WHO stresses the urgent need for mental health and mental health care reform

WHO stresses the urgent need for mental health and mental health care reform

A new report, calls on policymakers and mental health advocates to take action to change attitudes, policies and approaches to mental health, its determinants, and care.

The World Health Organization today released the most comprehensive review of global mental health since the early 2000s. This comprehensive work is a guide for governments, researchers, health workers, civil society, and others with the ambitious goal of improving mental health worldwide.

In 2019, nearly one billion people-including 14 percent of the world's youth-were living with a mental disorder. More than one in 100 deaths are due to suicide, and 58 percent of these deaths occurred before age 50. Mental disorders are the leading cause of disability, responsible for one out of every six years of disabled life. People with severe mental disorders live 10-20 years less than the general population, often due to preventable physical illness. The main causes of depression are childhood sexual abuse and bullying. Social and economic inequalities, health emergencies, war, and the climate crisis are among the global structural threats to mental health. Depression and anxiety increased by more than 25 percent in the first year of the pandemic alone.

Worldwide, stigma, discrimination against people with mental health problems, and violations of their human rights are widespread in communities and health systems. In all countries, the poorest and most disadvantaged people in society are at greater risk of mental disorders and are also less likely to receive adequate services.

Even before the COVID 19 pandemic, only a small percentage of people in need had access to effective, affordable, and quality mental health care. For example, 71% of people with psychosis worldwide do not receive mental health care. While 70% of people with psychosis receive treatment in high-income countries, only 12% receive mental health care in low-income countries. In the case of depression, there are large differences in care between countries: even in high-income countries, only one-third of people with depression receive formal mental health care, and the minimum requirement for depression treatment is estimated to range from 23% in high-income countries to 3% in low- and middle-income countries.

Based on the latest available data, examples of best practices, and people's experiences, this comprehensive WHO report shows why and where change is most needed and how best to achieve it. It calls on all stakeholders to work together to raise awareness and call attention to reforming the environment that affects mental health and strengthening mental health systems.

Tedros Adhanom Ghebreyesus, WHO Director-General, said, "Everyone is close to someone with mental health problems in their life. Good mental health leads to good physical health, and this new report is a strong call for change. Because mental health is inextricably linked to public health, human rights, and socioeconomic development, changing mental health policies and practices can bring real and meaningful benefits to individuals, communities, and countries around the world. Investing in mental health means investing in a better life and a better future for all."

All 194 WHO member states have adopted the Global Plan of Action for Mental Health 2013-2030 and committed to global targets for mental health transformation. Over the past decade, progress at the local level shows that change is possible. But change is not happening fast enough, and mental health remains a story of scarcity and neglect: of the low public spending on mental health, two out of every three dollars go to individual mental health institutions, rather than to community-based mental health services that are closer to people. For decades, mental health has been one of the most neglected areas of public health, receiving only a fraction of the attention and resources it needs and deserves.

Devora Kestel, head of WHO's mental health and substance use section, called for change: "Every country has a great opportunity to make significant progress toward improving the mental health of its population. The many examples in this report show that policy changes can make a big difference, whether it is developing stronger mental health policies and laws, integrating mental health into health insurance systems, creating or strengthening community mental health services, or introducing mental health into public health services, schools and prisons."

The report calls on all countries to implement the Global Mental Health Action Plan 2013-2020. It makes a series of recommendations for action, grouped into three "pathways to transformation" aimed at changing attitudes toward mental health, addressing mental health risks, and strengthening mental health systems.

1. Increase visibility and attention to mental health. For example.

Increase investment in mental health, not only by ensuring adequate funding and staffing in the health sector and other sectors to meet mental health needs, but also by engaging leadership, implementing evidence-based policies and practices, and establishing robust reporting and monitoring systems.

Include people with mental health problems in all aspects of society and decision-making to eliminate stigma and discrimination, reduce inequalities, and promote social justice.

2 Transform environments that affect mental health, including homes, communities, schools, workplaces, health services, and the physical environment. For example.

Intensify cross-sectoral efforts, including by understanding the social and structural determinants of mental health and taking steps to reduce risk, build resilience, and remove barriers that prevent people with mental disorders from fully participating in society.

Implement concrete measures to improve mental health conditions, including stepping up action against domestic violence and the abuse and neglect of children and the elderly, promoting flexible child development assistance and introducing livelihood support for people with mental health problems, introducing social and psychological education programs, addressing bullying in schools, changing attitudes, and strengthening the right to mental health.

3 Strengthen mental health care by changing where, how, by whom and for whom mental health care is provided.

Create community networks of interconnected services that go beyond safe care in psychiatric hospitals and cover a wide range of care and support through a combination of mental health services integrated into general health care, community mental health services, and non-mental health services.

Diversify and expand care options for common mental health problems such as depression and anxiety, as the cost-benefit ratio is five to one. This includes adopting a task-sharing approach that extends evidence-based care to care also provided by primary care physicians and community health providers. Digital technologies should also be used to support guided and unguided self-help and to provide remote care.