"The time is now," said Tom Insel in his recent blog on the World Economic Forum discussions in Davos about -- can you believe this? -- mental health. Insel, Director of the NIMH in Washington, D.C., thinks there are important reasons for this unprecedented attention: recognition of mental illness as a profound public health problem that affects productivity and, therefore, a threat to the economy of nations; and that in a world where economies are rapidly becoming "brain-based."
There are an estimated 450 million people worldwide with mental disorders. Three quarters of them live in developing countries, and 85 percent of those are not under treatment -- the treatment gap. Even where treatment is provided, it often is far below minimum acceptable standards. This is juxtaposed by the severe poverty of affected families. This means that the impact of mental illness is magnified by inadequate nourishment, clothing and shelter, and a complete denial of opportunities for change; the chronic trauma of untreated mental illness leads families to resort to human rights abuse of shackling and chaining in order to get on with their meagre everyday lives.
The silver lining seen at Davos may or may not be the result of efforts in recent years by what is loosely called the global mental health community. Sometimes spontaneous and sometimes labored, this community is a coming-together of psychiatrists, academicians, researchers, practitioners and, increasingly, affected persons or "users" and governments. It represents an effort to find answers to a problem about which very few questions have been asked.
Investments in mental health, by governments and others who have the resources, are grossly inadequate. This is beginning to change as some major funders such as NIMH, Grand Challenges Canada, DFID are funding large mental health research efforts and often investing funds to pool all the evidence.
Given the global magnitude of the problem and the desperation of the need of those affected, this is too little -- not only in money terms but in scope, scale and pace. The scope of mental health research must expand from psychiatry and public health to equally cover socio-economic factors that are critical determinants of mental illness as well as of recovery. But, even more importantly, the pace of evidence creation through research must be matched, if not outpaced, by effective, affordable and widespread delivery of services that address mental illness as well as the poverty of affected families.
Comprehensive delivery models already operating at scale, such as the BasicNeeds model for Mental Health and Development, can offer effective delivery solutions based on their extensive experience in developing countries. Speaking about the need for a "science of delivery" and the significance of their experience and insights, World Bank President Jim Yong Kim said that implementers "test solutions, observe the results, make corrections, test again ... In most cases where countries and partners achieve good development outcomes, it's actually this tacit implementer know-how that is driving the success."
More investments are required for generating useable evidence and lessons from such solutions-driven approaches that not only go beyond treatment delivery, but also operate in the real world of families and communities.
"I used to work as a nurse at the clinic of a military camp and had to resign in the year 2008 due to my illness. I felt so disappointed being unemployed and considered as a useless person by my family and my neighbors. After having treatment since December 2010 with the BasicNeeds program, I got better and my confidence has returned. I am able to help my family to generate income. I am now able to work growing mushrooms and selling them at the market. I earned about 600,000 LAK (or £50) per week from selling mushrooms! My family financial situation is improved and I feel so proud of myself being again worthy for my family."
-- 41-year-old woman from Khamkeut district in Lao PDR, married with five children and now engaged in farming
This post is part of a series produced by The Huffington Post and the Schwab Foundation for Social Entrepreneurship, in recognition of the latter's Social Entrepreneurs Class of 2014. For more than a decade, the Schwab Foundation for Social Entrepreneurship has selected leading models of social innovation from around the world. Follow the Schwab Foundation on Twitter at @schwabfound or nominate a Social Entrepreneur here. To see all the post in the series, click here.