Eighty per cent of people with any form of mental or substance use disorder in India and China do not seek treatment. This was stated in a newly released Lancet Commission report on mental health.

The report, which brought together 28 global experts in psychiatry, public health, neuroscience, advocacy and people with first-hand experience of mental health conditions, exposes a “collective failure to respond to this global health crisis, causing long-lasting and preventable harm to people, communities and economies”, said the paper.

The Lancet Commission on Global Mental Health and Sustainable Development report added that mental disorders are on the rise in every country in the world and will cost the global economy $16 trillion by 2030.

“Driven by violence, environmental changes and inequality, mental disorders are going unchecked in every country in the world. Governments are failing both to prevent mental disorders and provide treatment of acceptable quality,” said the report.

“Mental health is the foundation of human capability that makes each life worthwhile and meaningful. It is for this reason that there can be no sustainable development without attention to mental health,” said Commission joint lead editor Professor Vikram Patel of Harvard Medical School.

“Anyone who cares about poverty, education, social cohesion or economic progress should work to improve mental health, putting the vast knowledge we have on promotion, prevention and care into action,” he added.

The report shows that in many countries, people with mental disorders still routinely suffer gross human rights violations — including shackling, torture and imprisonment. Bringing attention to these kinds of abuse and discrimination, the Commission calls for a human rights-based approach to ensure that people with mental health conditions are not denied any of their fundamental human rights — not just to health but also to employment and education, among others.

“The Commission calls out the shameful and shocking treatment of people with mental ill health around the world,” said The Lancet editor-in-chief Richard Horton.

“The Commission advocates for the rights of the communities it covers and argues that everyone is entitled to dignity, autonomy and freedom from discrimination.”

The Commission also recommended a wholesale shift to community-based care. It recommended the delivery of psychosocial interventions by community health workers, peers and a range of other providers, such as teachers and the clergy, as well as medical professionals working in primary care, to provide the foundation of mental health care system.

“Mental health affects everyone, either directly or through our relatives and close friends. There has been great progress in research and awareness over the last decades. But as the Lancet Commission shows, too many people are still left behind. By bringing together expertise from around the world and across disciplines we can improve understanding and treatment of mental health to tackle one of the greatest challenges of our time,” said Wellcome director Jeremy Farrar.

“We have seen a rise in mental illness in young people when, with all the knowledge we have, we should be seeing a decrease,” said Professor Helen Herrman, president of the World Psychiatric Association.

“Treatment in hospitals needs to be complemented by care in communities to bring mental health services to the masses,” she said.

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