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The new World Mental Health Report: Believing impossible things

Overview

Australian psychiatrists critique the WHO's World Mental Health Report for prioritizing broadly defined mental health conditions affecting over a billion people while neglecting severe psychiatric illnesses like schizophrenia. They argue this violates "vertical equity" principles, where the most severe illnesses should receive greatest priority and resources.

Individual authors

The five authors are:

  1. Stephen Allison - Flinders University, Adelaide
  2. Tarun Bastiampillai - Flinders University and Monash University
  3. Jeffrey CL Looi - Australian National University
  4. Stephen R Kisely - University of Queensland and Dalhousie University, Canada
  5. Vinay Lakra - Northern Health, Melbourne

Key insights

Key Insights:

  1. WHO report broadens mental health definition beyond ICD-11 disorders to include general distress

  2. Schizophrenia is most disabling psychiatric illness but relatively neglected in WHO report

  3. Report recommends scaling interventions for billion people without proven effectiveness evidence

  4. Vertical equity principle demands prioritising severe illnesses over mild-moderate conditions

  5. Only 29% of people with psychosis receive adequate treatment globally

  6. LMICs should focus 80% mental health spending on severe illnesses

  7. Rising treatment rates haven't reduced mental disorder prevalence in high-income countries

  8. Global deinstitutionalisation requires doubling LMIC mental health budgets during transition

Did this resource draw on transformative evidence?

This document is based on academic and clinical expertise rather than direct experimental research. The authors are university-affiliated psychiatrists and researchers who analysed existing WHO reports, Global Burden of Disease data, and disability weightings. Their critique relies on policy analysis, ethical frameworks (vertical equity), and interpretation of published statistics rather than original empirical studies.

This document demonstrates practice wisdom through the authors' clinical understanding that severe psychiatric illnesses like schizophrenia require intensive resources and prioritization. Their critique reflects accumulated professional knowledge about treatment realities in low-resource settings, the challenges of deinstitutionalization, and practical experience with disability levels across different mental health conditions in clinical practice.

This document is heavily based on research and evaluation insights. The authors analyzed WHO Global Health Estimates, Global Burden of Disease studies, disability weightings from international surveys, treatment coverage statistics, and systematic reviews of intervention effectiveness. They evaluated evidence showing rising treatment rates haven't reduced mental disorder prevalence in high-income countries.

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Literature Review