Transform Commitment to Mental Health

Homeless Adults Exposed to More Trauma

As the countries dedicate less than two per cent of their health care budgets to mental health, the World Health Organisation has called on governments to deepen the value and commitment given to mental health.

In its largest review released on Friday (June 17, 2002), the World Health Organization provides a blueprint for governments, academics, health professionals, civil society and others with an ambition to support the world in transforming mental health.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said, “Everyone’s life touches someone with a mental health condition. Good mental health translates to good physical health and this new report makes a compelling case for change. The inextricable links between mental health and public health, human rights and socioeconomic development mean that transforming policy and practice in mental health can deliver real, substantive benefits for individuals, communities and countries everywhere, Investment into mental health is an investment into a better life and future for all.”

THE THREATS

Although most people are remarkably resilient, people who are exposed to unfavourable circumstances – including poverty, violence and inequality – are at higher risk of experiencing mental health conditions. Risks can manifest themselves at all stages of life, but those that occur during developmentally sensitive periods, especially early childhood, are particularly detrimental, the report said.

Pointing out that mental health risks and protective factors can be found in society at different scales, the report said that local threats heighten risk for individuals, families and communities, Global threats heighten risk for whole populations and can slow worldwide progress towards improved well-being. In this context, key threats today include: economic downtums and social polarization: public health emergencies; widespread humanitarian emergencies and forced displacement, and the growing climate crisis.

The WHO said that COVID-19 pandemic also created a global crisis for mental health, fuelling short- and long-term stresses and undermining the mental health of millions. Meanwhile, WHOs Mental Health and Substance Use Department Director Dévora Kestel, called for change: “Every country has ample opportunity to make meaningful progress towards better mental health for its population. Whether developing stronger mental health policies and laws, covering mental health in insurance scheme, developing or strengthening community mental health services or integrating mental health into general health care, schools, and prisons, the many examples in this report show that the strategic changes can make a big difference.”

RESPONSES INSUFFICIENT AND INADEQUATE

The report said that about one in eight people in the world live with a mental disorder and the economic consequences of mental health conditions are enormous. Productivity losses and other indirect costs to society often far outstrip health care costs. Economically, schizophrenia is the most costly mental disorder per person to society. Depressive and anxiety disorders are much less costly per person; but they are more prevalent, and so majorly contribute to overall national costs.

The WHO in the review stated that countries dedicate less than two per cent of their health care budgets to mental health. More than 70% of mental health expenditure in middle-income countries still goes towards psychiatric hospitals. Around half the world’s population live in countries where there is just one psychiatrist to serve 200 000 or more people, it said.

The WHO stated that poor quality of services, low levels of health literacy in mental health, and stigma and discrimination often stopped people from seeking help for mental health conditions,

HIGHLIGHTS

Drawing on the latest evidence available, showcasing examples of good practice, and voicing people’s lived experience, WHO’s comprehensive report highlights why and where change is most needed and how it can best be achieved. It calls on all stakeholders to work together to deepen the value and commitment given to mental health, reshape the environments that influence mental health and strengthen the systems that care for people’s mental health.

The report urges all countries to accelerate their implementation of the Comprehensive mental health action plan 2013-2030. It makes several recommendations for action which are grouped into three paths to transformation that focus on shifting attitudes to mental health, addressing risks to mental health and strengthening systems of care for mental health. They are:

1. Deepen the value and commitment we give to mental health. For example

Stepping up investments in mental health, not just by securing appropriate funds and human resources across health and other sectors to meet mental health needs, but also through committed leadership, pursuing evidence-based policies and practice, and establishing robust information and monitoring systems.

2. Including people with mental health conditions in all aspects of society and decision-making to overcome stigma and discrimination, reduce dispanties and promote social Justice

3. Reshape environments that influence mental health, including homes, communities, schools, workplaces, health care services, natural environments. For example: intensifying engagement across sectors, including to understand the social and structural determinants of mental health and intervening in ways that reduce risks, build resilience and dismantle barriers that stop people with mental health conditions participating fully in society.

4. Implementing concrete actions to improve environments for mental health such as stepping up action against intimate partner violence and abuse and neglect of children and older people; enabling nurturing care for early childhood development, making available livelihood support for people with mental health conditions, introducing social and emotional learning programmes while countering bullying in schools, shifting attitudes and strengthen rights in mental health care, increasing access to green spaces, and banning highly hazardous pesticides that are associated with one fifth of all suicides in the world.

5. Strengthen mental health care by changing where, how, and by whom mental health care is delivered and received. Building community-based networks of interconnected services that move away from custodial care in psychiatric hospitals and cover a spectrum of care and support through a combination of mental health services that are integrated in general health care; community mental health services, and services beyond the health sector.

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