To reduce the rising burden of mental disorders around the world, the Lancet Commission on Global Mental Health and Sustainable Development has declared a need to increase psychiatric services globally, which should include an effort to “reduce the cost and improve the supply of effective psychotropic drugs for mental, neurological, and substance use disorders.”
While reducing the burden of mental disorders is certainly a laudable goal, we believe that implementing this plan will increase the global burden of mental disorders rather than decrease it.
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Yet even as more and more people have been getting medical treatment for psychiatric disorders, the number of adults on government disability due to these disorders has more than tripled since 1987.
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Any call for improving global mental health needs to recognize two facts: First, there are commercial forces at work in this enterprise, which urge more access to psychiatric drugs. Second, as the globalization of mental health has unfolded over the past several decades, the burden of mental disorders has increased in tandem. Without such recognition, proposals for closing the global treatment gap risks further exporting a failed paradigm of care.
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Indeed, it is easy to make the case, as we have sought to quickly do here, that “closing the treatment gap,” when treatment includes increased use of psychiatric drugs, will likely make things worse.
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