The WHO emphasizes the urgent need to transform mental health and mental health care

World Health Organization today published his top review world mental health since the turn of the century. The detailed work provides a blueprint for governments, academics, health professionals, civil society and others with the ambition to support the world in the transformation of mental health.

In 2019, nearly a billion people – including 14% of adolescents in the world – lived with a mental disorder. Suicide caused more than 1 in 100 deaths, and 58% of suicides occurred before the age of 50. Mental disorders are the leading cause of disability, causing 1 in 6 years of life with a disability. People with severe mental health problems die on average 10 to 20 years earlier than the general population, mainly due to preventable physical illnesses. Childhood sexual abuse and victimization of abuse are major causes of depression. Social and economic inequalities, public health emergencies, war and climate crisis are among the global, structural threats to mental health. Depression and anxiety increased by more than 25% in the first year of the pandemic alone.

Stigma, discrimination and human rights violations of people with mental health problems are widespread in communities and care systems everywhere; 20 countries are still criminalizing suicide attempts. In all countries, the poorest and most vulnerable in society are those who are most at risk of mental illness and who are also the least likely to receive adequate services.

Even before the COVID-19 pandemic, only a small proportion of people in need had access to effective, affordable, and quality mental health care. For example, 71% of people with psychosis in the world do not receive mental health services. While it is stated that 70% of people with psychosis are treated in high-income countries, only 12% of people with psychosis receive mental health care in low-income countries. As far as depression is concerned, service coverage gaps are large in all countries: even in high-income countries, only one third of people with depression receive formal mental health care, and the minimum adequate treatment for depression is estimated to range from 23% to high- countries with income at 3% in low- and lower-middle-income countries.

Building on the latest available evidence, showing examples of good practice and expressing people’s life experiences, a comprehensive WHO 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 values ​​and commitment to mental health, reshape the environment that affects mental health and strengthen systems that care for people’s mental health.

WHO Director-General Dr. Tedros Adhanom Ghebreyesus said, “Everyone’s life touches someone with a mental health condition. Good mental health means good physical health, and this new report provides a compelling argument for change. The inextricable links between mental health and public health, human rights and socio-economic development mean that the transformation of mental health policies and practices can bring real, significant benefits to individuals, communities and countries everywhere. Investing in mental health is investing in a better life and a future for all. ”

All 194 WHO member states have signed Comprehensive Mental Health Action Plan 2013-2030, which commits them to global goals for mental health transformation. The pockets of progress made over the past decade prove that change is possible. But change isn’t happening fast enough, and the mental health story is still a story of need and neglect with $ 2 out of $ 3 of meager government spending on mental health allocated to independent psychiatric hospitals rather than community-based mental health services . For decades, mental health has been one of the most neglected areas of public health, receiving little of the attention and resources it needs and deserves.

Dévora KestelThe Director of the WHO Department of Mental Health and Substance Use called for a change: “Each country has ample opportunity to make significant progress towards better mental health for its population. Whether developing stronger mental health policies and laws, covering mental health in insurance programs, developing or strengthening community mental health services, or integrating mental health into general health care, schools and prisons, many examples in this report show that strategic change I can make a big difference. ”

The report calls on all countries to speed up their implementation Comprehensive Mental Health Action Plan 2013-2030. It provides several recommendations for action, which are grouped into 3 paths to transformation that focus on changing attitudes towards mental health, addressing mental health risks and strengthening the mental health care system. They are:

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

Increase investment in mental health, not only by providing adequate resources and human resources in the health and other sectors to meet mental health needs, but also through committed leadership, evidence-based policies and practices, and establishing robust information and monitoring systems.

Involving people with mental health problems in all aspects of society and making decisions to overcome stigma and discrimination, reduce disparities and promote social justice.

2. Reshape environments that affect mental health, including homes, communities, schools, workplaces, health services, the natural environment. For example:

Intensify engagement in all sectors, including understanding the social and structural determinants of mental health and intervening in ways that reduce risks, build resilience, and remove barriers that prevent people with mental health problems from fully participating in society.

Implementation concrete actions to improve the mental health environment, such as increased action against intimate partner violence and the abuse and neglect of children and the elderly; enabling the care of early childhood development, providing life support for people with mental health problems, introducing social and emotional learning programs while combating bullying in schools, changing attitudes and strengthening rights in mental health care, increasing access to green spaces and banning highly dangerous pesticides that are linked to one-fifth of all suicides in the world.

3. Strengthen mental health care by changing where, how and who provides and receives mental health care.