The role of global vulnerability for mental and substance use disorders.

Social exclusion and poverty are associated with increased mental health issues. In addition, the current political and civil conflicts worldwide are also considered as leading factors to mental disorders and substance use disorders. The Compassion, Assertive action, Pragmatism and Evidence (CAPE) index comprises nine country-level measures and highlights the need for assistance in countries with a high degree of vulnerability. Several findings from previous studies reported a broad relationship between CAPE indices and increased levels of mental disorders and substance use. In this paper, we identified the prevalence of mental disorders and substance use disorders among those countries reporting higher (i.e., highest CAPE Index scores) as well as lower (i.e., highest Quality of Life Index scores) vulnerability. We extracted prevalence data from the Institute for Health Metrics and Evaluation global database in 2019. There was a lower prevalence of mental (12.5%) and substance use (1.7%) disorders in highly vulnerable countries than less vulnerable ones (15.1% and 3.5%, respectively). These findings suggest an urgent need for early detection of mental and substance use disorders in vulnerable countries: increasing mental health literacy among non-specialized health professionals in these regions may greatly improve the level of detection and treatment.