• 450 million people worldwide are affected by mental, neurological or behavioural problems at any given time. These problems are expected to increase considerably in the years to come.
  
  
• Mental problems are common to all countries, cause immense human suffering, social exclusion, disability and poor quality of life. They also increase mortality and cause staggering economic and social costs.
  
  
• One in every four persons going to health services has at least one mental, neurological or behavioural disorder. Most often these are neither diagnosed nor treated. Mental problems affect and are affected by chronic conditions such as cancer, heart disease, diabetes and HIV/AIDS. Untreated, they bring about poor health behaviour, non-compliance with prescribed medical regimens, diminished immune functioning, and negative disease outcomes.
  
  
• Cost-effective treatments for most disorders do exist and if used correctly, could permit affected persons to be functioning members of the community. Yet, in most countries there are major barriers to both the care and the reintegration of people with mental disorders.
  
  
• Setbacks include the lack of recognition, awareness, and action. Policy makers, insurance companies, health and labour policies, and the public at large – all discriminate between physical and mental problems. This discrimination leads to stigma against people who need help.
  
  
• Most middle and low-income countries devote less than 1% of their health expenditure to mental health which means that mental health policies, legislation, community care facilities, and treatments for the mentally ill are dismally short of resources.
  

It is a state of well-being in which the individual realises his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental health promotion is an umbrella term that covers a variety of strategies, all aimed at having a positive effect on mental health. The encouragement of individual resources and skills and improvements in the socio-economic environment are among them.

Most health care resources are spent on the specialised treatment and care of the mentally ill, and to a lesser extent on community treatment and rehabilitation services. Even less funding is available for promoting mental health.

Mental health promotion requires multi-sectoral action, involving a number of government sectors such as health, employment/industry, education, environment, transport and social and community services as well as non-governmental or community-based organisations such as health support groups, churches, clubs and other bodies.

Mental illnesses affect the functioning and thinking processes of the individual, greatly diminishing his or her social role and productivity in the community. In addition, because mental illnesses are disabling and last for many years, they take a tremendous toll on the emotional and socio-economic capabilities of relatives who care for the patient, especially when the health system is unable to offer treatment and support at an early stage. Some of the specific economic and social costs include:

• lost production from premature deaths caused by suicide (generally equivalent to, and in some countries greater, than deaths from road traffic accidents);
  
  
• lost production from people with mental illness who are unable to work, in the short, medium or long term;
  
  
• lost productivity from family members caring for the mentally-ill person;
  
  
• reduced productivity from people being ill while at work;
  
  
• cost of accidents by people who are psychologically disturbed, especially dangerous in people like train drivers, airline pilots, factory workers;
  
  
• supporting dependents of the mentally ill person;
  
  
• direct and indirect financial costs for families caring for the mentally-ill person;
  
  
• unemployment, alienation, and crime in young people whose childhood problems, e.g., depression, behaviour disorder, were not sufficiently well addressed for them to benefit fully from the education available;
  
  
• poor cognitive development in the children of mentally ill parents, and the emotional burden and diminished quality of life for family members.
  

Stigma can be defined as a mark of shame, disgrace or disapproval which results in an individual being shunned or rejected by others. The stigma associated with all forms of mental illness is strong but generally increases the more an individual's behaviour differs from that of the 'norm'.

Because of stigma, persons suffering from a mental illness are:

• often rejected by friends, relatives, neighbours and employers leading to aggravated feelings of rejection, loneliness and depression;
  
  
• often denied equal participation in family life, normal social networks, and productive employment;
  
  
• Stigma has a detrimental effect on a mentally ill person's recovery, ability to find access to services, the type of treatment and level of support received and acceptance in the community;
  
  
• Rejection of people with mental illness also affects the family and caretakers of the mentally ill person and leads to isolation and humiliation; and
  

• openly talking about mental illness in the community;
  
  
• providing accurate information on the causes, prevalence, course and effects of mental illness;
  
  
• countering the negative stereotypes and misconceptions surrounding mental illness; providing support and treatment services that enable persons suffering from a mental illness to participate fully in all aspects of community life;
  
  
• ensuring the existence of legislation to reduce discrimination in the workplace, in access to health and social community services.
  

• the right not to be discriminated against (e.g., in access to health care, social services or employment);
  
  
• the right to liberty (e.g., not to have restrictions automatically imposed on freedom of movement through measures such as detention);
  
  
• the right to integrity of the person (e.g., not to be unduly subjected to mental or physical harm. Typical violations include treatment that ignores the requirement to obtain either the patient's informed consent or a surrogate decision-maker's, and sexual abuse);
  
  
• The right to control one's own resources (e.g., one should not be automatically removed on the mere grounds of status as a mental patient, but should be judged on his or her actual ability to manage resources).
  

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