Despite growing awareness, mental health remains marginalized in global health systems. Around the world, services in this area continue to be significantly underfunded, with substantial shortcomings in both accessibility and quality: As many as 90% of individuals with severe mental health conditions receive no treatment in some countries. Although this is true across the world, the problem is especially aggravated for treatment regimens that require tight monitoring in low-resource and hard-to-reach settings. “If we truly stand by the principle of leaving no one behind, then access to mental health treatment must extend to everyone, everywhere, regardless of their circumstances,” Lena Wahlhed, director for alliance development at HemoCue, told Devex.
The key to more inclusive mental health treatment may lie with an improvement in diagnostics. “Having access to an easy-to-use blood test using a hemoglobin system can make screening easier and more accessible,” Lena explained.
Portable, point-of-care diagnostic tools (used at or near the site of patient care), like HemoCue’s blood testing technologies, could help health workers better monitor patients and identify at-risk individuals sooner — even in low-resource or custodial settings such as prisons, where diagnosis and treatment are scarce and incidence rates are high. A global meta-analysis found that 1 in 7 people in prison suffers from a severe mental illness, with rates of depression and psychosis significantly more prevalent than in the general population. Without early diagnosis, these conditions can worsen, contributing to self-harm, repeat incarceration, and even suicide.
As countries prepare for World Expo 2025 in Osaka — set to spotlight global health — Wahlhed said it’s time for global health systems to make mental health diagnostics more accessible across all communities.
This conversation has been edited for length and clarity.
At the World Expo 2025 in Osaka this month, HemoCue will spotlight the intersection between diagnostics and mental health. Why has HemoCue decided to engage more directly in the mental health conversation, and why now — particularly as mental health becomes more central to global noncommunicable disease, or NCD, discussions?
We’ve always focused on meeting existing needs rather than creating them, and we align our offerings with what makes clinical sense. When it comes to mental health, it is such an important area that remains very stigmatized. It may be less known that anemia is related to mental health issues such as depression and anxiety — and is important to act on in this context.
For patients with more complex diagnoses, such as schizophrenia, especially those who are resistant to general treatment options, certain medications like Clozapine can be effective. However, Clozapine requires close monitoring of white blood cell counts due to the potential side effect — while small — of agranulocytosis, a fast and significant drop of neutrophils [a type of white blood cell] in the blood.
Point-of-care devices allow patients with schizophrenia to begin treatment and be monitored in the comfort of their own space. We have seen a customer who has a patient who would only allow one person [to care for him], and treatment was only possible close to him. So we are proud that we can actually do so with the device that we have.
Why is HemoCue focusing on Clozapine treatment for Schizophrenia, and what gap is the company hoping to fill?
The main gap has been access to testing at the point of care. Usually, you need to take a venous specimen, send it to the laboratory, and then wait for the result to come back. This is especially important for Clozapine patients, who require weekly blood tests for [at least] the first 26 weeks, then biweekly, and eventually monthly for as long as treatment continues.
Many patients dislike repeated venous sampling and cite it as a reason for refusing or discontinuing treatment. It also places logistical demands on clinicians, which can deter them from prescribing Clozapine in the first place. That's why we need to have the convenience and the closeness to the patient available. With a portable system that is easy to use, like our WBC DIFF System, point-of-care testing with capillary samples can now happen closer to the patient.
There’s growing evidence linking anemia to mental health conditions such as depression and anxiety. One study found that nearly 28.6% of people with untreated anemia experience depression, compared to just 14.4% of those without anemia. The link is bidirectional — deficiencies in nutrients impact the brain and nervous system functioning, affecting the appearance of depressive symptoms, while studies have found depression can disrupt nutrition and iron absorption. Girls and women face higher rates of both anxiety and depression. How can diagnostics become a more effective entry point for holistic female health care?
Female care needs to be looked at throughout the lifetime. In young women, malnutrition — whether from lack of access to nutritious food or body image pressures — can lead to depression and anxiety. Iron deficiency anemia, in particular, is linked to higher rates of depression in young women. And if you have these symptoms of being depressed or having anxiety, just reaching out to a health care professional takes a lot, and then they also need to wait for the result. Each additional barrier can make access harder.
What is the impact of point-of-care diagnostics in mental health treatment? What does a more integrated, proactive approach to mental health look like?
Point-of-care diagnostics can have a major impact on mental health treatment by removing key barriers to care. Tools such as the WHO Essential Diagnostics List help define what should be available, especially in primary care settings without lab access — tests [for] hemoglobin, white blood cell count, glucose, and HbA1c.
When I go to my own primary care site here in Sweden, these are exactly the tests they have. They’re essential because they can be a sign that something more serious needs to be acted on. The same applies to mental health —- [early detection and continuous monitoring] can have a considerable impact on daily life for that person or that person's family. So whatever can be done at the point of contact with a clinician or nurse can make a real difference.
As global attention turns toward the United Nations High-Level Meeting on NCDs and mental health — with the Zero Draft of the political declaration recently published — what concrete feedback or call to action would you offer to ensure diagnostics are part of the solution in the global mental health response?
Mental health deserves the same attention and actions as other health issues — it needs to be brought to the forefront because it has such grave implications. There are easy point-of-care diagnostics that can be used in psychiatric settings by psychologists and psychiatrists [to improve patient outcomes].
It's my understanding that people within the justice system may also benefit from the availability of these tools. It may support the person, but also those working in these institutions. It's also something that could benefit from a cost efficiency point of view, as it may be more efficient to have [point-of-care] diagnostics on hand, rather than [arranging] for transport to care. Whether in rural or urban settings, poor to rich, diagnostics make a huge impact in every aspect around the world — whoever or wherever you are. Mental health is a human right, and HemoCue will continue to advocate and advance care for those who suffer and [support] health care staff.
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