Mental Health in Community Life

Abstract

Mental health is considered a public health problem due to the following particularities of the mental diseases: high incidence and prevalence; long term duration, with consequences over family, social and professional life; cause severe disability; high cost imposed on individual, family and community; associated stigma and discrimination. The main determinants of mental health are: socio-economic, demographic and psychological factors. Public health can bring a major contribution to the improvement of mental health by its main functions, such as: needs evaluation, priority setting, policy development, health promotion and disease prevention, mental health services research and development. According to WHO recommendations, mental health services should be organized based on principles of accessibility, coordinated care, continuity of care, effectiveness, equity and respect for human rights. As well, mental health care should be provided through general health services and community settings. Large and centralized psychiatric institutions need to be replaced by other more appropriate mental health services. The shifting of patients from mental hospitals to care in the community should be based, primarily on the existence of a mental health policy that promotes the development of community-based care. Policies should be drawn up with the involvement of all stakeholders and should be based upon up-to-date and reliable information. Mental health policy and service provision should take into account the context of general health systems organization and financing. For a successful implementation of the mental health policy, political, legislative, financial and administrative support is required.