Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project
BackgroundCurrent coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.AimsTo identify the challenges, opportunities and strategies for more eq...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2019-09-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472419000243/type/journal_article |
| _version_ | 1811157006025752576 |
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| author | Dan Chisholm Sumaiyah Docrat Jibril Abdulmalik Atalay Alem Oye Gureje Dristy Gurung Charlotte Hanlon Mark J. D. Jordans Sheila Kangere Fred Kigozi James Mugisha Shital Muke Saheed Olayiwola Rahul Shidhaye Graham Thornicroft Crick Lund |
| author_facet | Dan Chisholm Sumaiyah Docrat Jibril Abdulmalik Atalay Alem Oye Gureje Dristy Gurung Charlotte Hanlon Mark J. D. Jordans Sheila Kangere Fred Kigozi James Mugisha Shital Muke Saheed Olayiwola Rahul Shidhaye Graham Thornicroft Crick Lund |
| author_sort | Dan Chisholm |
| collection | DOAJ |
| description | BackgroundCurrent coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.AimsTo identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.MethodIn the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options.ResultsKey challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries.ConclusionsIncluding mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities.Declaration of interestD.C. is a staff member of the World Health Organization. |
| first_indexed | 2024-04-10T05:00:16Z |
| format | Article |
| id | doaj.art-6571a55b7b68436496222aaab1915f33 |
| institution | Directory Open Access Journal |
| issn | 2056-4724 |
| language | English |
| last_indexed | 2024-04-10T05:00:16Z |
| publishDate | 2019-09-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj.art-6571a55b7b68436496222aaab1915f332023-03-09T12:28:55ZengCambridge University PressBJPsych Open2056-47242019-09-01510.1192/bjo.2019.24Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald projectDan Chisholm0Sumaiyah Docrat1Jibril Abdulmalik2Atalay Alem3Oye Gureje4Dristy Gurung5Charlotte Hanlon6https://orcid.org/0000-0002-7937-3226Mark J. D. Jordans7https://orcid.org/0000-0001-5925-8039Sheila Kangere8Fred Kigozi9James Mugisha10Shital Muke11Saheed Olayiwola12Rahul Shidhaye13Graham Thornicroft14Crick Lund15https://orcid.org/0000-0002-5159-8220Health Systems Adviser, Department of Mental Health and Substance Abuse, World Health Organization, SwitzerlandResearch Officer, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South AfricaConsultant Psychiatrist, Department of Psychiatry, University of Ibadan, NigeriaProfessor of Psychiatry, College of Health Sciences, School of Medicine, Department of Psychiatry, Addis Ababa University, EthiopiaProfessor of Psychiatry and Director, WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, University of Ibadan, Nigeria; and Professor Extraordinary, Department of Psychiatry, Stellenbosch University, South AfricaResearch Coordinator, Transcultural Psychosocial Organization (TPO) Nepal, NepalReader in Global Mental Health, Health Services and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Adjunct Associate Professor, Addis Ababa University, College of Health Sciences, School of Medicine, Department of Psychiatry, EthiopiaReader, Health Service and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK; and Senior Advisor, TPO Nepal, NepalResearch Officer, Butabika National Referral and Teaching Mental Hospital, UgandaProfessor of Psychiatry, Butabika National Referral and Teaching Mental Hospital, UgandaResearch Officer, Butabika National Referral and Teaching Mental Hospital, UgandaResearch Fellow, Public Health Foundation of India, Bhopal, IndiaLecturer II, Department of Economics, Federal University of Technology, NigeriaResearch Coordinator, Public Health Foundation of India, Bhopal, India; and CAPHRI School for Public Health and Primary Care, Maastricht University, the NetherlandsProfessor of Community Psychiatry, Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKProfessor of Public Mental Health, Alan J Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, South Africa; and Professor of Global Mental Health and Development, Health Services and Population Research Department, Centre for Global Mental Health, Institute of Psychiatry, Psychology and Neuroscience, King's College London, UKBackgroundCurrent coverage of mental healthcare in low- and middle-income countries is very limited, not only in terms of access to services but also in terms of financial protection of individuals in need of care and treatment.AimsTo identify the challenges, opportunities and strategies for more equitable and sustainable mental health financing in six sub-Saharan African and South Asian countries, namely Ethiopia, India, Nepal, Nigeria, South Africa and Uganda.MethodIn the context of a mental health systems research project (Emerald), a multi-methods approach was implemented consisting of three steps: a quantitative and narrative assessment of each country's disease burden profile, health system and macro-fiscal situation; in-depth interviews with expert stakeholders; and a policy analysis of sustainable financing options.ResultsKey challenges identified for sustainable mental health financing include the low level of funding accorded to mental health services, widespread inequalities in access and poverty, although opportunities exist in the form of new political interest in mental health and ongoing reforms to national insurance schemes. Inclusion of mental health within planned or nascent national health insurance schemes was identified as a key strategy for moving towards more equitable and sustainable mental health financing in all six countries.ConclusionsIncluding mental health in ongoing national health insurance reforms represent the most important strategic opportunity in the six participating countries to secure enhanced service provision and financial protection for individuals and households affected by mental disorders and psychosocial disabilities.Declaration of interestD.C. is a staff member of the World Health Organization.https://www.cambridge.org/core/product/identifier/S2056472419000243/type/journal_articleLow and middle income countriesmental healthmental health systemsfinancing |
| spellingShingle | Dan Chisholm Sumaiyah Docrat Jibril Abdulmalik Atalay Alem Oye Gureje Dristy Gurung Charlotte Hanlon Mark J. D. Jordans Sheila Kangere Fred Kigozi James Mugisha Shital Muke Saheed Olayiwola Rahul Shidhaye Graham Thornicroft Crick Lund Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project BJPsych Open Low and middle income countries mental health mental health systems financing |
| title | Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project |
| title_full | Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project |
| title_fullStr | Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project |
| title_full_unstemmed | Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project |
| title_short | Mental health financing challenges, opportunities and strategies in low- and middle-income countries: findings from the Emerald project |
| title_sort | mental health financing challenges opportunities and strategies in low and middle income countries findings from the emerald project |
| topic | Low and middle income countries mental health mental health systems financing |
| url | https://www.cambridge.org/core/product/identifier/S2056472419000243/type/journal_article |
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