Presentation by Dr Ross White from Glasgow University, presented at CPG on Malawi on the 18th January 2012

1. The Burden of Mental Illness in Low and
Middle Income Countries
Dr Ross White
Mental Health and Well-being
University of Glasgow
Ross.White@glasgow.ac.uk

2. Global Burden of Disease
• The top five leading causes of disability (DALYs) for all ages were
(WHO, 2005):
• By 2030 unipolar depression will be the No. 1 contributor to total
years lived with disability (WHO, 2005).
• Mental health difficulties are set to become the leading global
cause of disability.

3. The Mental Health GAP
• 4 out of 5 people in low and middle-income countries who need
services for mental, neurological and/or substance use
disorders do not receive them (MH-Gap, 2008).
• Globally, spending on mental health is less than $2 per person,
per year. It is 25c in low income countries (WHO, 2011).
• When available, the interventions in low income countries are
often not evidence-based or of high quality. (MH-Gap, 2008)
• Malawi has been identified as a country requiring ‘intensified
support’ for mental health services (MH-Gap, 2008).
• Marked disparities exist between mental health provision
in low and high-income countries.

4. Human Resource
Median rates of human resources per 100,000 population
working in the mental health sector by World Bank income
group:

5. The Brain Drain
• The UK, the USA, New Zealand, and Australia employ
almost 9000 psychiatrists from India, the Philippines,
Pakistan, Bangladesh, Nigeria, Egypt, and Sri Lanka
(Kakuma et al., 2011).
• Without this migration, many source countries would have
more than double (in some cases five to eight times) the
number of psychiatrists per 100 000 population (Kakuma
et al., 2011).

6. MSc Global Mental Health
• Provide teaching on designing and implementing
culturally appropriate mental health services and policies.
• A ‘training for trainers’ approach to develop future leaders
and policy makers (e.g. Nurse Lecturers from Malawi).
• Block method of teaching will allow students to continue
to work in their country of origin.
• We are keen to collaborate with the SMMHEP:
– Malawian students completing the MSc programme.
– Senior clinical academics at the University of Glasgow
offering supervision and mentorship.

7. Key points
• Mental health difficulties are set to become the leading cause
of global disability.
• Disparities exist between the provision made for mental health
problems in low and high-Income countries. Human resources
in low income countries are particularly scarce.
• The MSc Global Mental Health will offer high quality education
on the design and implementation of mental health services
and policies in low and middle income countries.
• We are keen for students from Malawi to complete the MSc
programme.