2014 MENTAL HEALTH ATLAS World Health ganization
ATLAS MENTAL HEALTH WHO’s Mental Health Atlas series has already established itself as the single most comprehensive and most widely used source of information on the global mental health situation. WHO’s mental health Atlas 2014 provides up-to-date information on the state of mental health services and systems in countries across the world. It covers critical areas of mental health system development, including governance and financing, human resources, service availability and delivery, promotion and prevention, and surveillance. These data serve as a baseline for targets agreed by 194 member states of WHO in the Comprehensive Mental Health Action Plan 2013-2020. ISBN 978 92 4 156501 1 For more information, please contact: Department of Mental Health and Substance Abuse World Health Organization Avenue Appia 20 CH-1211 Geneva 27 Switzerland Email: mhatlas@who.int http://www.who.int/mental_health/ evidence/atlasmnh/
MENTAL HEALTH ATLAS 2014 World health Organization
ATLAS 2014 MENTAL HEALTH
WHO Library Cataloguing-in-Publication Data: The designations employed and the presentation of the material in this publication do not imply the expression of any opinion Mental health atlas 2014 whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area 1. Mental Health Services- statistics. 2. Mental Health Services or of its authorities, or concerning the delimitation of its frontiers atlases. 3. Health Policy -trends. 4.Health Personnel-statistics. or boundaries. Dotted and dashed lines on maps represent 5. Global Health. I World Health Organization approximate border lines for which there may not yet be full sBN9789241565011 NLM classification: WM 17) The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended o world Health Organization 2015 by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions All rights reserved. Publications of the World Health Organization kcepted, the names of proprietary products are distinguished areavailableontheWhowebsitewww.whoint)orcanbe by initial capital letters purchased from WHO Press, World Health Organization, 20 venue Appia, 1211 Geneva 27, Switzerland (tel. +41 22 791 ll reasonable precautions have been taken by the World 3264; fax: +41 22 791 4857; e-mail: bookorders @who. int) Health Organization to verify the information contained in this publication. However, the published material is being distributed Requests for permission to reproduce or translate WHO without warranty of any kind, either expressed or implied. The publications -whether for sale or for non-commercial responsibility for the interpretation and use of the material lies distribution- should be addressed to WHO Press through with the reader. In no event shall the World Health Organization the wHo website be liable for damages arising from its use (www.who.int/about/licensing/copyright_form/en/index.htn Design: Erica Lefstad
WHO Library Cataloguing-in-Publication Data: Mental health atlas 2014. 1.Mental Health Services - statistics. 2.Mental Health Services - atlases. 3.Health Policy - trends. 4.Health Personnel - statistics. 5.Global Health. I.World Health Organization. ISBN 978 92 4 156501 1 (NLM classification: WM 17) © World Health Organization 2015 All rights reserved. Publications of the World Health Organization are available on the WHO website (www.who.int) or can be purchased from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: bookorders@who.int). Requests for permission to reproduce or translate WHO publications –whether for sale or for non-commercial distribution– should be addressed to WHO Press through the WHO website (www.who.int/about/licensing/copyright_form/en/index.html). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted and dashed lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either expressed or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. Design: Erica Lefstad Printed in France
MENTAL HEALTHATLAS 2014 6 PROJECT TEAMS AND PARTNERS 7 PREFACE 8 EXECUTIVE SUMMARY 12 INTRODUCTION 16 RESULTS 18 1. GLOBAL REPORTING ON CORE MENTAL HEALTH INDICATORS 22 2. MENTAL HEALTH SYSTEM GOVERNANCE 30 3 FINANCIAL AND HUMAN RESOURCES FOR MENTAL HEALTH 38 4. MENTAL HEALTH SERVICE AVAILABILITY AND UPTAKE 46 5. MENTAL HEALTH PROMOTION AND PREVENTION 52 6 COMPARISONS WITH SELECTED MENTAL HEALTH ATLAS 2011 RESULTS 56 REFERENCES 58 APPENDICES 58 APPENDIX A: PARTICIPATING COUNTRIES AND CONTRIBUTORS MENTAL HEALTH SYSTEM GOVERNANCE 64 APPENDIX B: GLOSSARY OF TERMS CONTENTS
CONTENTS 5 6 7 8 12 16 18 22 30 38 46 52 56 58 58 64 PROJECT TEAMS AND PARTNERS PREFACE EXECUTIVE SUMMARY INTRODUCTION RESULTS 1. GLOBAL REPORTING ON CORE MENTAL HEALTH INDICATORS 2. MENTAL HEALTH SYSTEM GOVERNANCE 3. FINANCIAL AND HUMAN RESOURCES FOR MENTAL HEALTH 4. MENTAL HEALTH SERVICE AVAILABILITY AND UPTAKE 5. MENTAL HEALTH PROMOTION AND PREVENTION 6. COMPARISONS WITH SELECTED MENTAL HEALTH ATLAS 2011 RESULTS REFERENCES APPENDICES APPENDIX A: PARTICIPATING COUNTRIES AND CONTRIBUTORS MENTAL HEALTH SYSTEM GOVERNANCE APPENDIX B: GLOSSARY OF TERMS MENTAL HEALTH ATLAS 2014
