Prof Martin Knapp

This course is available on the MSc in Global Health Policy, MSc in International Health Policy and MSc in International Health Policy (Health Economics). This course is available as an outside option to students on other programmes where regulations permit.

The proposed course should appeal to students interested in the challenges of, and policy responses to mental illness across a wide range of societies and economies. 

Priority will be given to students from the Health Policy Department.

Students are required to have some knowledge of health systems or mental health issues. 

The course will consider how public policy can be shaped to address the personal, social and economic challenges posed by mental illnesses, across the life-course. Mental health will be considered in various contexts: high-, medium- and low-income settings. An important emphasis will be on the global nature of the challenges, and the need to find responses that have relevance across different societies.

The strong associations with disadvantage will be a theme running through the course, linked to social determinants of health. Key areas of policy-making will be covered: e.g. evaluating effectiveness, cost-effectiveness and viability of treatments, and social impacts of prevention and interventions in different contexts and life-stages.

Students will discuss issues and strategies on how public policy (not just health policy) can play crucial roles in prevention and risk-reduction, access to and funding of treatments, recovery and re-integration, social and economic inclusion. In addition to coursework, students will have the opportunity, if they wish, to link with an ongoing mental health-related research project in the Department of Health Policy. (This will not be compulsory, and students who do not make such links will not be disadvantaged.) Students may wish to use this as a platform for their group-based summative assessment (see below).

Course outline (by week)

1. What is mental illness? Cultural, clinical and other interpretations and definitions; prevalence; incidence; disability; consequences across the life-course for individuals, families, societies (including subgroups with different risks, such as migrants, LGBTQ+, those experiencing natural or other disasters) and economies (broad introduction); links to broader concepts of wellbeing.

2. Responses? History of responses to mental illness (across a range of sectors); stigma; discrimination; help-seeking and treatment; institutionalisation; bi-directional implications (e.g. links to economic disadvantage, social marginalisation, crime, physical health, mental health comorbidities). The survival movement; interpretations of recovery.

3. Mental health in low- and middle-income settings: particular challenges in those contexts, although these issues will feature in all later topics too.

4. Perinatal mental health: meaning; risk and protective factors; interventions; policy challenges and responses.

5. Child and adolescent mental wellbeing: meaning; risk and protective factors; interventions; policy challenges and responses.

6. Adult mental health (including addictions and workplace issues): meaning; risk and protective factors; interventions; policy challenges and responses.

7. Old age mental health (especially dementia): meaning; risk and protective factors; interventions; policy challenges and responses.

8. Financing responses to mental illness, including issues of parity

9. Making mental health policy and legislation: contributions from a policy-maker and someone with lived experience of mental illness. 

10. Enduring lessons for mental health policy: bringing the strands together.

10 hours of lectures, 10 hours of seminars and 2 hours of help sessions in the LT.

Students will be expected to produce 1 essay in the LT (of up to 1500 words) during the course, which could be linked to the topic of their group-based project.

• Knapp M, Iemmi V (2016) Mental health. In Scheffler R (ed.) Global Handbook of Health Economics. World Scientific Press.
• Livingston G, Sommerld A, Orgeta V et al (2017) Dementia prevention, intervention and care (Lancet Commission). Lancet 390(10113):2673-2734.
• Lund C, De Silva M, Plagerson S et al. (2011) Poverty and mental disorders: breaking the cycle in low‐income and middle‐income countries. The Lancet 378(9801):1502‐1514.
• McDaid D, Park A, Knapp M (2017) Commissioning Cost-Effective Services for Promotion of Mental Health and Wellbeing and Prevention of Mental Ill-Health. London: Public Health England.
• Mental Health Task Force (2016) The Five Year Forward View for Mental Health. NHS England.
• Patel V, Saxena S, Lund C et al (2018) The Lancet Commission on global mental health and sustainable development. Lancet 392(10157):1553-1598.
• Prince M, Patel V, Saxena S et al (2007) No health without mental health. Lancet 370(9590):859-877.
• Saxena S, Thornicroft G, Knapp M, Whiteford H (2007) Resources for mental health: scarcity, inequity and inefficiency. The Lancet 370(9590):878-889.
• Slade M, Amering M, Farkas M et al (2014) Uses and abuses of recovery: implementing recovery-oriented practices in mental health systems. World Psychiatry, 13:12-20.
• Thornicroft G (2006) Shunned: Discrimination Against People with Mental Illness. Oxford.

Project (100%, 3000 words) in the ST.