A consortium of researchers, advocates and clinicians announces here research priorities for improving the lives of people with mental illness around the world, and calls for urgent action and investment.
This is a preview of subscription content, access via your institution
Relevant articles
Open Access articles citing this article.
-
Effectiveness of Vortioxetine in Patients with Major Depressive Disorder Associated with Chronic Pain: An Observational Study in a Spanish Population
Pain and Therapy Open Access 29 April 2024
-
Socioeconomic inequalities in child and adolescent mental health in Australia: the role of parenting style and parents’ relationships
Child and Adolescent Psychiatry and Mental Health Open Access 21 February 2024
-
Making cities mental health friendly for adolescents and young adults
Nature Open Access 21 February 2024
Access options
Subscribe to this journal
Receive 51 print issues and online access
$199.00 per year
only $3.90 per issue
Buy this article
- Purchase on SpringerLink
- Instant access to full article PDF
Prices may be subject to local taxes which are calculated during checkout
References
World Health Organization The Global Burden of Disease: 2004 Update (WHO, 2008).
WHO Atlas on Substance Use (WHO, 2010).
Ferri, C. P. et al. Lancet 366, 2112–2117 (2005).
Wimo, A., Winblad, B. & Jönsson, L. Alzheimer's & Dementia 6, 98–103 (2010).
Bertolote, J. & Flieschmann, A. Suicidologi 7, 6–8 (2002).
WHO Country Resources for Neurological Disorders 2004 (WHO, 2004).
WHO Mental Health Atlas (WHO, 2005).
Saxena, S., Thornicroft, G., Knapp, M. & Whiteford, H. Lancet 370, 878–889 (2007).
Daar, A. S. et al. Nature 450, 494–496 (2007).
Lancet Mental Health Group Lancet 370, 1241–1252 (2007).
Sharan, P. et al. Br. J. Psychiatry 195, 354–363 (2009).
Tomlinson, M. et al. Bull. WHO 87, 438–446 (2009).
Jones, J. & Hunter, D. Br. Med. J. 311, 376–380 (1995).
Daar, A.S. et al. Nature 450, 494–496 (2007).
Varmus, H. et al. Science 302, 398–399 (2003).
Beddington, J. et al. Nature 455, 1057–1060 (2008).
Rupp, A. Br. J. Psychiatry 166, 26–33 (1995).
Author information
Authors and Affiliations
Corresponding authors
Supplementary information
Supplementary Information
This file contains Supplementary Methods, a Supplementary Discussion, Supplementary Figures 1-3, Supplementary Tables 1-3 and Supplementary Notes. (PDF 1307 kb)
Rights and permissions
About this article
Cite this article
Collins, P., Patel, V., Joestl, S. et al. Grand challenges in global mental health. Nature 475, 27–30 (2011). https://doi.org/10.1038/475027a
Published:
Issue date:
DOI: https://doi.org/10.1038/475027a
This article is cited by
-
Socioeconomic inequalities in child and adolescent mental health in Australia: the role of parenting style and parents’ relationships
Child and Adolescent Psychiatry and Mental Health (2024)
-
The association between lifelines diet score (LLDS) with depression and quality of life in Iranian adolescent girls
Nutrition Journal (2024)
-
Mutual Aid Groups for Loneliness, Psychosocial Disability, and Continuity of Care
Community Mental Health Journal (2024)
-
Effectiveness of Vortioxetine in Patients with Major Depressive Disorder Associated with Chronic Pain: An Observational Study in a Spanish Population
Pain and Therapy (2024)
-
Making cities mental health friendly for adolescents and young adults
Nature (2024)
C Lickwar
Our "increasing mental sickness" may find expression in neurotic symptoms. These symptoms are conspicuous and extremely distressing. But "let us beware," says Dr. Fromm, "of defining mental hygiene as the prevention of symptoms. Symptoms as such are not our enemy, but our friend; where there are symptoms there is conflict, and conflict always indicates that the forces of life which strive for integration and happiness are still fighting." The really hopeless victims of mental illness are to be found among those who appear to be most normal. "Many of them are normal because they are so well adjusted to our mode of existence, because their human voice has been silenced so early in their lives, that they do not even struggle or suffer or develop symptoms as the neurotic does." They are normal not in what may be called the absolute sense of the word; they are normal only in relation to a profoundly abnormal society. Their perfect adjustment to that abnormal society is a measure of their mental sickness. These millions of abnormally normal people, living without fuss in a society to which, if they were fully human beings, they ought not to be adjusted, still cherish "the illusion of individuality," but in fact they have been to a great extent deindividualized. Their conformity is developing into something like uniformity. But "uniformity and freedom are incompatible. Uniformity and mental health are incompatible too. . . . Man is not made to be an automaton, and if he becomes one, the basis for mental health is destroyed."
