Project Atlas
Mental Health Atlas 2011
Mental Health Atlas questionnaire
In the year 2001 WHO published two volumes- Atlas: Mental Health Resources in the World 2001 and Atlas Country Profiles on Mental Health Resources 2001. In 2005 this information was updated. In view of the usefulness and importance of these two products, one of WHO's priorities for this year is to update the ATLAS database and publish Mental Health Atlas-2011.
Information and Evidence for better decisions
Without information it is hardly possible for decision-makers, planners, NGOs, and consumers and families to orient themselves through the complex maze of facts and options. Good information is a prerequisite to good decisions, for both WHO and Member States. This is particularly true in the case of mental disorders , which until recently have been largely overlooked as public health issues.
Collecting, generating, processing, interpreting and distributing it in a timely manner implies an investment that saves funds and unyielding efforts in the short and long run. At present the information about mental health matters is ill organized. Its collection is irregular, its quality mediocre and its use sporadic and often misleading.
The recent WHO ATLAS study was the first of its kind: a comprehensive and systematic attempt to understand the mental health resources in the world. As important as its contribution has been, many crucial questions are still unanswered. To be able to effectively assist Member States, it is essential for WHO to have an improved understanding of the mental health situation around the world.
Member States, too, are suffering from their own lack of mental health information. As seen in the ATLAS study, more than 27% of countries do not have a system for collecting and reporting mental health indicators. For many others, information systems have extremely limited reliability and reach. As a result, rational mental health policy and service development is impeded. And, around the world, innumerable health care workers do not have access to even the most basic information concerning how to detect and treat mental disorders, thus compromising the treatment of those in need.
To address this need for better information, WHO will provide technical assistance and infrastructure support to countries so as to enable them to develop the necessary information and surveillance capability to drive true health reform efforts. Particular attention will be given to ensure these efforts are compatible with and linked to broader health sector information systems. In particular assistance will be given to:
- develop standards of quality of information on differential needs, the operation of services and the development of resources;
- establish information systems at national level;
- train the technical resources to attend the information requirements;
- produce analysis and interpretation reports that assist in planning, monitoring and evaluating services and programmes.
Background
What is the case for action?
Atlas 2001 has identified severe deficiencies in the mental health situation in developing countries. The World Health Report 2001 has submitted to the countries a set of feasible recommendations based on the best available scientific and technical knowledge. The mhGAP programme-initiative, that was approved in 2002 by WHO Director General in answer to the challenges raised by both documents, envisions an active role for research in the multidimensional efforts required to change the current mental health situation at country level. Novel ideas for old problems, and tested data for current mental health action are expected to guide and accompany the efforts for change that developing countries are undertaking. WHO is committed to actively support these attempts.
Why research?
For a change, research is no longer perceived as an optional activity lacking major public health significance in helping low-income countries to reduce their burden with regard to mental disorders. Research-generated information has been identified by WHO as essential to determine needs; to propose new cost-effective interventions of an individual or collective nature, to monitor the process of their implementation and to evaluate the changes sought; and to explore the obstacles that prevent recommended cost-effective action to be carried out. Yet, as noted, research is mistakenly regarded as an activity limited to countries with developed economies while, too often, developing countries regard it as an unaffordable luxury. The culture of poverty has contaminated the culture of research.
It is obvious, however, that lesser the resources the more rationally they need to be invested. Conceivably with research-generated information, developing countries will be able to better utilize their meagre mental health resources. In summary, WHO intends to collaborate with countries to make research an instrument for change.
How to assure the relevance of research?
The World Health Report 2001 provides a suitable framework of reference. This theoretical and operational framework may be confirmed, modified and expanded by the experts convened by WHO to discuss the role research should play in and for the developing countries, and within the mhGAP programme-initiative.
What are the strategies required to advance information and research in developing countries?
- To review the information and research needs of developing countries in mental health and substance abuse area.
- To create a favourable cultural climate with regard to the role of research in supporting mental health action in those countries. Policy makers, programme planners and administrators, other governmental officials, mental health advocates, professionals, users and carers, and university settings in developing nations need to endorse and actively join this undertaking.
- To establish a highly relevant and viable research agenda tailored to country needs, characteristics and resources.
- To promote the acquisition of the knowledge and skills needed to conceive and conduct research using suitable and feasible methodologies.
- To establish the mechanisms for scientific, technical and financial support. These research efforts have greater odds to succeed if research institutions in countries with developed economies, research foundations and country donors, and editors of scientific journals provide those countries full and sustained support.
Are there constraints?
There are many, among them: research methods have become extremely complex and often not within the reach of those who need to use it in developing countries; universities in these countries neglect or are ill-equipped to provide training in research; selection for research studies are dictated by the scarce research funds available, rather than by agreed national mental health policies; researchers that have left for training abroad may not return to their countries of origin, thus depleting the national brain pool; and the current scientific "zeitgeist" has propelled biological factors to the forefront of mental health research almost world-wide, to the detriment of other areas of immediate public health relevance.
Who are the partners in this research effort?
- Policy makers and program planners searching for solutions.
- Dedicated researchers from developed countries that wish to support their peers in developing nations.
- WHO Collaborating Centres that are fully identified with WHO mission and the mhGAP programme-initiative.
- Editors of scientific journals who are willing to support prompt dissemination of relevant research findings.
- Donors that are aware the salient role research could play in reducing the burden of mental disorders in developing countries.
- The mental health advocates that are dissatisfied with the current situation and look for innovative ways to improve the mental health of the populations.