1 Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
2 Centre for Mental Health Law and Policy, Indian Law Society, Pune, India.
Int J Soc Psychiatry. 2018 Feb;64(1):3-8. doi: 10.1177/0020764017745108. Epub 2017 Dec 8.
The burden of disease related to mental disorders across the world is substantial. However, there remains inequality between funding for clinical and research activities between physical illness and mental illness in almost all countries.
One way of reducing this inequality is to ensure that mental health policies reflect this. We were interested in looking at the policies of members of Commonwealth.
We decided to survey 52 member countries of the Commonwealth to explore whether mental health policies existed and whether there was equity between physical and mental health services funding. Using World Health Organization (WHO) data sets and other sources when indicated, we looked at the existence and contents of mental health policies.
We found that less than half of the countries had a mental health policy. Deinstitutionalization was not seen as a priority in many countries and there was no equity between physical and mental health funding. Although integration between physical and mental health care was recommended in many countries, there was a clear gap.
It is apparent that there is still a long way to go in terms of equity between physical and mental health in terms of funding in member states of the Commonwealth. These findings confirm earlier observations of discrimination against people with mental illness. We suggest that there must be mechanisms in place to facilitate and support change wherever required.
全球范围内，与精神障碍相关的疾病负担相当沉重。然而，在几乎所有国家，用于临床和研究活动的资金在躯体疾病和精神疾病之间仍然存在不平等。
减少这种不平等的一种方法是确保精神卫生政策对此有所反映。我们有兴趣研究英联邦成员国的政策。
我们决定对英联邦的 52 个成员国进行调查，以探讨是否存在精神卫生政策，以及在躯体卫生服务资金和精神卫生服务资金之间是否存在公平性。我们使用世界卫生组织（WHO）数据集和其他相关来源，研究精神卫生政策的存在和内容。
我们发现，只有不到一半的国家制定了精神卫生政策。在许多国家，去机构化并没有被视为优先事项，躯体卫生和精神卫生资金之间也没有公平性。尽管许多国家都建议在躯体卫生和精神卫生保健之间进行整合，但两者之间仍存在明显差距。
显然，在英联邦成员国的资金方面，躯体卫生和精神卫生之间的公平性仍有很长的路要走。这些发现证实了早些时候对精神疾病患者的歧视的观察。我们建议，必须建立机制，在需要的地方促进和支持变革。
