Introduction
This week in the UK there has been a focus on public investment in health, with the announcement of £5bn for health research in the 2021 Autumn budget.1 However, this is only part of the picture: the pharmaceutical industry makes a significant contribution to health, particularly with regards to research and innovation.2 With this in mind, there has been a concerning trend in the context of mental health.
In middle- and high- income countries, over 50% of adults will be affected by at least one mental health condition across their lives.3 Yet in the last 10 years, pharmaceutical companies have cut research into psychiatric medicine by 70%.4 This raises the question, are pharmaceutical companies underinvesting in mental health?
The Current Treatment Landscape
In the late 1980s and 1990s, SSRIs (selective serotonin re-uptake inhibitors, which are commonly used in the treatment of mental health conditions), such as Prozac, reached the market.4 The arrival of these medications altered the landscape of mental health treatment. However, since then, pharmaceutical companies’ investment in psychiatry has declined, despite the global pharmaceutical industry committing more than a trillion dollars to research and development over the last 10 years.5
This decline can partly be attributed to the cost of clinical trials: while SSRIs have proved to be both clinically effective6 and highly lucrative for the pharmaceutical industry, it has been argued that there is little incentive to make the necessary investment to develop alternatives. While understanding and public awareness of mental health has continued to grow over this time, there is a need to invest in research and development to match this knowledge.3
However, with the wide availability of current treatments and a growing appreciation for a more holistic treatment approach to mental health, is more investment in mental health necessary?
Research has shown that current mental health treatments can be unsatisfactory for many patients, only working partially if at all, or coming with an array of side effects.7 Additionally, World Economic Forum research by the Harvard School of public health found that by 2030, the global cost of mental health conditions is likely to reach $6 trillion,5 highlighting the widespread prevalence of mental health disorders and the need for investment in this field to develop new treatments.
Some hold the idea that mental health is too complicated in comparison to physical health disorders to warrant investment and research.8 Yet, perhaps, if similar science, research and investment were applied to the field of mental health that it is currently done for physical health, it would start to reap the same rewards and advances.
Future Hope?
There are reasons for optimism. There is increasing recognition of the gap in mental health treatments which is generating research into potentially exciting new therapies. Clinical research is looking into both the aetiology and pathophysiology of mental health conditions to inform the development of new drugs and treatments.5 Beyond this, there is creativity being displayed by pharmaceutical companies as they research and trial various digital and technology-based approaches to address patients’ needs. For example, Takeda have partnered with Cognition Kits to create a wearable piece of technology that syncs with an app to monitor patients with Manic Depressive Disorder (MDD).9 Additionally, Otsuka are exploring the use of a digital sensor in a pill to improve schizophrenia treatment compliance.9
Furthermore, there is growing investment and interest in the use of novel treatments, for example using psychedelics for the treatment of a wide range of mental health disorders, from depression to alcohol use disorder.7 This combination of new clinical research, the application of technology, as well as new medications, could revolutionise patient care from drug discovery to delivery.
Innovation in Treatment, Innovation in Med Comms
With the current economic global burden of mental health surpassing all other health conditions,3 it is more important than ever that pharmaceutical companies invest in and apply innovative thinking to the realm of mental health. A committed and innovative approach will also need to be combined with robust medical communication campaigns. With creativity in both development and communication, there is the potential to once again re-shape the mental health treatment landscape.
By Sinead Smith
