The Vulnerability Paradox in Global Mental Health: Psychologist Density, Social Development, and the Disease Burden of Mental Disorder.
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 di...
| Published in: | International Journal of Mental Health & Addiction Vol. 23; no. 5; pp. 3975 - 3988 |
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| Main Authors: | , , , , , |
| Format: | Article |
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Springer Nature
Oct2025
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=189679734&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 189679734 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 15571874 46AW jtl: International Journal of Mental Health & Addiction issn: 15571874 maglogo: N pubinfo: dt: Oct2025 vid: 23 iid: 5 pid: 237 pub: Springer Nature artinfo: ui: 189679734 10.1007/s11469-024-01331-y ppf: 3975 ppct: 13 formats: fmt: – @attributes: type: T – @attributes: type: P size: 1.5MB tig: atl: The Vulnerability Paradox in Global Mental Health: Psychologist Density, Social Development, and the Disease Burden of Mental Disorder. aug: au: Chen, Yifan Li, Xiao Zhong, Yunxi Li, Qixiu Su, Xiaoying Sun, Long affil: https://ror.org/0207yh398 Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, 44 Wenhuaxi Road, 250012, Jinan, Shandong, China https://ror.org/0207yh398 National Health Commission of China (NHC) Key Laboratory of Health Economics and Policy Research (Shandong University), 250012, Jinan, China https://ror.org/0207yh398 Institute of Health and Elderly Care, Shandong University, Jinan, Shandong, China https://ror.org/04gndp242 Genentech, Inc., 1 DNA Way, 94404, South San Francisco, CA, USA su: Social development Mental illness Employment policy Precarity Analysis of variance Psychological well-being Global burden of disease Mental health personnel sug: subj: Social development Mental illness Employment policy Precarity Analysis of variance Psychological well-being Offices of Mental Health Practitioners (except Physicians) Global burden of disease Mental health personnel keyword: Disease Burden of Mental Disorders Medical and Health Sciences Public Health and Health Services Mental Health Workforce Psychologist Density Social Development Vulnerability Paradox Disease Burden of Mental Disorders Medical and Health Sciences Public Health and Health Services Mental Health Workforce Psychologist Density Social Development Vulnerability Paradox ab: 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. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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