But at the same time, if they could get the public to truly understand how little of the national budget they get, they might be able to actually get them to rally behind a real project, like getting back to the Moon, or building even better probes to the planets, moon, comets, and asteroids in our solar system — not to mention building bigger and more sensitive telescopes that can see the Universe across the electromagnetic spectrum. I think he made a really good point.
Exploration, science, understanding, beauty: Without some sort of Slaver telepathy amplification helmet http: Personally, as alien technologies for fixing broken behaviors go, I prefer talsit http: No tyranny, just the power of clear thinking. How much would you be willing to bet the Chinese will make it to the moon before we go back? People as a group can be so stupid and selfish sometimes. Nearly 32 years for one billion seconds… And nearly 32, years for one trillion seconds to pass us by. How large a number is one trillion?
The Neanderthals disappeared from Earth about one trillion seconds ago. I meant Zero difference to Iraq or whatever. I re-read my comment above and saw how it could be misinterpreted.
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I was in rant mode and typing really fast. While I think money spent on NASA is money well spent, and they should get a lot more than they currently get, the Iraq dollars would be a little too much money. Sometimes, having a tight budget is actually helpful. Every country has this in one form or another.
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On the flip side, our own space program is considered expensive, and wasteful of money. Our soldiers, despite recent budget increases, still make do with equipment that is, in many cases, older than the soldiers who use it. Research and development is being strangled….
My apologies for the multiple posts. I am on a wireless mouse and the cell phone which is sitting too close, evidently, interferes with the mouse when an email comes in. Unfortunately this might seem like a fairly substantial sum of money to some people. You could not fly from NY to California for the same percentage of budget that we are supposed to fly to the moon.
Maybe that tells people something.
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Can you imagine what research could be done with more than half a trillion dollars? We could be on the moon next week! Why should they add up to ? Everyone knows we are overtaxed. But, GWB just vetoed a 1 billion increase in the budget for science grants. Maybe people should look at pie charts of the budget more often. Something visual often works best for people. Reminds me of a quote by Werhner von Braun, in the early days of the Space Race.
He was talking about the tendency of Government the expect instant results if they only throw more money at the problem. The whole thing is just a travesty. There is a good way of visualising a million and a billion. Picture a meter rule divided into millimetres, there are 1, of them in a meter and both the meter and millimeter are on a comfortable scale for us to compare and have a feel for. The analogy is, if your hard drive is almost full, do you delete a 15kb text file, or do you delete a mb first-person shooter game?
NASA is the smallest government agency. The largest the welfare agency, technically called Health and Human Services HHS , is more than half of the government all by itself. Back on the original point, NASA is not only the smallest agency, it is the only one to provide an actual dividend in terms of technology and education. Most of the research done for military is also eventually made available, and, once the direct costs of the manpower are removed, this is most of the remaining budget. It is much worse among some elements of the population. This kind of ignorance is a jaw-dropper to those who know the real numbers, but not really a surprise in terms of American public perception in general.
I recall reading that the general public also vastly exaggerates the amount spent on food stamps, as well as the percentage of minorities receiving welfare. Besides fundamental ignorance, a lot of this distortion could no doubt be blamed on inferences drawn from media and popular culture, especially the tendency to confuse the newsworthy, and therefore exceptional, with the typical. Not only that, but people tend to think that all NASA missions cost billions of dollars. This is not to say that NASA has an overly generous budget.
The DOE has for year a budget of Geological Survey is only currently at less than one billion annually. Considering how much service the public receives from each of these entities, the investment in their operations is positively miniscule. People have a hard time grasping large numbers, but not so hard grasping size ratios between different circles. This graph illustrates the size of NASAs budget quite nicely. NASA is nowhere near the smallest government agency. You go buy a new GB and run it along side. So basically every Not only could that same money be used for basic science, but it could also be used to fund the hell out of developing alternate energy sources, making war even less likely in the future.
I have kept Math Pure and Just like my Father before me. If you tell me you know the future, than go amuze yourself playing the lottery. I could say that when using 3,4,5 or 6 in an Ecliptical Module you better come to me with more than dreams. You better have all the facts or you will have no chance. You have everything you need minus patience. Fear not and come in peace and all will be revealed and you could be like The ONE.
Quit using up all you matter for next to none anti-matter. You will need it for positive progress. Come in peace with respect to my privacy and Thy Will Be Done. It was different when I was a kid. The recent Titan landing got about a day. Maybe they can study my natural resistance. Why spend money on NASA when all the secrets of the universe are laid out quite literally in the Bible? I was not thinking of our income as a nation from taxes.
Do you feel safer today than you did seven years ago? After what must be nearing a Trillion dollars, do you think the world is a better place?
