Table 1. Mental health system comparisons across four countriesa.
WHO-AIMS | Iraq | Japan | Philippines | The former Yugoslav Republic of Macedonia |
---|---|---|---|---|
1. Policy and legislative framework | ||||
Mental health policy | Yes | Yes | Yes | No |
Mental health policy (1st, latest) year | 1982, 2005 | 1950, 1995 | 1990, 2001 | n/a (draft 2005) |
Mental health programme | Yes | Yes | Yes | No |
Law in mental health | Yes (1982) | Yes (2000) | No | No |
Insurance policy | No | Universal coverage | Poor policy | Yes – not comprehensive |
Financing mental health – main method | Tax-based | Tax-based | Tax-based | Social insurance |
Mental health budget/health budget | n/a | 5% | 0.02% | n/a |
Substance abuse policy | Yes (1966) | Yes (1953) | Yes (1972) | Yes (1999) |
Therapeutic drug policy – essential list of drugs | Yes | No | Yes | Yes |
Inspecting human rights | No | Yes | No | No |
2. Mental health services | ||||
Disability benefits for mental health | Yes | Yes | Yes | Yes |
Community care in mental health | Yes | Yes | No | Yes |
Psychiatric beds/10 000 individuals | 0.63 | 28.4 | 0.9 | 8.2 |
Psychiatric beds in general hospitals/10 000 individuals | 0.06 | 7.8 | 0.3 | 2 |
Psychiatric beds in mental hospitals/10 000 individuals | 0.55 | 20.6 | 0.56 | 6.2 |
Disproportion services (city) | Yes | Yes | Yes | Yes |
Medication | Limited access | Adequate | Short/limited | Short/limited |
3. Mental health in primary care | ||||
Treatment for severe mental disorders in primary care | Yes | No | No | No |
Mental health care facilities in primary care | Yes | Yes | Yes | Yes |
Training for primary care personnel in mental health | Yes | Yes | Yes | Yes |
Trained physician interaction of primary doctor with mental health services | No information | No information | No information | No information |
Links between mental health facilities and alternative practitioners | No information | No information | No information | No information |
4. Human resources | ||||
Psychiatric training | Yes | Yes | Yes | Yes |
Psychiatrist/100 000 individuals | 0.7 | 9.4 | 0.4 | 7.5 |
Psychologist in mental health/100 000 individuals | 0.05 | 7 | 0.9 | 2 |
Social workers in mental health/100 000 | 0.2 | 15.7 | 16 | 1.5 |
Psychiatric nurses/100 000 individuals | 0.1 | 59 | 0.4 | 24 |
Family/consumer association involvement in policies and plans | No information | No information | No information | No information |
5. Public education and links with other sectors | ||||
Mental health policy promotion | Few | Yes | Few | No information |
Mental health policy advocacy | Yes | Yes | Yes | No information |
NGO in mental health | Yes | Yes | Yes | Yes |
Mental health care for prisoners | Minimal | Yes | None | No information |
6. Monitoring and research | ||||
Mental health monitor/inspection system | Yes/poor monitor | Yes | No monitor | Yes/inspection |
Research | Few | Yes/larger scale | Few | Few |
Data collection system in mental health | Yes | Yes (periodically) | No | No |
Reporting system for mental health | Yes | Yes | No | Yes |
n/a, not applicable; NGO, nongovernmental organization; WHO-AIMS, WHO Assessment Instrument for Mental Health Systems. a Statistical data were gathered from WHO website (2005) and from the Ministries of Health of Iraq, Japan, the Philippines and The former Yugoslav Republic of Macedonia.