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The treatment gap

The treatment gap
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In many low and middle income countries, mental health resources are insufficient. This results in what’s known as a treatment gap, the difference between the number of people who need mental health services and the number of people who can actually receive them. The treatment gap exists because of a shortage in human, financial, and infrastructural resources, along with the uneven, and in many cases, unfair distribution of resources among communities. In countries where a treatment gap exists, a trend known as the inverse care law is often seen. This is a situation where those with the highest mental health need, like the poorest individuals in the society, have the least access to appropriate care.
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A large treatment gap for many conditions has been well-documented around the world. For example, in Kenya, in rural regions, there is a disproportionate shortage of mental health specialists and essential medications when compared to urban regions. The endemic poverty and unemployment in those rural areas widens the treatment gap for mental health disorders. The treatment gap is the absolute difference between the true prevalence of a disorder and the proportion of affected individuals who are treated for the disorder. Exact treatment gap calculations can be hard to make because reliable data are often hard to come by in low and middle income countries.
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But the World Health Organisation calculates a treatment gap by processing data recorded on how services are used and by considering rates for particular disorders. The World Health Organisation estimates that the treatment gap in many low and middle income countries is as high as 80%. A treatment gap of 80% suggests that only 20% of individuals with a diagnosable condition receive appropriate professional help. To close the treatment gap for mental health, we need to not only ensure that resources are available, but also understand how the sociocultural context shapes people’s help seeking behaviours. A number of social, economic, and cultural factors make closing the treatment gap particularly difficult.
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For example, there’s a trend for medical professionals from low and middle income countries to emigrate to high income countries in search of better vocational opportunities. This is called the brain drain and poses a serious challenge to ensuring adequate numbers of trained mental health professionals in low income regions.

A treatment gap in mental health is observed globally, and is particularly wide in low- and middle-income countries.

The treatment gap refers to the difference between the number of individuals in need of mental health treatment and that of those who have access to such effective and appropriate care options. Worldwide, a lack of resources, in addition to stigma, armed conflict and other contextual factors, contributes to the persistence of disparities in the access to mental health care. To demonstrate, with a population of over 1.3 billion people and approximately 3,600 psychiatrists, India is facing a significant mental health treatment gap (Gilmoor et al., 2019).

Urgent action is needed to reduce the human suffering and the healthcare gap associated with mental disorders worldwide. This requires innovations in prevention, screening, diagnosis and treatment for PTSD, among other mental health conditions. Take some time to think about what is needed to address the wide treatment gap associated with PTSD care across the globe.

References

Gilmoor, A. R., Adithy, A., & Regeer, B. (2019). The cross-cultural validity of post-traumatic stress disorder and post-traumatic stress symptoms in the Indian context: A systematic search and review. Frontiers in Psychiatry, 10(439), 1-24. doi:10.3389/fpsyt.2019.00439

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Post-Traumatic Stress Disorder (PTSD) in the Global Context

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