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Pardon me, I must step out expose some unwanted babies and burn a witch or two before replying. Assuming, of course, that the plague does not carry me off before I return. Does anyone really think that an increase of half a percent will suddenly solve our problems on Earth? We need to go into space, both humans and machines. We cannot remain confined on this planet and hope to survive as a species. True, the steps we take today and in the immediate future are small ones. However, they will add up. The problem with space programs is that they are long term investments in a world that wants instant results.
However, before resources are committed, it is critically important to delineate and understand the architecture for donor-supported global initiatives in relation to mental health, including those currently targeted at mental health and those targeted at physical health or social development but whose efficiency would be strengthened if they also simultaneously addressed mental health.
Primary health care — now more than ever , which strongly reaffirmed the Alma Ata principles of primary health care, including equity, solidarity, social justice, universal access to services, multisectoral action, decentralisation and community participation as the basis for strengthening health systems. This is exactly what is needed for mental health, and there is an opportunity for a critical policy dialogue with the WHO to ensure that mental health is included in all these activities.
Mental health advocates also need to link with other sectors, health initiatives and programmes funded by the Global Fund to Fight AIDS, Tuberculosis and Malaria Global Fund , as these three diseases have a considerable burden of associated mental illness. For example, Zambia has successfully integrated mental health into Global Fund proposals for training of health staff, and Tanzania, Kenya, Uganda and Malawi have integrated mental health into general health service delivery utilising general health service budgets as set out in the national health sector strategic plans and annual operational plans.
These provide good examples of systematic implementation of mental health service delivery within highly resource-constrained environments. The contribution of better health goes well beyond the reduction of clinical symptoms and disability. While a renewed approach to mental health in the context of health sector reform is crucial, this needs to be complemented by a multisectoral and multilevel perspective on mental health, to ensure that factors which influence mental wellbeing and its relationship to physical well being, empowerment at family and community levels, livelihoods, workplace productivity, human security and the development of human, social and economic capital are effectively addressed.
An analysis recently explored for the UK in the Foresight project on mental capital and wellbeing shows the importance and benefits of a holistic approach to mental health. A societal perspective is not just an analytical point of view. It needs to be reflected in structures for planning and financing that can realise an integrative and synergistic role for mental health capacity and expertise across sectors. Appropriate financing, in line with burden, need and availability of effective interventions, should be allocated to mental health from government, multilateral and bilateral resources, including financing entities such as the Global Fund and philanthropic foundations, for example the mental health training programme for Kenya primary care staff funded by the UK-based Nuffield Trust.
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Governments respond to what they perceive to be the core priorities of donors, who need to more clearly communicate that given its burden, including increasing an increased risk of poor physical health, addressing mental illness should be a priority. The Paris and Accra principles of aid effectiveness commit donors to ensuring country ownership. Exceptions include Uganda, where despite some donor opposition, mental health was included in health policy 49 and in three Health Sector Strategic Plans. Significant health gains can be achieved by appropriate investment in mental health.
While the focus on demonstrating how improved mental health positively impacts on the MDGs globally, DFID and other donors should stress evidence-based policies that foster better prioritisation of mental health. Country counterparts should be empowered to develop evidence and arguments for the inclusion of mental health in their country health strategies.
It is important to learn lessons from targeted communicable disease programmes which have successfully raised large financing and effectively scaled up services for AIDS, tuberculosis and malaria to reach MDGs in many countries. For example, the Nuffield Trust-funded mental health-related continuing professional development of primary care workers in Kenya referred to above 40 , 54 is being delivered through the Kenya Medical Training College and the Ministry of Health. The training has a health and social welfare systems approach, with modules that integrate understanding of mental, child and reproductive health, malaria and HIV, health system issues such as health information systems, working with community health workers and traditional healers and annual operational planning.
Introduction
This is an important lever, which has been effectively used in Western countries, where legal advice is accessible and affordable and where governments have resources to improve services and expand access to mental health services. However, in low- and middle-income countries the effectiveness of the human rights approach in expanding access to mental health services is less evident, partly because of a relative lack of resources and in some countries less democratic systems. Further, in Western countries the human rights and mental health movement has focused on ending the inhumane incarceration of mentally ill patients in large institutions for long periods of time: Hence there is a difference in the focus of mental health rights activists in high- and middle-income countries and those in low-income countries, unlike other advocacy movements such as those for AIDS, which has clearly benefited from north—south partnerships.
Mental health legislation has an important role to play in clearly articulating human rights issues to governments and populations, especially if a person has to be admitted or treated against their will. However, mental health legislation is only effective if successfully implemented: For example, Kenya still lacks a code of practice for the Mental Health Act, and the police are still operating according to the Act because their statutes and training have not been updated.
