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International Journal of Mental Health and Addiction

16-05-2024 | Original Article

The Vulnerability Paradox in Global Mental Health: Psychologist Density, Social Development, and the Disease Burden of Mental Disorder

Authors: Yifan Chen, Xiao Li, Yunxi Zhong, Qixiu Li, Xiaoying Su, Long Sun

Published in: International Journal of Mental Health and Addiction

Abstract

Global efforts underscore the imperative of increasing the mental health workforce to improve mental health. However, the “vulnerability paradox” in global mental health questions the effectiveness of increased workforce. Evidence is lacking on whether mental health workforce input can reduce the disease burden of mental disorders at different levels of social development. Data from the Global Burden of Disease Study 2019, United Nations Statistics, and Our World in Data and all data are publicly available. The concentration index (CCI) and slope index (SI) were used to assess psychologist density inequality across 204 countries and territories from 1990 to 2019. Generalized additive mixed model was used to analyze the nonlinear associations among psychologist density, the socio-demographic index (SDI), and age-standardized rates (ASRs) of DALY for mental disorders. Psychologist density increased globally from 1990 to 2019, excluding Zimbabwe. The psychologist density SI increased from 3.8 in 1990 to 10.5 in 2019. CCI decreased from 66.8 in 1990 to 52.8 in 2019. The psychologists were concentrated in countries and territories with higher SDI rankings. Psychologist density had a negative nonlinear association with DALY ASR (EDF, 5.86; P<.001), with a slowing decline as psychologist density increased. SDI correlated positively with DALY ASRs (EDF, 6.36; P<.001). In the interaction between psychologist density and SDI, as SDI increased, the impact of the increase in psychologist density on the reduction of DALY ASRs for mental disorders gradually weakened. Despite an overall increase, substantial global inequality persists in psychologist density. Psychologist density has a notable negative nonlinear association with the disease burden of mental disorders, with varying input-response relationships across different SDI levels. Formulating equity-oriented mental health workforce policies and allocating resources to low human resources for mental health and underdeveloped areas are imperative. And consider reshaping mental health services rather than just increasing the mental health workforce, especially in high-development areas.

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Title: The Vulnerability Paradox in Global Mental Health: Psychologist Density, Social Development, and the Disease Burden of Mental Disorder
Authors: Yifan Chen
Xiao Li
Yunxi Zhong
Qixiu Li
Xiaoying Su
Long Sun
Publication date: 16-05-2024
Publisher: Springer US
Published in: International Journal of Mental Health and Addiction
Print ISSN: 1557-1874
Electronic ISSN: 1557-1882
DOI: https://doi.org/10.1007/s11469-024-01331-y

ERS Congress 2024

Springer Medicine

The Vulnerability Paradox in Global Mental Health: Psychologist Density, Social Development, and the Disease Burden of Mental Disorder

Abstract

ERS Congress 2024

Springer Medicine

Abstract

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