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Mental Health Expert Graham Thornicroft Explores Gaps in Access to Care
On April 9, Graham Thornicroft, FRCP, PhD, professor of community psychiatry and head of the multi-disciplinary Health Service and Population Research Department at the Institute of Psychiatry, King’s College London, came to the School to discuss the need for improved access to mental health care services throughout the world.
As a pioneer in the field, Dr. Thornicroft has earned a reputation for advocating for the humane treatment of mental health patients, “caring for caregivers,” collaborating with consumer groups, and evaluating innovative large-scale mental health systems.
Following an introduction by Pamela Collins, MD, assistant professor of clinical Epidemiology and Psychiatry, Dr. Thornicroft began by stating that worldwide, a minimum of two-thirds of the mentally ill population will go untreated. On a recent visit to a facility in Bucharest, Romania, Dr. Thornicroft was reminded that even policies with the best intentions can result in unintended consequences.
“Upon arrival, I noticed that some of the buildings were shabby, while others had a new coat of brightly colored paint,” said Dr. Thornicroft. His guide was proud that the buildings were recently painted, but she also noted that there had been no money for medicine that month. “A new ‘anti-corruption’ policy was the reason why funding was not at the discretion of the director,” explained Dr. Thornicroft. As a result, money would not go to ‘bad’ places.
According to Dr. Thornicroft, the issue is two-fold. “On the one hand, there is not enough money to both care for the patients and upkeep the facility. On the other, discrimination can affect the availability of services.” His experience reviewing twelve low- and middle-income countries led him to create a ten-year plan.
In Dr. Thornicroft’s plan to address the under-use and inaccessibility of mental health services, funding should be channeled to inpatient and outpatient services, training, infrastructural development, and program management. His plan aims to improve pharmacological and psychosocial treatment for key target conditions—schizophrenia, bipolar disorder, depression, and hazardous alcohol use.
“Required expenditures to meet target coverage levels are not unreasonable when compared to other disease initiatives,” stated Dr. Thornicroft. He continued, “The resulting funding gap is substantial. In low-income countries only large-scale redistribution of domestic resources and/or new investments from external sources can overcome these obstacles and will require political will and stamina.”
Throughout the presentation, he stressed the need for approaching the issue of treating mental illness from a humane perspective. His experience in the field has taught him that mental illness acts as mediator for overall health, and that the growing gap will result in adverse affects.
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