Thus the human rights approach can only have an impact if there is major funding for training staff and developing a code of practice that can be implemented. In many of the SSA countries mental health legislation is old, with most dating back to the late s or early s. Even when new mental health legislation is enacted, implementation, as in Kenya, is likely to be slow until good practice guidelines are developed and used by the relevant sectors health, social welfare, police and prisons , with professional training to ensure appropriate implementation.
New and additional resources will be needed from both domestic and external sources. Donors have an important role to play in encouraging the adoption of good human rights practices; this has been the case with some European Commission-funded programmes. In this regard, possible roles that donors can play include placing mental health at the heart of their policy dialogues with countries and integrating mental health with health system strengthening, health management information systems, communicable diseases and NCDs; as well as education, social protection and criminal justice strengthening.
Donors can make it clear to governments that they regard mental health an equivalent priority to the major communicable and other non-communicable diseases, stressing the inextricable links amongst these conditions that affect individuals. In addition, donors can place mental health at heart of dialogue about health systems strengthening, to ensure mental health is integrated into primary care and that any human resource strategy includes attention to psychiatric nurses, who are the mainstay of specialist mental health service delivery in Africa; and last but not least donors can explore how the international overseas aid community can help in the development of research capacity for mental health.
We discuss the social and economic challenges to mental health, highlighting implementation issues at country level as well as on the global development agenda, demonstrating the obvious gaps in the global funding architecture for mental illness. Our analysis shows the clear need to provide increased international financing to address growing mental illness in low- and middle-income countries, and to integrate mental health into general health policy and the essential healthcare package at all levels of the health sector, especially at primary care level, to develop a holistic and client-centred approach to health care and to help better achieve MDGs.
Such an integrated approach will ensure mental health has a budget line and will also allow entry points for mental health into other budgets and initiatives e. Integration into the non-health sectors, especially education, social welfare, employment, social, agricultural and business development and the criminal justice system is also essential.
Developing partnerships and effective use of existing financial and human resources holds the key to the development of sustainable mental health care for the general population.
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The mental health sector needs to form partnerships, underpinned by collaborative training, research and mutual dialogue, with other health and non-health sectors to enhance the use of wider budgets and initiatives for mental health. The next article in this series will examine international and national policy challenges to the inclusion of mental health in the global development agenda. National Center for Biotechnology Information , U.
Ment Health Fam Med. Author information Article notes Copyright and License information Disclaimer. This article has been cited by other articles in PMC. Introduction This is the second in our series of four articles about mental health and the global agenda. Mental health, poverty and debt Mental disorders impose a significant economic burden, not just on the individuals with the disorders but also on households, communities, employers, healthcare systems and government budgets.
The need for more health economics research on the cost-effectiveness of actions to address mental illness In spite of the high burden of disease or poor socio-economic outcomes caused by mental illness 17—19 policy makers have not appropriately prioritised investments in mental health in primary care, specialist care or in non-health sectors. Implementation of policy and practice We have highlighted the health, social and economic impacts of poor mental health, and also reflected on the need for more focus on economic research to help make the case for investment in mental health.
The need for strategic dialogue around public policy and its implementation To date, three main approaches have been used to improve mental health in low- and middle-income countries. A need to use national mechanisms for scaling up mental health services At country level, in order to establish a well-functioning mental health system for a country, mental health needs to be systematically integrated into core planning documents for the country as a whole, including not only planning for the health system, but ideally also for the other sectors.
The need for more funding for systematic delivery of decentralised mental health care Improved governance structures for mental health and better coordination between different actors at a national level, while critical, does not negate the need to shift funding so that it can help promote a more decentralised, primary care-led approach to mental health. What is role of health professionals in scaling up mental health services in primary care? Need for an improved global architecture for mental health Despite compelling evidence on the adverse personal, social and economic impacts of mental illness and the potential benefits that could be gained from readily available cost-effective interventions, appropriate attention to mental health and mental disorders appears to be lacking in most low-income country contexts.
Need to strengthen the links between mental health and social development The contribution of better health goes well beyond the reduction of clinical symptoms and disability. The need to address asymmetry between donor and government priorities Governments respond to what they perceive to be the core priorities of donors, who need to more clearly communicate that given its burden, including increasing an increased risk of poor physical health, addressing mental illness should be a priority. Human rights as a lever for mental health policy and implementation This is an important lever, which has been effectively used in Western countries, where legal advice is accessible and affordable and where governments have resources to improve services and expand access to mental health services.
Conclusions We discuss the social and economic challenges to mental health, highlighting implementation issues at country level as well as on the global development agenda, demonstrating the obvious gaps in the global funding architecture for mental illness. Mental health and the global agenda: Mental Health in Family Medicine ; 8: International and national policy challenges in mental health.
Health system challenges and solutions to improving mental health outcomes. The Government Office for Science, Shah A, Jenkins R. Mental health economic studies from developing countries reviewed in the context of those from developed countries.
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