By Anibal Velásquez
In the National Burden of Disease Study conducted by the Peruvian Ministry of Health (MINSA, 2006) it was reported that neuro-psychiatric diseases were the leading cause of burden of disease. This group of diseases produced 800,889 disability adjusted life years (DALYs) in Peru in 2004 (Cachay, 2007).
The levels of burden of disease caused by depression and other mental diseases are very high (Cachay, 2007; Velásquez, 2006; MINSA, 2006); in consequence, the health system should respond by introducing mental health services, which don’t currently exist, and include these diseases in the public and private health insurance package.
The national study of burden of disease with adjusted data showed that psychiatric diseases led to 553,714 DALYs and depression resulted in 430,404 DALYs (Cachay, 2007). These figures are as high as in developed countries.
It was reported that the prevalence of psychiatric disorders will increase (Murray & López, 1997). Nevertheless, the majority of patients with these disorders have no access to mental health services. In Latin America it was found that 80% of patients with mental disorders did not have access to mental health care (Medina-Mora et al., 2003). In Peru, poor people are the most affected group because mental health services there are not readily available. In Lima, for example, only 24.5% of cases of mental illness are treated under the health services (INSM, 2002), while in the highland and jungle regions 14% of patients used the mental health services (INSM, 2003; INSM, 2004 respectively). In addition, the diagnosis and treatment of these diseases are lacking in quality (CNS, 2006).
Therefore, I am convinced that this group of diseases should be included in future insurance health packages. To sum up, it requires the implementation of primary mental health care, the provision of psychotropic drugs and the training of health care workers to prevent and treat mental disorders (mainly depression, schizophrenia and alcohol abuse). Indeed, it will be necessary to improve the information system because not only is there no national data recording the true extent of mortality and morbidity of mental disorders, but the current information is incomplete and of poor quality.
References
The levels of burden of disease caused by depression and other mental diseases are very high (Cachay, 2007; Velásquez, 2006; MINSA, 2006); in consequence, the health system should respond by introducing mental health services, which don’t currently exist, and include these diseases in the public and private health insurance package.
The national study of burden of disease with adjusted data showed that psychiatric diseases led to 553,714 DALYs and depression resulted in 430,404 DALYs (Cachay, 2007). These figures are as high as in developed countries.
It was reported that the prevalence of psychiatric disorders will increase (Murray & López, 1997). Nevertheless, the majority of patients with these disorders have no access to mental health services. In Latin America it was found that 80% of patients with mental disorders did not have access to mental health care (Medina-Mora et al., 2003). In Peru, poor people are the most affected group because mental health services there are not readily available. In Lima, for example, only 24.5% of cases of mental illness are treated under the health services (INSM, 2002), while in the highland and jungle regions 14% of patients used the mental health services (INSM, 2003; INSM, 2004 respectively). In addition, the diagnosis and treatment of these diseases are lacking in quality (CNS, 2006).
Therefore, I am convinced that this group of diseases should be included in future insurance health packages. To sum up, it requires the implementation of primary mental health care, the provision of psychotropic drugs and the training of health care workers to prevent and treat mental disorders (mainly depression, schizophrenia and alcohol abuse). Indeed, it will be necessary to improve the information system because not only is there no national data recording the true extent of mortality and morbidity of mental disorders, but the current information is incomplete and of poor quality.
References
Cachay C (2007). DALYs of neuro-psychiatric disorders in Peru-2004 (Estimaciones de parámetros epidemiológicos y cálculo de AVISA del grupo de enfermedades psiquiátricas en el Perú). Lima: PRAES-USAID (In Spanish, in press).
CNS (2006). Mental health plan (Plan Nacional de Salud Mental). Lima: Comité Nacional de Salud Mental 2005-2006 del Consejo Nacional de Salud, Peru. Avalable at: http://www.minsa.gob.pe/portal/03Estrategias-Nacionales/10ESN-SaludMental/Archivos/Plan_Nacional_de_Salud_Mental_FINAL%2010.10.06.doc, access 10 October 2007
INSM (2002). Mental health study in Lima (Estudio Epidemiológico Metropolitano en Salud Mental: Informe General). Lima: Anales de Salud Mental 18(1 y 2), (in Spanish)
INSM (2003). Mental health study in highland region (Estudio Epidemiológico Metropolitano en Salud Mental en la Sierra Peruana: Informe General). Lima: Anales de Salud Mental 18(1 y 2) (in Spanish)
INSM (2004). Mental health study in jungla region (Estudio Epidemiológico Metropolitano en Salud Mental en la Selva Peruana: Informe General). Lima: Anales de Salud Mental 18(1 y 2), (in Spanish)
Medina-Mora, ME., Borges, G., Lara, C., Benjet, C., Blanco, J., Fleiz, C., Villatoro, J., Rojas, E., Zambrano, J., Casanova, L., Aguilar, S. (2003). Prevalence of mental disorders and use of health services, Mexico (Prevalencia de trastornos mentales y uso de servicios: Resultados de la Encuesta Nacional de Epidemiología Psiquiátrica en México). Salud Mental, 26(4): 1-16.
MINSA (2006). Burden of Disease in Peru-2004 (Estudio de Carga de Enfermedad en el Perú – 2004). Lima: Ministerio de Salud, 41 p (in Spanish). Available at: http://www.oge.sld.pe/publicaciones/pub_asis/asis18.pdf, access 25 October 2007
Murray C, López A (1997). Alternative projections of mortality and disability by cause 1990-2020: Global Burden of Disease Study. The Lancet ; 349:1498-1504
Velásquez A. Analysis of the Burden of Disease Study in Peru, MoH, 2004 (Análisis del Estudio de Carga de Enfermedad en el Perú – MINSA 2004 y propuesta metodológica para el ajuste con datos nacionales de morbilidad), Proyecto PRAES-USAID, Lima 2006, 64 p. Available at: http://www.praes.org/docs-pdf/publica/4.pdf, access 21 March 2007
Credit picture: Anibal Velásquez
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