Why does mental health not get the attention it deserves? An application of the Shiffman and Smith framework
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Introduction - The lifetime prevalence of mental disorders has been estimated to be between 12.2% and 48.6% globally. More than 13% of the global burden of disease for mental disorders is due to neuropsychiatric disorders, and over 70% of this burden lies in low- and middleincome countries. Suicide is one of the leading causes of death globally for all ages. Despite this urden, mental illness has thus far not achieved commensurate visibility, policy attention, or funding, particularly in low- and middle-income countries. Shiffman and Smith have developed a framework of analysis that attempts to understand why some global health initiatives are more successful in generating funding and political priority than others. The framework has been applied most prominently to maternal mortality and newborn survival. Global mental health is one initiative that is attempting to garner an increased share of international funding as well as prioritisation by political leaders. In this essay, we will use the Shiffman and Smith framework to demonstrate that while some significant strides have been made, mental health still faces major challenges in establishing itself as a global initiative with meaningful political priority. We will conclude with a discussion of the way forward for the global mental health movement, and make some suggestions about how this aim can be furthered.