The WHO report highlights the global lack of investment in mental health

The World Health Organization’s new Mental Health Atlas provides a disappointing picture of the global failure to provide people with the necessary mental health services, at a time when the COVID-19 pandemic highlights the growing need to support mental health.

The latest edition of the Atlas, which includes data from 171 countries, provides a clear indication that the increased attention paid to mental health in recent years has not yet resulted in an increase in the quality of needs-oriented mental services.

The biennial atlas is a collection of data provided by countries around the world on mental health policies, legislation, funding, human resources, availability and use of services, and data collection systems. It is also a mechanism for monitoring progress towards the goals of the WHO Comprehensive Mental Health Action Plan.

“It is extremely worrying that, despite the evident and growing need for mental health services, which became even more acute during the COVID-19 pandemic, good intentions are not being met by investment,” said Dr. Tedros Adhanom Ghebreyesus, Director General of the World Health Organization. “We need to heed this call to wake up and act on it and dramatically accelerate the increase in investment in mental health, because there is no health without mental health.”

Lack of progress in leadership, management and funding

None of the goals for effective mental health leadership and management, the provision of mental health services in community settings, the promotion and prevention of mental health, and the strengthening of information systems were close to being achieved.

In 2020, only 51% of the 194 WHO member states reported that their mental health policy or plan was in line with international and regional human rights instruments, far from the 80% target. And only 52% of countries have met the target of mental health promotion and prevention programs, also well below the 80% target. The only goal for 2020 was to reduce the suicide rate by 10%, but even then only 35 countries said they had a stand-alone strategy, policy or prevention plan.

Steady progress has been evident, however, in adopting mental health policies, plans and laws, as well as in improving the ability to report on a range of key mental health indicators. However, the percentage of state health budgets spent on mental health has barely changed in recent years, still hovering around 2%. Moreover, even when policies and plans included an assessment of the required human and financial resources, only 39% of countries responded that the necessary human resources had been allocated and 34% that the necessary financial resources had been provided.

The transfer of care to the community is slow

Although the WHO has long recommended the systematic decentralization of mental health care to the environment, only 25% of countries responded met all the criteria for integrating mental health into primary care. Although progress has been made in training and supervision in most countries, the supply of medicines for mental health and psychosocial care in primary health care remains limited.

This is also reflected in the way state funds are allocated for mental health, emphasizing the urgent need for deinstitutionalization. More than 70% of total government expenditure on mental health is allocated to mental hospitals in middle-income countries, compared to 35% in high-income countries. This indicates that centralized mental hospitals and institutional hospital care continue to receive more funding from services provided in general hospitals and primary health care centers in many countries.

However, there has been an increase in the percentage of countries reporting that the treatment of people with specific mental health conditions (psychosis, bipolar disorder and depression) is included in national health insurance or compensation schemes – from 73% in 2017 to 80% (or 55 % of Member States) in 2020.

Global estimates of people receiving care for specific mental health conditions (used as a substitute for mental health care as a whole) remained less than 50%, with a global median of 40% of people with depression and only 29% of people with psychosis of care.

Increasing the promotion of mental health, but the effectiveness is questionable

Encouraging was the increase in countries reporting mental health promotion and prevention programs, from 41% of Member States in 2014 to 52% in 2020. However, 31% of the total reported programs did not have dedicated human and financial resources, 27% did not have a defined plan, and 39% had no documented evidence of progress and / or impact.

A slight increase in the mental health workforce

The global median number of mental health workers per 100,000 population increased slightly from nine workers in 2014 to 13 workers per 100,000 inhabitants in 2020. However, there was a very large difference between countries with different incomes, with the number of mental health workers in countries with high incomes more than 40 times higher than in low income countries.

New targets for 2030

The global targets reported in the Mental Health Atlas are from the WHO Comprehensive Mental Health Action Plan, which contained the 2020 targets approved by the World Health Assembly in 2013. This plan has now been extended to 2030 and includes new goals to include mental health. health and psychosocial support in emergency preparedness plans, the integration of mental health into primary health care, and mental health research.

“New data from the Atlas of Mental Health shows us that we still have a long way to go to ensure that everyone, everywhere, has access to quality mental health care,” said Dévora Kestel, director of the WHO’s Department of Mental Health and Substance Use. . “But I am encouraged by the renewed strength we have seen from governments as they discuss and agree on new targets for 2030 and I am convinced that together we can do what it takes to move from baby steps to huge leaps forward in the next 10 years. ”

Note to editors:

The atlas is being released ahead of World Mental Health Day on October 10, which this year focuses on increasing access to quality mental health care.