At this point,the investigation was narrowed to premature NCD mortality in low andlower-middle income countries. Premature deaths carry significant individual(Mahal et al, 2010) and macroeconomicproblems (Beaglehole et al, 2011).The benefits of reducing these would be greatest in LMICs.Mental healthmanagement indicators were standardised for income, due to the significant relationshipobserved between mental health expenditure and income. Negative linear relationshipswere observed between premature NCD mortality with psychiatric availability,and outpatient facilities for mental health in low- and lower-middle incomecountries.
This is an interesting finding, as psychiatric services largelyremain independent from primary care in such countries (Saraceno et al, 2007).Primary care is where most mental health patients present with symptoms(Goldberg, 2003). Correlation analysis has suggested that the increasedavailability of psychiatric services could help reduce premature NCD mortality.Increasing headcount would be expensive. Perhaps instead, increasedavailability of psychiatric services could be achieved through integration withprimary care. Such methods would improve prevention and detection of mentaldisorders in a more cost-effective strategy where funding could be generated bythe redistribution of secondary/tertiary care money, rather than new investment(WHO and Wonca Working Party on Mental Health, 2008).
Premature NCDmortality was also interrogated in the presence of plans, policies, andlegislation for mental health. Low- and lower-middle income countries withlegislation and policy in place for mental health had significantly lowerpremature mortality rate than those without. However, differences are minimaland standard deviations are large and overlapping. A large spread of data whenassessing health-related variables is a by-product of variation in environmentalfactors and genetic disposition amongst different regions on a global scale. Thisis a limitation of global analysis, and in instances such as this, a meaningfulconclusion is difficult to draw.
Despite this, mental health policies and laws arecritical to improving the quality of life of mental health sufferers (WorldHealth Organization, 20176). In less developed countries, there isevidence of discrimination against mental health sufferers, affecting education,employment and housing opportunities (World Health Organization, 20176).Furthermore, the availability of psychiatric institutions is limited, andprevious publications have identified concerns over the violation of humanrights (Drew et al, 2011). Whilstthese strategies may not be efficacious in reducing premature NCD mortality,the integration of mental health into NCD strategy would be beneficial inbattling stigma and raising awareness. The integration of mental health intoprimary care could help here too.
The reduced stigma associated with receiving primary-leveltreatment could reduce discrimination and prevent admission into inhumane psychiatricinstitutions (WHO and Wonca Working Party on Mental Health, 2008).