MedAccess and University of Oxford convene expert panel on access to mental health treatments

MedAccess and the University of Oxford this week convened mental health clinicians, policy experts, researchers and people with lived experience to identify potential products that could be safe and practical for use in low-resource settings.

The meeting was a milestone in a Wellcome-funded project to scope opportunities for market shaping tools to boost access to effective treatments. Discussions focused on treatments for the management of schizophrenia.

Chaired by Andrea Cipriani, Professor of Psychiatry at the University of Oxford, the meeting heard from a multidisciplinary panel of international experts in psychopharmacology, evidence synthesis, philosophy, bioethics, climate change and people with lived experience, together with eminent psychiatrists from Ethiopia, Nigeria, Rwanda and South Africa about the successes and challenges providing mental health care in their countries.

The group used GALENOS, a continuously updated synthesis of global evidence on mental health conditions developed by the University of Oxford and Wellcome, to build a shared understanding of the best available evidence of comparative effects of antipsychotics across schizophrenia and psychosis. Then the group reappraised evidence applying country-specific lenses, based on regional expert input for contextualisation.

Speaking after the meeting, Professor Cipriani said: “Having a more balanced and equitable approach to accessing mental health treatment is crucial, ensuring patients and clinicians across the world have the best evidence-based tools and treatments to tackle symptoms.

“Bringing together people from diverse backgrounds, different countries and multidisciplinary approaches, this event is uniquely positioned to give a material contribution to the use and implementation of effective and well tolerated treatments for schizophrenia at a global scale.

“Our conversation is enriched by the experiences of people with lived experience and clinicians from different parts of the world, because the context and reality of what we do as psychiatrists, is a key factor in considering how we can ensure that people everywhere get the support and treatment that works best for them.”

Mental health conditions affect more than one billion people globally. In low- and middle-income countries (LMICs), some 75% of people living with a mental health condition are typically unable to access treatment. Additionally, individuals often face increased stigma because their symptoms are untreated. When patients turn to the private market, a month’s treatment with a common antidepressant such as fluoxetine can cost more than a week’s wages.

MedAccess is assessing opportunities to access to affordable treatments for four mental health conditions – schizophrenia, depression, anxiety and bipolar disorder – in LMICs. MedAccess’ work in this area is funded by a $450,000 Wellcome Trust grant and is being carried out in collaboration with the Clinton Health Access Initiative (CHAI), supported by complementary funding.

CHAI’s closely aligned programme, also supported by Wellcome, seeks to generate local data in four priority countries about attitudes, ongoing activities and access challenges related to mental health treatment. CHAI and MedAccess will work closely to ensure their respective findings support each other’s work.