way it can affect the siblings. Great performances from Tommy Jessop as Ben and Nicholas “About a Boy” Hoult as David too. Good work.

Source: Sam Wollaston, Last night’s TV, The Guardian, London, September 3, 2007.

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Indian representation in Hawaii University

G.N. Karna, honorary president of the Society for Disability and Rehabilitation Studies, has been nominated as a member of the Review Board of The Review of Disability Studies published by the Centre on Disability Studies at the University of Hawaii in the US Dr. Karna, a leading India expert on disability studies, is associated with the Centre for Promotion of Human Rights Teaching and Research at Jawaharlal Nehru University.

Source: New member for disability studies, The Hindu, New Delhi, 30 August 2007.

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