Intended for healthcare professionals


Relation between mental health care and general development

BMJ 2006; 333 doi: (Published 19 October 2006) Cite this as: BMJ 2006;333:861
  1. Alex Souter, volunteer,
  2. R Srinivasa Murthy, medical officer, mental health (murthys_srinivasar{at},
  3. Ahmad Mohit, ex-director, health protection and promotion
  1. World Health Organization, Eastern Mediterranean Region, Cairo, Egypt
  2. World Health Organization, Eastern Mediterranean Region, Cairo, Egypt

    EDITOR—Disparities remain worldwide between high and low income countries in mental health services and protection of human rights for mentally ill patients.1 Substantial improvement has not been achieved in mental health since 2001, regional imbalances also remaining similar.2 When does society give importance to disadvantaged people? Can society be expected to protect the human rights of mentally ill people, irrespective of the state coming together as a functioning unit?

    Two sets of data illustrate the relation between the development of the state and society and the country's commitment to mental health. The first is the failed states index 3 and the second the availability of mental health staff in different countries.2

    We examined the 15 countries of the WHO eastern Mediterranean region included in the failed states index and found a correlation with mental health staff. Lebanon and Morocco are the two notable exceptions. For the remaining countries, their position in the failed states index is similar to that for mental health staff. The five eastern Mediterranean countries with the highest position in the failed states index (Sudan, 3; Iraq, 4; Somalia, 5; Yemen, 8, Afghanistan, 11) had the smallest numbers of mental health staff.

    The results show that when a state and society are struggling to keep their integrity, mental health is not a priority. Realistic strategies from mental health advocates are needed to develop mental health services in such countries. A need also exists to develop reliable mental health indicators to help monitor the development of mental health services and foster debate and research on mental health.


    • Competing interests None declared.


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