Scaling Up Interventions for Better Access to Mental Health and Epilepsy Care: A Forum with Impact

Abstract

Psychiatric and neurological disorders are now considered among the first contributors to the global burden of disease. In low- and middle-income countries (LMICs), insufficient specialized human resources, inadequate training of primary care workers, traditional beliefs, stigmatization, and discrimination are the most common barriers to access to care. Availability and cost of medicines are also common problems. Although in many cases effective treatments exist, 76%–85% of patients with mental disorders or epilepsy living in LMICs are not treated. Over the last 8 years, through the Interactive Meetings Promoting Access to Care and Treatment (IMPACT) forum, the Institute of Epidemiology and Tropical Neurology UMR 1094 INSERM, the World Association of Social Psychiatry, and Sanofi Global Health Programs have convened every year a group of approximately forty people from about twenty countries (not only from Africa, Asia, and Latin America, but also from Europe), and from various backgrounds (public, private, associative, and academic sectors), who are all involved in developing access to care for people living with mental disorders or epilepsy in LMICs. The meeting held in Versailles, France, on September 13 and 14, 2018, focused on “Scaling Up Interventions for Better Access to Mental Health and Epilepsy Care.” Through didactic presentations based on the World Health Organization-ExpandNet “Nine steps for developing a scaling-up strategy” guide, as well as case studies and workshops around three pilot projects implemented in Cambodia, Guatemala, and Madagascar, this forum provided participants with an opportunity to gain in knowledge and understanding of scaling-up theories and to apply these to practical cases.