RT Book, Section
A1 Robinson, Diana M.
A1 Levy-Carrick, Nomi C.
A1 Berkowitz, Aaron L.
A1 L. Smith, Stephanie
A2 Silbersweig, David A.
A2 Safar, Laura T.
A2 Daffner, Kirk R.
SR Print(0)
ID 1178765518
T1 Neuropsychiatry in Global Health 
T2 Neuropsychiatry and Behavioral Neurology: Principles and Practice
YR 2021
FD 2021
PB McGraw Hill
PP New York, NY
SN 9781260117103
LK neurology.mhmedical.com/content.aspx?aid=1178765518
RD 2024/04/20
AB Neuropsychiatric  conditions  are  common  throughout  the  world  and  account  for  a  substantial  portion  of  the  global  burden  of  illness.  Over  the  last  decade,  the  burden  of  illness  attributable  to  mental  health,  neurological,  and  substance  use  disorders,  as  measured  in  disability-adjusted  life  years  (DALYs),  has  risen  dramatically  and  exceeds  the  burden  of  illness  attributable  to  cancer  and  cardiovascular  disease.1  DALYs  have  been  one  of  the  most  prominent  health  metrics  used  to  describe  the  global  burden  of  mental,  neurologic,  and  substance  use  disorders.  The  DALY  includes  both  years  lived  with  disability  (YLDs)  in  addition  to  years  of  life  lost  (YLL).2  Yet  there  are  too  few  specialized  psychiatric  and  neurologic  providers  to  meet  this  burden.  In  many  rural  and  resource-limited  settings  across  the  globe,  the  number  of  people  with  neuropsychiatric  conditions  who  do  not  receive  appropriate  or  adequate  treatment  for  their  disorder  (defined  as  the  treatment  gap)  can  reach  almost  90%.3  There  are  many  structural  and  operational  challenges  associated  with  mental  health  and  neurologic  care  delivery,  including  a  global  scarcity  of  skilled  psychiatric  and  neurologic  practitioners,  challenges  in  effective  flow  of  medical  services  and  goods  from  manufacturer  to  patient  (defined  as  supply  chain  management),  limited  funding,  sociocultural  and  stigma  factors,  and  weak  health  systems  in  many  places  around  the  globe.  Task  sharing—moving  care  responsibilities  from  more  specialized  providers  to  less  specialized  health  workers—has  been  increasingly  emphasized  as  one  key  approach  for  addressing  the  global  burden  of  mental  disorders;  however,  this  should  be  combined  with  improved  funding,  health  system  strengthening  efforts  and  training,  and  engagement  of  specialized  providers  in  task-shared  systems  of  care.  This  chapter  will  provide  an  overview  of  the  epidemiology  and  global  burden  of  neuropsychiatric  illness  and  the  global  neuropsychiatric  treatment  gap.  It  will  then  describe  the  challenges  and  potential  solutions  to  effective  global  mental  health  service  delivery,  including  current  evidence  on  task-sharing  approaches  to  neuropsychiatric  care  across  the  globe.