PROJECT TEAM AND PARTNERS At WHO Headquarters, a team comprising Dan Chisholm Fahmy Hanna and Grazia Motturi provided the central technica leadership and administrative support to the project, includir Atlas is a project of the World Health Organization(WHO development of the questionnaire and an associated Headquarters, Geneva and is supervised and coordinated by completion guide, management of the online data collection Shekhar Saxena. Mental health Atlas 2014 is the latest in a ystem, validation of information and responses, liaison with series of publications that first appeared in 2001, with Member States and WHO regional and country offices, as well subsequent updates published in 2005 and 2011 as analysis of data and preparation of this report. They received inputs and advice from the following colleagues In WHO Member States, key project collaborators were the Natalie Drew, Tarun Dua, Alexandra Fleischmann michelle mental health focal points in Ministries of Health, who provided Funk, Vladimir Poznyak, Chiara Servili, Mark van Ommeren and information and responses to the atlas survey questionnaire Taghi Yasamy. The contribution of Antonio Lora, Peter Ventevogel and to follow-up queries for clarification. a full list of Julian Eaton, Yulia Bakonina, Melissa Harper, Elise Gehring collaborators is provided as Appendix A of this report. Pooja Pradeep, Shelly Chopra and Alessandra Trianni to particular aspects of data collection, processing, or analysis are also Key collaborators from WHO regional offices, who contributed acknowledged to the planning and collation of data and liaised with focal points in Member States, were: Sebastiana Da Gama Nkomo The development of the Atlas 2014 questionnaire was overseen (WHO Regional Office for Africa); Jorge Rodriguez, Devora and approved by an expert group, consisting of Florence Kestel (WHO Regional Office for the Americas); Khalid Saeed Baingana, Harry Minas, Antonio Lora, Crick Lund, Pratap (WHO Regional Office for the Eastern Mediterranean); Matthijs Sharan and Graham Thornicroft. The proposed set of selected Muijen and Elena Shevkun(WHO Regional Office for Europe): indicators were subsequently field-tested in Chile, South Africa, Nazneen Anwar (WHO Regional Office for South East Asia); Vietnam, and for this stage thanks go to Sifiso Phakathi, Xiangdong Wang, Yutaro Setoya and Marie Villanueva (WHo Melvyn Freeman, Alfredo Pemjean, Harry Minas and Ritsuko Regional Office for the Western Pacific The contribution of each of these team members and partners, which has been crucial to the success of this project, is very warmly acknowledged MENTAL HEALTH ATLAS 2014
At WHO Headquarters, a team comprising Dan Chisholm, Fahmy Hanna and Grazia Motturi provided the central technical leadership and administrative support to the project, including development of the questionnaire and an associated completion guide, management of the online data collection system, validation of information and responses, liaison with Member States and WHO regional and country offices, as well as analysis of data and preparation of this report. They received inputs and advice from the following colleagues: Natalie Drew, Tarun Dua, Alexandra Fleischmann, Michelle Funk, Vladimir Poznyak, Chiara Servili, Mark van Ommeren and Taghi Yasamy. The contribution of Antonio Lora, Peter Ventevogel, Julian Eaton, Yulia Bakonina, Melissa Harper, Elise Gehring, Pooja Pradeep, Shelly Chopra and Alessandra Trianni to particular aspects of data collection, processing, or analysis are also acknowledged. The development of the Atlas 2014 questionnaire was overseen and approved by an expert group, consisting of Florence Baingana, Harry Minas, Antonio Lora, Crick Lund, Pratap Sharan and Graham Thornicroft. The proposed set of selected indicators were subsequently field-tested in Chile, South Africa, Vietnam, and for this stage thanks go to Sifiso Phakathi, Melvyn Freeman, Alfredo Pemjean, Harry Minas and Ritsuko Kakuma. The contribution of each of these team members and partners, which has been crucial to the success of this project, is very warmly acknowledged. PROJECT TEAM AND PARTNERS Atlas is a project of the World Health Organization (WHO) Headquarters, Geneva and is supervised and coordinated by Shekhar Saxena. Mental health Atlas 2014 is the latest in a series of publications that first appeared in 2001, with subsequent updates published in 2005 and 2011. In WHO Member States, key project collaborators were the mental health focal points in Ministries of Health, who provided information and responses to the Atlas survey questionnaire and to follow-up queries for clarification. A full list of collaborators is provided as Appendix A of this report. Key collaborators from WHO regional offices, who contributed to the planning and collation of data and liaised with focal points in Member States, were: Sebastiana Da Gama Nkomo (WHO Regional Office for Africa); Jorge Rodriguez, Devora Kestel (WHO Regional Office for the Americas); Khalid Saeed (WHO Regional Office for the Eastern Mediterranean); Matthijs Muijen and Elena Shevkun (WHO Regional Office for Europe); Nazneen Anwar (WHO Regional Office for South East Asia); Xiangdong Wang, Yutaro Setoya and Marie Villanueva (WHO Regional Office for the Western Pacific). 6 MENTAL HEALTH ATLAS 2014