Innovative strategies for closing the mental health treatment gap globally

被引:60
作者
Rebello, Tahilia J. [1 ]
Marques, Andrea [2 ]
Gureje, Oye [3 ]
Pike, Kathleen M. [1 ]
机构
[1] Columbia Univ, Global Mental Hlth Program, New York, NY 10032 USA
[2] Univ Sao Paulo, Dept Psychiat, Sao Paulo, Brazil
[3] Univ Coll Ibadan Hosp, Inst Neurosci, Ibadan, Nigeria
关键词
mental health integration; mental health innovations; task-sharing; telemental health; treatment gap; COMMUNITY-BASED INTERVENTION; MIDDLE-INCOME COUNTRIES; SUBSTANCE USE DISORDERS; PHONE-BASED ASSESSMENT; COLLABORATIVE CARE; SMARTPHONE APPLICATION; SYSTEMATIC ANALYSIS; ANXIETY DISORDERS; DEPRESSION; DISEASE;
D O I
10.1097/YCO.0000000000000068
中图分类号
R749 [精神病学];
学科分类号
100205 ;
摘要
Purpose of review In the field of global mental health, an enormous gap between what we know and what we do exists in the delivery of clinical care. Creative and effective strategies that surmount the barriers to provision of mental healthcare are essential to improve the lives of millions affected by mental illness. This article provides a review of three classes of innovative strategies currently being developed and implemented to diminish the mental health treatment gap globally. Recent findings This review provides recent evidence related to the feasibility of implementation and efficacy for the following three classes of innovation that show promise for building clinical capacity and expanding mental health coverage: integration of mental health services into primary care; expansion of human capacity through task sharing and training of nonspecialists; and innovative use of technological platforms to enhance access, cut costs, and reduce stigma. Summary The strategies outlined in this review hold great potential for enhancing mental health treatment services, and address some of the major barriers globally to accessing mental healthcare, such as scarcity of resources (infrastructure, capacity, and funding) and stigma. Despite much evidence supporting the efficacy of these models, thorough studies that test their feasibility, acceptability, utility, and effectiveness in various contexts, including low-income and middle-income countries, are required. Moreover, these innovations require social support and political will in order to be successfully implemented and scaled-up such that they have a meaningful impact on the burden of disease associated with mental illness worldwide.
引用
收藏
页码:308 / 314
页数:7
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