A major public health issue
- 1 in every 5 French citizens suffers from a psychiatric illness (as opposed to 1% for cancer) (1)
- 2nd leading cause of handicap in the world (2)
- 240 billion Euros: total direct and indirect cost of these illnesses in Europe, far in excess of that for cancer or diabetes (3)
Inadequate access to treatment
- Delay in diagnosis (up to 10 years after the first symptoms)
- Delay in diagnosis of associated medical conditions
- Frequent compulsory hospitalization, too often in a situation of emergency
Lack of investment in research
- Just 2% of the budget for public and private biomedical research (as opposed to 20% for cancer) (4)
(1) Eur Neuropsychopharmacol 2005
(2) WHO, 2002: World Health Report
(3) Wittchen and Jacobi, 2005
(4) Etude FondaMental, IRDES,URC Eco Ile de France, 2009
Serious and life-threatening illnesses
Mental disorders are chronic and severely disabling conditions that seriously disrupt the lives of those afflicted. Often associated with an increased risk of suicidal behaviors. A study by the European Commission on Brain and Nervous System disorders (*) indicates 12,000 suicides each year in France and 58,000 in Europe. At the European level, the number of suicides is greater than the number of road accidents.
(*) Plan National du cerveau et des maladies du système nerveux 2007 – European Commission and Directorate-General for Health and Consumer Protection 2005
Costly and lack of knowledge
The lack of knowledge and taboos that shroud mental illness, as well as delayed diagnosis, lead to inappropriate and costly management of patients.
In France, psychiatric disorders are the second reason for absence on sick leave and the leading cause of disability (Caisse Nationale d’Assurance Maladie, 2004). They represent one tenth of healthcare expenditure and are at the top of the list in hospital expenditure (Institut de Recherche d’Etude et de Documentation en Economie de la Santé 2003). Nevertheless, little progress has been made in the understanding and diagnosis of these illnesses unlike other chronic illnesses such as cardiovascular disease, cancer or AIDS.
Exclusion and stigmatisation
Despite progresses made to better understand their causes, psychiatric disorders are surrounded by myths and misconceptions that affect patients and their families. Fear and misunderstanding create barriers of shame and cast negative judgments on mental illness, wrongly associating it with a weakness of character. Patients are thus indirectly incriminated and held ‘responsible’ for their condition and ‘inability’ to help themselves. But mental illness if not a fatality: therapeutic tools exist and research holds great promise for the improvement of diagnosis and care. It is time for a medical and therapeutic approach to blot out stigma and prejudice.