One in four people will require mental health care at some point in their lives but in many countries only two per cent of all health sector resources are invested in mental health services.

Average global spending on mental health is still less than US$ 3 per capita per year. In low income countries, expenditure can be as little as US$0.25 per person per year, according to the WHO's Mental Health Atlas 2011, released on World Mental Health Day.

The report also finds that the bulk of those resources are often spent on services that serve relatively few people.

"Governments tend to spend most of their scarce mental health resources on long-term care at psychiatric hospitals," says Dr Ala Alwan, Assistant Director-General of Noncommunicable Diseases and Mental Health at WHO. "Today, nearly 70 per cent of mental health spending goes to mental institutions. If countries spent more at the primary care level, they would be able to reach more people, and start to address problems early enough to reduce the need for expensive hospital care."

The Atlas highlights other imbalances. Good mental health services focus equally on providing patients with a combination of medicines and psychosocial care. In lower income countries, however, shortages of resources and skills often result in patients only being treated with medicines. The lack of psychosocial care reduces the effectiveness of the treatment.

Meanwhile, many people have no access to mental health services at all. Across the low-and middle-income group of countries, more than three quarters of people needing mental health care do not even receive the most basic mental health services.

"Almost half of the world's population lives in a country where, on average, there is one psychiatrist (or less) to serve 200 000 people, says Dr Shekhar Saxena, Director, Mental Health and Substance Abuse at WHO. "Many low-income countries have less than one mental health specialist per one million population."

In 2008, WHO launched its mental health Gap Action Programme (mhGAP) to assist countries to scale up services for mental, neurological and substance use disorders. The programme provides knowledge and skills to primary health care providers such as general doctors, nurses and health care workers to identify and manage these disorders.