Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years

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dc.contributor.authorCharlson, Fiona Jen_ZA
dc.contributor.authorDiminic, Sandraen_ZA
dc.contributor.authorLund, Cricken_ZA
dc.contributor.authorDegenhardt, Louisaen_ZA
dc.contributor.authorWhiteford, Harvey Aen_ZA
dc.date.accessioned2015-12-28T06:45:57Z
dc.date.available2015-12-28T06:45:57Z
dc.date.issued2014en_ZA
dc.description.abstractThe world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals.en_ZA
dc.identifier.apacitationCharlson, F. J., Diminic, S., Lund, C., Degenhardt, L., & Whiteford, H. A. (2014). Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years. <i>PLoS One</i>, http://hdl.handle.net/11427/16019en_ZA
dc.identifier.chicagocitationCharlson, Fiona J, Sandra Diminic, Crick Lund, Louisa Degenhardt, and Harvey A Whiteford "Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years." <i>PLoS One</i> (2014) http://hdl.handle.net/11427/16019en_ZA
dc.identifier.citationCharlson, F. J., Diminic, S., Lund, C., Degenhardt, L., & Whiteford, H. A. (2013). Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years. PloS one, 9(10), e110208. doi:10.1371/journal.pone.0110208en_ZA
dc.identifier.ris TY - Journal Article AU - Charlson, Fiona J AU - Diminic, Sandra AU - Lund, Crick AU - Degenhardt, Louisa AU - Whiteford, Harvey A AB - The world is undergoing a rapid health transition, with an ageing population and disease burden increasingly defined by disability. In Sub-Saharan Africa the next 40 years are predicted to see reduced mortality, signalling a surge in the impact of chronic diseases. We modelled these epidemiological changes and associated mental health workforce requirements. Years lived with a disability (YLD) predictions for mental and substance use disorders for each decade from 2010 to 2050 for four Sub-Saharan African regions were calculated using Global Burden of Disease 2010 study (GBD 2010) data and UN population forecasts. Predicted mental health workforce requirements for 2010 and 2050, by region and for selected countries, were modelled using GBD 2010 prevalence estimates and recommended packages of care and staffing ratios for low- and middle-income countries, and compared to current staffing from the WHO Mental Health Atlas. Significant population growth and ageing will result in an estimated 130% increase in the burden of mental and substance use disorders in Sub-Saharan Africa by 2050, to 45 million YLDs. As a result, the required mental health workforce will increase by 216,600 full time equivalent staff from 2010 to 2050, and far more compared to the existing workforce. The growth in mental and substance use disorders by 2050 is likely to significantly affect health and productivity in Sub-Saharan Africa. To reduce this burden, packages of care for key mental disorders should be provided through increasing the mental health workforce towards targets outlined in this paper. This requires a shift from current practice in most African countries, involving substantial investment in the training of primary care practitioners, supported by district based mental health specialist teams using a task sharing model that mobilises local community resources, with the expansion of inpatient psychiatric units based in district and regional general hospitals. DA - 2014 DB - OpenUCT DO - 10.1371/journal.pone.0110208 DP - University of Cape Town J1 - PLoS One LK - https://open.uct.ac.za PB - University of Cape Town PY - 2014 T1 - Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years TI - Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years UR - http://hdl.handle.net/11427/16019 ER - en_ZA
dc.identifier.urihttp://hdl.handle.net/11427/16019
dc.identifier.urihttp://dx.doi.org/10.1371/journal.pone.0110208
dc.identifier.vancouvercitationCharlson FJ, Diminic S, Lund C, Degenhardt L, Whiteford HA. Mental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 years. PLoS One. 2014; http://hdl.handle.net/11427/16019.en_ZA
dc.language.isoengen_ZA
dc.publisherPublic Library of Scienceen_ZA
dc.publisher.departmentCentre for Public Mental Healthen_ZA
dc.publisher.facultyFaculty of Health Sciencesen_ZA
dc.publisher.institutionUniversity of Cape Town
dc.rightsThis is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.en_ZA
dc.rights.holder© 2014 Charlson et alen_ZA
dc.rights.urihttp://creativecommons.org/licenses/by/4.0en_ZA
dc.sourcePLoS Oneen_ZA
dc.source.urihttp://journals.plos.org/plosoneen_ZA
dc.subject.otherMental health and psychiatryen_ZA
dc.subject.otherAfricaen_ZA
dc.subject.otherGlobal healthen_ZA
dc.subject.otherDisabilitiesen_ZA
dc.subject.otherPublic and occupational healthen_ZA
dc.subject.otherInfectious diseasesen_ZA
dc.subject.otherDepressionen_ZA
dc.subject.otherInpatientsen_ZA
dc.titleMental and substance use disorders in sub-saharan Africa: predictions of epidemiological changes and mental health workforce requirements for the next 40 yearsen_ZA
dc.typeJournal Articleen_ZA
uct.type.filetypeText
uct.type.filetypeImage
uct.type.publicationResearchen_ZA
uct.type.resourceArticleen_ZA
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