New UN guidelines aim to simplify treatment of mental disorders

A mental health counsellor talks with clients in the Democratic Republic of the Congo. Photo: WHO/Marko Kokic

7 October 2010 – The United Nations health agency today unveiled new guidelines designed to facilitate the management of depression, alcohol use disorders, epilepsy and other common mental disorders in the primary health-care setting.

Millions of people with common, but untreated, mental, neurological and substance use disorders will benefit from the new simplified diagnosis and treatment guidelines, the UN World Health Organization (WHO) said.

The evidence-based guidelines in the Intervention Guide are presented as flow charts to simplify the process of providing care in the primary health-care setting by non-mental health specialists, including doctors, nurses and other health providers.

“In a key achievement, the Intervention Guide transforms a world of expertise and clinical experience, contributed by hundreds of experts, into less than 100 pages of clinical wisdom and succinct practical advice,” says Margaret Chan, the WHO Director-General.

WHO estimates that more than 75 per cent 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.

“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 Ala Alwan, Assistant Director-General for Non-communicable 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, according to WHO. In the majority of countries, less than 2 per cent of health funds are spent on mental health. As a result, a large majority of people with these disorders receive no care at all.

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.

“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 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,” he added.

The Intervention Guide will also help scale up care for mental, neurological and substance use disorders – which is the aim of WHO’s mental health Gap Action Programme (mhGAP).

Multiple partners including Member States, UN agencies, research institutes, universities, multilateral agencies, foundations, WHO Collaborating Centres and non-governmental organizations (NGOs) under the 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.


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