Worldwide, mental illness devastates individuals, families and communities, and is a growing global public health challenge. Three-quarters of all people suffering from mental illness live in low- and middle-income countries with fewer than one in 50 people with severe mental illnesses in these countries receiving evidence-based treatment.13
Access to care is complicated by several challenges, such as insufficient data on the burden of mental illness; the lack of trained healthcare providers; inconsistent access to care and affordable, quality medicines; and strong social stigma associated with mental illness. Treating severe mental illness, including schizophrenia, represents a significant investment for the healthcare system.
With more than 60 years of supporting those affected by mental illness, Johnson & Johnson is committed to expanding access to transformational mental health innovations to positively impact people’s lives. In August 2018, Johnson & Johnson announced a comprehensive partnership with the Rwanda Ministry of Health to strengthen and expand access to quality mental healthcare in the country. Over the past 25 years, Rwanda has made significant progress in this field. Together, we aim to transform mental healthcare in the country through a series of innovative collaborations, demonstrating that it is possible to apply an affordable, sustainable and scalable quality care model for the treatment of severe mental illness, specifically schizophrenia, in low- and middle-income countries.
As part of this effort, we are:
- Supporting the first-ever government-initiated national mental health survey to better understand the prevalence and burden of mental health disorders in low-resource settings and further inform policy, budgets and healthcare provider resourcing for the delivery of high-quality mental healthcare.
- Accelerating access to innovative schizophrenia medicines, including undertaking a clinical study to determine the value and impact of introducing long-acting injectable treatments (paliperidone palmitate).
- Enabling Partners in Health through a three-year Johnson & Johnson Foundation grant to expand and scale up their innovative Mentoring and Enhanced Supervision at Health Centers (MESH) model for mental health in two additional districts in Rwanda. The MESH model integrates mental healthcare into a community-based healthcare setting, increasing the number of trained mental healthcare workers and facilitating patient access to quality care within the communities where they live.
- Supporting the Centre for Global Mental Health, co-hosted by the London School of Hygiene & Tropical Medicine and King’s College London, to assist the development of a new generation of mental healthcare professionals on the front lines of care in communities throughout Africa and other parts of the world.
This is the first systematic effort to integrate mental healthcare into the public primary healthcare system in Rwanda. Through this innovative work, we aspire to change the trajectory of mental health treatment and care in sub-Saharan Africa and beyond.
The Ministry of Health believes this partnership comes in due time as addressing severe mental illness is one of our priority areas in order to ensure equitable access to mental health services for those in need.
The stigma of mental illness
As a way of continuing Dr. Paul Janssen's legacy of championing science for humanity, in 2018 we launched a new initiative, The Art & Science of Ending Stigma About Mental Illness, with the mission to reduce cultural stigma of mental illness and increase awareness of the biological basis of brain disorders. The program combines the transcendent nature of art in its many forms with the rationality of science to engage the public in understanding mental illness and how we can work together to conquer stigma.
We are bringing mental health to the attention of the world and we’re committed to advancing innovation and access and destigmatizing mental health.
New for treatment-resistant depression
In 2018, Janssen submitted a New Drug Application to U.S. Food and Drug Administration (FDA) and a Marketing Authorization Application to the European Medicines Agency seeking approval of esketamine nasal spray for treatment-resistant depression (TRD) in adults. In March 2019, the U.S. FDA-approved SPRAVATO (esketamine) CIII nasal spray for adults with TRD who have cycled through multiple treatments without relief. SPRAVATO uses the first new mechanism of action in decades to treat major depressive disorder.14 15 16 Esketamine has U.S. FDA Breakthrough Therapy Designations for treatment-resistant depression and for a second indication, major depressive disorder with imminent risk for suicide, which is currently in clinical development.
New for schizophrenia
In 2018, the U.S. FDA approved an expansion to the U.S. Prescribing Information for our treatment (paliperidone palmitate) to include real-world data demonstrating its superior effectiveness for adults living with schizophrenia in delaying time to relapse versus commonly prescribed oral antipsychotics. This marks an important milestone in our work to serve the needs of our mental health community, and enables us to engage healthcare professionals with clear evidence of how our medicine performs in the patients they are likely to see every day in clinical practice.