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Mental disorders have high aggregate prevalence, are responsible globally for nearly a quarter of all years lived with disability, and represent the largest cause of lost economic output among all classes of noncommunicable disease worldwide. Cost-effective treatments, including both generic drugs and brief, manualized cognitive therapies are available to address this burden. Nonetheless, treatment of mental disorders remains a low priority worldwide-disproportionately so in low- and middle-income countries. Here, I focus on possible reasons for the failure of policy-makers to respond effectively, and I suggest corrective approaches.