Promoting mental health in scarce-resource contexts: emerging evidence and practice

Mental health in scarce-resource settings has received considerable attention in the new millennium, in response to the growing evidence on the burden of mental disorders and their cost-effective treatments. The World Health Organization’s (WHO) World Health Report 2001, and The Lancet series on Global Mental Health in 2007, are two major initiatives that synthesised the evidence from these settings. While the former highlighted the burden of mental disorders and the large treatment gaps in all countries, the latter described the exciting new evidence on treatment and prevention for many mental disorders, but also the many barriers to scaling up these treatments. The Lancet series ended with a call to action to scale up services for people with mental disorders, based on evidence and a commitment to human rights. Both these initiatives, however, focused on the extreme end of the distribution of distressing mental health experiences in the population – the end where most individuals would satisfy diagnostic criteria for mental disorder. It is in this context that the larger role of promoting mental health in scarce-resource settings at the level of the population as a whole, or sub-groups targeted on grounds of vulnerability or age, becomes highly relevant. This resource includes contributions from a range of experts makes this a must read text for students and practitioners, policy-makers and planners or anyone with an interest in improving mental and public health in South Africa.