PART II: medicines for mental health
Chapter 7 Medicines for mental health Introduction
However, over £600 million per year is directly spent on medication (Sainsbury Centre for
Approximately 450 million people worldwide
Mental Health, 2006). As with all medicines,
suffer from a mental disorder such as unipolar
there has been a steady increase in the
or bipolar depression, schizophrenia or
prescription of antidepressant and antipsychotic
Alzheimer’s disease, representing nearly 10%
drugs in recent years (Department of Health,
of the global adult population (WHO, 2001). In
2007). For instance, the number of prescription
the UK, it is estimated that one in six people
items for antidepressant drugs rose by 36%
between the ages of 16 and 74 experience
between 2000 and 2005, to approximately 29
a mood or anxiety disorder, which in 2000
million (ibid). Similarly, drugs used to treat
equated to approximately 7 million people
psychoses and related disorders increased by
(ONS, 2001). Importantly, all forms of mental
7% from 2002 to 2003 to reach 6.4 million
illness are associated with increased rates of
prescription items (Department of Health, 2007).
suicidal thoughts and attempts (ONS, 2002) and research indicates that 5-13% of patients
In this chapter we explore the development
with schizophrenia die from suicide (Pompili et
and use of medicines for the treatment and
al., 2007). Studies of suicide deaths have shown
prevention of mental illness in the context of
that around one in four individuals had been in
recent and potential advances in cognitive
contact with mental health services in the year
neuroscience. It should be emphasised that,
before death, and half had been in contact with
in considering medicines for mental health, we
mental health services in the preceding week
have focused on pharmacological therapies;
(Appleby et al., 1999).
psychological treatments such as Cognitive Behavioural Therapy (CBT) are briefly
The cost of all mental illness is estimated at
considered in Section 7.8.3, but a detailed
£77 billion per year in England alone. Much of
consideration is beyond the scope
this sum reflects indirect costs to the economy
of this discussion. We also emphasise the
through lost productivity, costs to the criminal
importance of developing new and effective
justice system and to society more broadly
treatments for the age-related cognitive
(Sainsbury Centre for Mental Health, 2003).
dementias, such as Alzheimer's disease. These
Box 7.1 Public engagement: views on mental illness
The results of the public engagement activity emphasised that most participants felt that eliminating the stigma attached to mental health was fundamental to improving the lives of people with mental health problems and those who care for them. The wider understanding that might arise through a more open discussion of the impact of mental illness seemed to be lacking. Some participants explained that the mental illness itself was less debilitating than the wider social consequences of the disorder, including isolation, vulnerability to abuse and sometimes violence. Participants also considered that the stigma attached to mental health problems and lack of obvious external manifestations contributed to the ‘invisibility’ of these problems. Participants felt that this stigma can leave people feeling ashamed of their condition or reticent to speak of their experiences.
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