Lord Crisp is leading a debate tomorrow on the global impact of the five leading chronic diseases — cancer, diabetes, heart disease, respiratory disease and mental illness, so called NCDs (non-communicable diseases, to distinguish them from communicable, ie infectious diseases). This follows on from a recent high level meeting of the UN at which the increasing problems of lifestyle related diseases, that is those caused largely through poor diet, smoking and lack of exercise were discussed with the aim of developing international agreements on how to tackle the problems not only in the developed world but also in low and middle income countries where these disorders now outstrip infectious diseases as causes of ill health and early death.
I shall talk tomorrow about mental ill health. Mental illness and heart diseases alone account for almost 70 percent of lost economic output. Mental and neuro-psychiatic disorders like dementia and stroke are the largest source of burden of disease globally. Over 90% of the 24 million people suffering from schizophrenia live in low and middle-income countries, but less than half of them receive treatment, even in developed countries.
Countless millions go untreated and suffer misery and poverty, despite the availability of effective interventions and affordable delivery. A decade of reports calling for political action has been widely ignored. I was disappointed that mental health was scarcely given a mention at the UN meeting; it was not on the agenda and the final communiqué had barely 3 passing mentions.
We can guess why these disorders were ignored. The problems of stigma and mistreatment are similar to the experience of those with stigmatizing infectious diseases like HIV, and in some instances there are serious abuses of human rights. But we now have evidence based knowledge of effective treatments and delivery systems that can be adapted to meet the needs of different cultures. Indeed the best community based mental health systems have much to teach the developed world about recovery and social integration. Nevertheless, an enormous gap in treatment persists throughout world, particularly in the least developed countries. The time for global action has come and I hope our Government will begin to support the push for global action on mental health.