PSYCHIATRY AND HEALTH IN LOW-INCOME POPULATIONS

Although mental health problems constitute 8.1% of the global burden o f disease (GBD), mental health has been largely missing from the inter national health agenda. The discrepancy between needs and services is likely to increase in the next millennium. Depression alone is current ly the fourth leading cause of disability-adjusted life-years (DALYs) the world over and is projected to become the second leading cause by the year 2020. The nations of the world must make a major commitment t o upgrade the quality of mental health services, including early detec tion and prevention of psychiatric problems in childhood and adolescen ce; to institute the collection of systematic data on the global burde n of alcohol and drug abuse and to develop innovative treatment and pr eventive measures; and to provide substantial support for research on treatment effectiveness, Because hunger, deprivation, and violence aff ect women disproportionately, there is a pressing need for coordinated efforts to improve state gender policies (including equal educational opportunity and improved health care for women) and to interdict dome stic violence. In the words of Boutros Boutros Ghali, the Secretary Ge neral of the United Nations: ''Medical and social issues which are oft en viewed separately must be dealt with as a whole...the priority of m ental health must be heightened...development policies must...protect and promote mental health.'' Copyright (C) 1997 by W.B. Saunders Compa ny.