China and India burdened by untreated mental disorders

Less than 10% of people in India and China with a mental disorder received effective treatment, says the research

The growing burden of untreated mental disorders in the world's two most populous countries, India and China, can't be adequately addressed without changes to their health care systems and by training folk healers to become collaborators, a new report has found.

The analysis, published as a part of a series in the journals The Lancet and The Lancet Psychiatry, draws on years of medical surveys in those countries. It represents the latest effort by an international coalition of researchers to put mental health care at the center of the global health agenda; last month, the World Bank and the World Health Organisation convened hundreds of public officials, doctors and other specialists in a landmark meeting in Washington to focus attention on global mental health. The new research, presented in three papers, found that less than 10 per cent of people in India and China with a mental disorder received effective treatment, and that the resulting burden of disability from those two countries was higher than in all Western countries combined.

"India and China together represent more than a third of the world's population, and both countries are at a remarkable stage of epidemiologic and demographic transition," said a co-author of one of the papers, Vikram Patel, a professor of international mental health and co-founder of a community-based mental health center, Sangath, in Goa State in India, in a recorded interview accompanying the articles.

One lesson, experts not involved in the research said, is that investment is still lagging well behind spending on other medical conditions. Both countries spend less than one per cent of their total medical budget on mental health. "I think politicians and service planners will find this research valuable," said Alex Cohen, the course director of the global mental health program at the London School of Hygiene & Tropical Medicine. "But if you don't have the resources to treat more than two per cent of the people who need it," then the overall burden can seem overwhelming.

In the past decade, both India and China have taken steps to expand access to mental health care. In China, a government program started in 2004 reportedly has trained 10,000 psychiatrists and built hundreds of community mental health centers, in what some consider a historic investment in better psychiatric care. An Indian government program to increase care in communities has effectively reduced hospital costs, in some areas, though implementation has been spotty at best, experts said.

But particularly in rural areas, the majority of people in both countries still have little means or access to psychiatrists or therapists.

"Very few Chinese with common mental illnesses such as depression and anxiety ever seek treatment," Michael Phillips, of Shanghai Jiao Tong University and Emory University, said in a statement.

© 2016 The New York Times News Service