(2004; 74 pages)
Mental and behavioural disorders account for a large proportion of the global burden of disease, but only a minority of those suffering from such disorders receive basic treatment. Relatively few people with mental disorders consult a physician. In developing countries, health systems often are not able to provide even the most essential mental care.
In the World Health Report 2001 (WHO, 2001a), a series of recommendations were made on how to improve care for people with mental disorders. The recommendations include improving access to a limited selection of “essential psychotropic medicines”. These are medicines that satisfy the priority mental health care needs of a population. They are selected with due regard to public health relevance, and based on evidence of their efficacy, safety and comparative cost-effectiveness. They can be used for the treatment of symptoms of mental disorders, to shorten the course of many disorders, reduce disability and prevent relapse. Not all “effective” pharmaceutical therapies are “essential”. The experiences of many countries demonstrate that improvements in the supply and use of medicines are possible. Systematic knowledge on strategies to improve access to medicines is also available. Yet over one-third of the world’s population currently to essential medicines. Whereas psychotropics have many aspects in common with other essential medicines, there are also several aspects that eed special consideration when improving access.