Cognitive enhancement interventions are effective for schizophrenia: why not provide them early?

World Psychiatry 22:2 June 2023 youth and adults with mental health conditions or intellectual disabilities face among the highest rates of stigma and exclusion. Yet, the SDG monitoring process has collected little data on access to quality education for children with disabilities overall, and even less on the experience of children with mental health conditions. Meanwhile, data available from other sources suggest that we have far to go: our study of policies in 193 countries found that over onethird fail to even guarantee integrated education along with individualized supports for children with disabilities, and much less specifically address the needs of children with mental health conditions. Regarding employment, the SDG indicators require tracking average wages and unemployment rates for workers with disabilities, but data are currently only available for the latter; similarly, though indicator 10.2.1 calls for data on income inequality by disability, measures are currently unavailable. Moreover, there are no specific efforts to monitor improvements in inclusive employment for people with mental health conditions. Again, these gaps are concerning, given other research indicating that many countries fall short: our center’s data show that, as of 2021, only 46% of countries worldwide explicitly guaranteed reasonable accommodations for workers with mental and/or in tellectual disabilities. It is not too late for the SDGs to provide an opportunity for accelerating progress in preventing poor mental health, treating mental health conditions, and improving the quality of life of people living with mental health conditions. To do that, however, we need to measure annually not only the suicide mortality rate, but also comprehensive coverage of mental health services in national health systems; the density of the mental health care workforce; the accessibility of essential mental health therapeutics; and the extent to which countries are ensuring the full inclusion of people with mental health conditions in education and employment. Only by specifically prioritizing and tracking progress for mental health prevention, treatment and equal rights can we create a world where meeting mental health needs is not an afterthought, where explicit and implicit discrimination is eliminated, and where all people can lead full and healthy lives.