Jake and Adrienne have discussed so far the core conceptual issues in rural mental health care, from the social and economic challenges. In this episode they close off by discussing the funding and political challenges of rural mental health.
Funding mechanisms are in transition from financing targeted programs, typically provided as 'project' funds to area's around the country. Unfortunately, even where mental health is identified as a policy priority, and despite it representing a large percentage of the disease burden in high-mortality low- and middle-income countries.
Donor funding is sometimes used to support the work of NGOs. We cannot provide a detailed overview here of the significance of their contributions, but suffice it to say that NGO service delivery activities, in relation to mental health, are never of sufficient scale and coverage to deliver mental health to the whole country on a sustainable basis, for this task a well functioning public health system is required.
There is a need for better indicators on mental health. Better dissemination of information on the case for investing in mental health and the need for urgent human resource planning in the face of the outward migration of health professionals from low income countries.
Governments should ensure that they have comprehensive mental health policies which are well integrated with general health sector reform strategies, medium-term expenditure frameworks and essential packages of health.