Missed Opportunities in Global Health: Identifying New Strategies to Improve Mental Health in LMICs

Mental illnesses are among the top causes of disability and disease in low- and middle-income countries (LMIC). Yet despite the enormous burden that mental ill-health imposes on individuals, their families, society, health systems and the economy, mental health care remains a truly neglected area of global health policy. Policy and practice in most LMIC and among development partners is either absent, outdated, or ineffective, characterized by systemic neglect and–in too many cases–outright human rights violations. In spite of this discouraging reality, the good news is that the evidence base on low-cost, effective interventions that can significantly reduce the burden of disease and enhance economic productivity in LMIC is increasing daily. Countries like South Africa and India are putting new mental health policies in place. There is now a clear agenda of “what to deliver” to make this deplorable reality better, and indeed a nascent advocacy community has begun to call for action and align scientific research. This paper sets out this status quo, but also makes a unique contribution by investigating practical and immediate opportunities on “how to deliver” more effectively on this new agenda, suggesting reforms to three existing LMIC government and donor strategies to extend healthcare coverage, pay healthcare providers, and alleviate poverty using cash transfers.