Aldous Huxley (Erich Fromm)
Neeraj Bhala
Grand challenges in preventing alcohol-related harms
We commend the collaborative efforts of the Grand Challenges in Global Mental Health team in identifying research priorities in the fields of mental, neurological and substance-use (MNS) disorders. (1) We note particularly the global burden due to alcohol-use disorders, which is the 2nd leading cause of MNS disorders worldwide(and in low- and middle-income countries). Whilst the grand challenges exercise is excellent in drawing attention to the breadth of issues in the arena of global mental health, we believe it would pay dividends to highlight in greater depth, factors which can be influenced. In particular, tackling alcohol-related harms would reap benefits in both mental and physical health internationally.
As well as mental health, excessive alcohol also has deleterious effects on other chronic diseases, particularly liver cirrhosis and some cancers. (2) The phenotypes of alcohol-related harms undoubtedly vary substantially? in Russia, for example, alcohol-associated excesses accounted for around half of all deaths of men aged 15-54 years in one large-scale study. (3) Whilst alcohol-use disorders may not account for the same extreme burden in other regions, the absolute effects are huge, with an estimated 3.8% of all global deaths and 4.6% of global disability-adjusted life-years attributable to alcohol. (2) As the Grand Challenges allude to, the lack of reliable information on MNS disorders (and specifically relations with alcohol) means this could be an underestimate of the global burden.
One of the key reasons we suggest alcohol-use disorders are particularly worthwhile focussing on is that there is an established evidence-base on interventions to reduce harms. Policies regulating the environment in which alcohol is marketed (particularly its price and availability) are effective in reducing its harms.(4) Moreover, as well as population-based strategies, strengthening the resources and training of health professionals in alcohol-use disorders will be required. Of course, tackling alcohol-related harms cannot be left to the mental health community alone, and will require the concerted global efforts of all physicians and public health practitioners. Other preventable hazards such as tobacco, obesity and blood pressure are relevant to chronic non-communicable diseases, (5) but alcohol-related harms warrant especial consideration as they constitute a grand challenge for physical and mental health globally.
Neeraj Bhala	Clinical Trial Service Unit, University of Oxford, OX3 7LF UK
Ian Gilmore	The Royal College of Physicians and the Alcohol Health Alliance UK
Address for correspondence:
Dr Neeraj Bhala	
Clinical Trial Service Unit, Richard Doll Building, University of Oxford, Oxford OX3 7LF UK
Email: neeraj.bhala@ctsu.ox.ac.uk
1.	Collins PY, Patel V, Joestl SS, et al. Grand challenges in global mental health. Nature. 2011 Jul 6;475(7354):27-30. doi: 10.1038/475027a.
2.	Rehm J, Mathers C, Popova S, et al. Global burden of disease and injury and economic cost attributable to alcohol use and alcohol-use disorders. Lancet. 2009 Jun 27;373(9682):2223-33.
3.	Zaridze D, Brennan P, Boreham J, et al. Alcohol and cause-specific mortality in Russia: a retrospective case-control study of 48,557 adult deaths. Lancet. 2009 Jun 27;373(9682):2201-14.
4.	Anderson P, Chisholm D, Fuhr DC. Effectiveness and cost-effectiveness of policies and programmes to reduce the harm caused by alcohol. Lancet. 2009 Jun 27;373(9682):2234-46.
5.	Daar AS, Singer PA, Persad DL, et al. Grand challenges in chronic non-communicable diseases. Nature. 2007 Nov 22;450(7169):494-6.
Ladonna Hendrickson
Mental places need to close remember asylums they all go against our religous rights its an attack on GODly people doping them for hearing HIS voice and seeing HIS visions having HIS dreams nightmares HE wants them too or is ok with and calling them a schitzophrenic for it its as bad as taking a gift from a king YOUR NOT AN AMERICAN ANYMORE the writer of the declaration or rights would say you dont dope any you teach them to handle if they want you dont force them they could be the writer of the book also their not stupid