In many low- and middle-income countries (LMICs), people with mental health conditions don’t receive the care they need. Stigma, lack of human resources, and fragmented service delivery models are common barriers to treatment uptake. To address this gap, researchers and clinicians must evaluate and implement real-world mental health services in the community. To do this, mental health research needs to consider a holistic system perspective rather than focusing on individual endpoints. Real-World Evaluation of Mental Health in LMICs.
Treatment
Treatment for mental health problems usually combines psychotherapy, medications and other treatments. People may also use community resources to help them deal with their symptoms.
People with mental illness often speak with their primary care physician, who will most likely refer them to a therapist. They can also go to a hospital or residential treatment program.
Some mental health professionals, including psychiatrists and psychiatric nurse practitioners, are trained to prescribe drugs. Other practitioners use psychotherapy primarily. Real-World Evaluation of Mental Health in LMICs.
Psychiatric medications are very effective in many cases and can help improve mental illnesses. Other therapies include cognitive behaviour therapy (CBT) and interpersonal psychotherapy. ECT, or electroconvulsive therapy, is also a powerful way to treat severe mental illnesses.
Stigma
Stigma is a negative attitude that causes people to view or think less of someone with a mental health problem. This can be a public stigma, self-stigma, or both.
Historically, the stigma associated with mental health has stemmed from fear and a lack of understanding. Even today, a 2013 review of studies on the public stigma of mental illness found that many people still have negative perceptions about those who have mental illnesses.
This stigma can prevent them from seeking treatment for their condition. It can result in discrimination in day-to-day circumstances, such as employment disputes, medical appointments, financial claims and housing problems.
Some stigmatizing stereotypes can be inherited from family members or friends who might not understand a mental health condition’s causes, symptoms or treatments. Some beliefs about mental health can also be based on the media’s depiction of people with these conditions.
Prevention
Preventing mental health problems is one of the soundest investments any society can make. It can lead to improved productivity, less suffering and premature mortality, more cohesive families and a lower cost of treatment.
Although the global burden of mental illness is low, it remains underfunded and underestimated in many countries. It can have significant consequences for a country’s social and economic development.
However, prevention associated with mental disorders is a complex issue and is not yet fully delineated. In comparison, physical illnesses are characterized by clearly defined etiologies and risk factors. Real-World Evaluation of Mental Health in LMICs.
Promoting and preventing mental health involves identifying the individual, social and structural determinants of mental health and then reshaping them to reduce risks, build resilience and establish supportive environments for mental health. Interventions may target individuals, specific groups or whole populations.
Research
Research associated with mental health problems improves understanding, uncovers effective evidence-based treatments, and helps people with mental illness get better faster. Often, it also prevents problems from happening in the first place.
Increasingly, psychiatric treatment plans are tailored to a person’s needs and preferences. These plans may include psychotherapy (talk therapy), medication or other treatments.
However, these methods can’t always replace the internal validity of randomized controlled trials that rely on rigorous controls and standards to determine cause-and-effect relationships between treatments and outcomes.
The National Institutes of Health has a team that deploys sophisticated, systemwide tracking and analysis of mental health data to evaluate the effectiveness of programs. It is made up of behavioural epidemiologists, data analysts, and other experts in the field.