Meffert Susan M, Lawhorn Collene, Ongeri Linnet, Bukusi Elizabeth, Campbell Holly R, Goosby Eric, Bertozzi Stefano M, Kahonge Simon Njuguna
Department of Psychiatry, University of California, San Francisco (UCSF), San Francisco, California, USA.
Communication, Dissemination and Engagement Research Program for HIV Prevention, Treatment and Cure, Division of AIDS Research, National Institute of Mental Health (NIMH), Bethesda, Maryland, USA.
Glob Ment Health (Camb). 2021 Nov 11;8:e41. doi: 10.1017/gmh.2021.41. eCollection 2021.
Models estimate that the disability burden from mental disorders in Sub-Saharan Africa (SSA) will more than double in the next 40 years. Similar to HIV, mental disorders are stigmatized in many SSA settings and addressing them requires community engagement and long-term treatment. Yet, in contrast to HIV, the public mental healthcare cascade has not been sustained, despite robust data on scalable strategies. We draw on findings from our International AIDS Society (IAS) 2020 virtual workshop and make recommendations for next steps in the scale up of the SSA public mental healthcare continuum.
Early HIV surveillance and care cascade targets are discussed as important strategies for HIV response in SSA that should be adopted for mental health. Advocacy, including engagement with civil society, and targeted economic arguments to policymakers, are reviewed in the context of HIV success in SSA. Parallel opportunities for mental disorders are identified. Learning from HIV, communication of strategies that advance mental health care needs in SSA must be prioritized for broad global audiences.
The COVID-19 pandemic is setting off a colossal escalation of global mental health care needs, well-publicized across scientific, media, policymaker, and civil society domains. The pandemic highlights disparities in healthcare access and reinvigorates the push for universal coverage. Learning from HIV strategies, we must seize this historical moment to improve the public mental health care cascade in SSA and capitalize on the powerful alliances ready to be forged. As noted by Ambassador Goosby in our AIDS 2020 workshop, 'The time is now'.
模型估计，在未来40年里，撒哈拉以南非洲地区（SSA）精神障碍造成的残疾负担将增加一倍多。与艾滋病毒类似，在许多撒哈拉以南非洲地区，精神障碍也受到污名化，解决这些问题需要社区参与和长期治疗。然而，与艾滋病毒不同的是，尽管有关于可扩展策略的有力数据，但公共精神卫生保健级联并未持续下去。我们借鉴了国际艾滋病学会（IAS）2020年虚拟研讨会的研究结果，并为扩大撒哈拉以南非洲地区公共精神卫生保健连续体的下一步行动提出了建议。
早期艾滋病毒监测和护理级联目标被视为撒哈拉以南非洲地区应对艾滋病毒的重要策略，精神卫生也应采用这些策略。在撒哈拉以南非洲地区艾滋病毒防治取得成功的背景下，对包括与民间社会接触在内的宣传以及向政策制定者提出有针对性的经济论据进行了审视。确定了针对精神障碍的平行机会。借鉴艾滋病毒防治经验，必须优先向广大全球受众宣传促进撒哈拉以南非洲地区精神卫生保健需求的策略。
新冠疫情正在引发全球精神卫生保健需求的大幅升级，这在科学、媒体、政策制定者和民间社会领域都得到了广泛宣传。疫情凸显了医疗保健获取方面的差距，并重新激发了对全民覆盖的推动。借鉴艾滋病毒防治策略，我们必须抓住这一历史时刻，改善撒哈拉以南非洲地区的公共精神卫生保健级联，并利用准备建立的强大联盟。正如戈斯比大使在我们2020年艾滋病研讨会上所说：“就是现在。”
