Mental health promotion for elderly populations in World Health Organization South-East Asia Region: Needs and resource gaps

Table 1 Existing health facilities with special reference to mental health (policy/plans/budgetary allocations) in World Health Organization South- East Asia Region Organization countries

Mental health policies and implementations	India	Bangladesh	Bhutan	Indonesia	Korea	Maldives	Myanmar	Nepal	Sri Lanka	Thailand	Timor-leste
Current health expenditure as share of GDP	3.6%	2.4%	3.5%	3.1%	Not found	10.6%	5.1%	6.3%	4.2%	3.7%	2.4%
Domestic general government health expenditure	3.1	3.4	8.3	8.3	-	20.2	4.8	5.3	8.6	15.3	3.2
Health worker density (per 10000 population)	27.5	8.3	19.3	24.4	81	50	17.9	33.5	31.7	38.15	25.04
Stand-alone policy or plan for mental health	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes	Yes
The mental health policy/plan	Yes	No	Yes	Yes	Yes	No	Yes	Yes	No	Yes	Yes
Policy/plan in line with human rights covenants	5	4	3	5	4	5	4	5	4	5	4
Stand-alone law for mental health	Yes	Yes	No	Yes	Yes	No	Yes	No	Yes	Yes	No
Dedicated authority or independent body assessing the compliance	Yes	No	No	Not found	Yes	Not found	Nonfunctional	Not found	Not found	Irregular and partial	Not found
Law is in line with human rights covenants	5	2	2	5	3	Not found	Not found	Not found	5	4	5
Existence of at least two functioning programs	Yes	Yes	Yes	Not found	Yes	Not found	Not found	Not found	Yes	Yes	Yes
Existence of a suicide prevention strategy	No	No	Yes	Not found	Yes	No	No	No	Yes	Yes	Yes
Total mental health expenditure/-person (reported currency)	4 INR	2.4 BDT (2.0 INR)	6.73 BTN (6.73 INR)	Not found	76370.40 KRW (5014 INR)	Not found	58.92 MMK (3 INR)	Not found	Not found	46.48 THB (112.4 INR)	Not found
The government’s expenditure on mental health as % of total health expenditure	1.30%	0.50%	0.30%	6.00%	3.80%	Not found	0.36%	Not found	Not found	0.30%	Not found

GDP: Gross domestic product; BDT: Currency code of Bangladesh; INR: Indian Ruppee; KRW: Korea won; MMK: Official currency of Myanmar; THB: Thailand Baht.

Table 2 Availability of mental health manpower in World Health Organization South- East Asia Region Organization countries

Mental health human resources1 (per 100000 population)	India	Bangladesh	Bhutan	Indonesia	Korea	Maldives	Myanmar	Nepal	Sri Lanka	Thailand	Timor-leste
Total number of mental health professionals (government and non government)	25312	1893	5	7751	20301	27	627	413	1480	9436	45
Total mental health workers	1.93	1.17	0.64	3.00	40.13	6.45	1.20	1.44	7.14	14.36	3.63
Psychiatrists	0.29	0.13	0.51	0.31	5.79	2.39	0.38	0.36	0.52	0.99	0.08
Child psychiatrists	0	0	Not found	Not found	0.38	Not found	Not found	0.003	0.03	0.26	0.24
Geriatric psychiatrists	24	Hardly available
Other specialist doctors	0.15	0.01	Not found	Not found	Not found	Not found	Not found	Not found	1.47	1.24	Not found
Mental health nurses	0.80	0.87	0.13	2.52	13.66	Not found	0.32	0.56	3.28	6.74	1.37
Psychologists	0.07	0.12	Not found	0.17	1.59	2.15	0	0.52	0.25	0.75	0.08
Social workers	0.06	0	Not found	Not found	8.40	0.48	0.01	Not found	0.28	0.91	1.61
Occupational therapists	0.03	0	Not found	Not found	0.08	0.24	0	Not found	0.22	0.98	0.16
Speech therapists	0.17	0	Not found	Not found	Not found	1.20	Not found	Not found	0.05	0.19	0.08
Other paid mental health workers	0.36	0.03	Not found	Not found	10.21	Not found	0.47	Not found	1.04	1893.45	Not found

¹This includes trained geriatric psychiatrists only.

Table 3 Available physical infrastructure for providing mental health services in South- East Asia Region Organization countries

Mental health infrastructure	India	Bangladesh	Bhutan	Indonesia	Korea	Maldives	Myanmar	Nepal	Sri Lanka	Thailand	Timorleste
Mental hospitals	136	2	Not found	48	181	Not found	2	6	1	19	Not found
Psychiatric units in general hospitals	389	56	1	269	197	1	22	18	31	104	1
Mental health outpatient facilities attached to a hospital	952	69	28	Not found	518	6	33	29	230	830	6
Private practitioners	1217	Not found	Not found	Not found	313	Not found	3	Not found	20	2	69

Table 4 Estimated human resource requirements for mental health care of elderly individuals in World Health Organization South- East Asia Region Organization countries

Human resources requirement norms for the general population[37]	Human resources requirement for total population of WHO SEARO countries on Feburary 18, 2021(2537079071)a	Human resources requirement for elderly population 248633749b (@ 9.8%-WHO) SEARO countries as per norms of general population	Older adults with mental health problems @ 20% (tiwari and pandey, 2012) in SEARO 49726750 population as per general population norms	Availability of manpower in WHO SEARO countries	The gap (requirement -availability)
Psychiatrists (1 per 50000 population)	50741.6	4972.7	(4972.7 × 5) 24863.5	994.5 × 5 = 4972.5	9945.2
Clinical psychologists 1 per 25000 population	10148316	9945.3	(9945.3 × 5) 49726.5	1989.7 × 5 = 9948.5	19893.8
Psychiatric social workers 1 for 25000 population	10148316	9945.3	(9945.3 × 5) 49726.5	1989.7 × 5 = 9948.5	19893.8
Psychiatric nurses 1 per 25 000 population	10148316	9945.3	(9945.3 × 5) 49726.5	1989.7 × 5 = 9948.5	19893.8

^ahttps://www.worldometers.info/world-population/asia-population/ accessed on Feburary 18, 2021.

^bhttps://www.WHO.int/southeastasia/health-topics/ageing#:~:text=the%20population%20in%20WHO%20south,2030%20and%20by%202050%2c%20respectively. Accessed on Feburary 18, 2021.

WHO: World health organization; SEARO: South-east asia region organization.