The World Health Organization (WHO) has published the ‘World Mental Health Report: Transforming Mental Health for All‘ in June 2022. The report focuses on transforming mental health services and urges everyone to deepen their value and commitment to mental health.
Why has the WHO published this report?
In 2019, according to the WHO, one billion people were living with mental health issues. This equates to approximately 15% of the world’s working-age population.
The recent WHO report updates the Comprehensive Mental Health Action Plan 2013–2030 and its Sustainable Development Goals. The report also serves as a commitment and an action plan from all countries to improve mental health provisions and integrate these at a community level.
In addition, the report incorporates the grave and long-lasting effects that the COVID-19 pandemic has had on mental health globally. It also urges the global transformation of mental health services across all countries, communities, and individuals.
The WHO vision for mental health
In the recent report, the WHO reconfirms its commitment to be the principal agency of global health, play its part, and sets out its vision for mental health. This vision aims for a world where –
- Mental health is valued, promoted and protected;
- Where mental health conditions are prevented;
- Where anyone can exercise their human rights and access affordable, quality mental health care; and
- Where everyone can participate fully in society free from stigma and discrimination.
Seven key areas for action
The action plan at a high level focuses on seven key areas –
1. Business as usual for mental health will not work
WHO reinforces its commitment to continue to work on a domestic and international level by providing strategic leadership, evidence, tools, and technical support. To help to achieve and transform its vision while working collaboratively with each country.
The report focuses specifically on the importance of multi sectors, policymakers, and those who implement mental health services to work together to provide impactful community-based mental health services
Dr. Tedros Adhanom Ghebreyesus, Director-General of WHO, calls on all,
“to work together to deepen the value and commitment given to mental health.”
2. Principles and drivers in public mental health
The WHO acknowledges that mental health is a fundamental human right. It is an integral part of general health and well-being. One challenge cited by the WHO is that mental health operates in a complex, multi-layered arena where no one experience is the same. Some experiences are optimal, while others create further suffering.
The risks increase if a child experiences suffering in their early development years, which can have a detrimental impact. It is evident that with the post-pandemic impact of COVID-19 and the likelihood of a global decline, individuals, families, and communities will be affected as whole populations. These effects have created a mental health crisis that will have a long-reaching impact on care and service disruption.
Local interventions across the different healthcare sectors are essential. The WHO state that mental health services after clinical treatment intervention are not often available. They estimate that depression and anxiety have risen by 25% during 2020 – the first year of the pandemic highlighting the growing importance of post-intervention care in recovery.
3. Response to mental health is inadequate
The report points out that mental health services are severely underserved even though mental health conditions affect many. There is still much social stigma and discrimination in accessing mental health services, and most suffer in silence. Education is imperative.
The WHO reports low levels of understanding and literacy of mental health in many countries. WHO has shockingly revealed that most people diagnosed with mental health conditions go untreated.
Here are some more alarming facts detailed about mental health expenditure and why mental health remains inadequate both in terms of spending on services but also the standard of care:
- Average investment in mental health services equates to less than 2% of a country’s health care budget;
- Around half of the world’s population lives in countries that have one psychiatrist per 200,000 or more people;
- More than 70% of mental health expenditure goes toward psychiatric hospitals; and
- In low-income countries, there is limited availability of psychotropic medicines.
4. Proactivity investing in Mental health care
Public health, human rights, and socioeconomic development are fundamental reasons why mental health must have sufficient investment and integrate into all public health agendas, according to the WHO. There is an urgent need to implement the Convention for the Rights of People with Disabilities internationally.
This implementation will help reduce the stigma and discrimination associated with mental health. It will also help stimulate and enable social and economic development, allowing individuals to contribute positively to their communities without the stigma attached.
Evidence from research consistently points to the fact that cost-effective interventions are available. These include social and emotional learning programs at school, preventing suicides by banning hazardous pesticides, and clinical interventions such as psychosocial and pharmacological detailed in the WHO Universal Health Coverage (UHC) Compendium.
The UHC Compendium aims to help countries strategically organize interventions. Global modeling found such interventions provide a significant return on investment, e.g., the treatment of depression and anxiety has a benefit-to-cost ratio of 5 to 1.
5. Building the foundations
To build the foundations of robust and responsive mental health services across all communities, the WHO argues that governments must commit and foster this in three ways. Be a steady fast advocate, legislate and provide the budgets for mental health services.
Legislation across every aspect of life that complies with, defends, and supports international human rights is paramount. Countries that cannot access additional funding at the community provider level need to reallocate resources and budgets.
Digital technologies are increasingly becoming cost-effective and play a pivotal role in mental health. They are a powerful tool for educating, training, informing individuals, and enabling self-care.
6. Promotion and prevention at all stages of life
Promotion and prevention of mental health are critical to transformation at the grassroots level and across all stages of life. Identification of Individuals, specific social groups, and populations with known factors is essential, as is putting the necessary support systems in place.
The health sector and governments are vital advocates and must facilitate prevention and promotion. Targeted interventions will help build resilience, create supportive surroundings, reduce risks, and implement the correct programs.
One of WHO’s Sustainable Development Goals is to reduce suicide by 2030 by one-third. The WHO program of LIVE LIFE prioritizes four interventions: limiting access to the means of suicide, responsible reporting of suicide by the media, adolescents fostering emotional and social life skills, and finally, early intervention for those experiencing suicidal behaviors.
In addition to suicide prevention, the WHO continues to focus on mental health services in children, campaigning and supporting the environment at home and school. They also assert that workplaces need to play their part in providing more work opportunities for those with mental health and promoting and protecting individuals in the workplace.
7. Reform to transform mental health
The WHO requires a total reorganization of mental health care provisions to ensure that People-centred, recovery-orientated, and human-rights-based care is available. According to the WHO, reform will need to occur in two ways in the long term –
- The first is to focus on the need to scale up care for universal conditions such as depression and anxiety.
- The second is to move care to community-based services away from psychiatric hospitals. Such hospitals should close once the correct community base provisions are in place.
According to the WHO, supported living services in the community will give more value. To ensure success, community care provisions and support must be fully integrated into general health care services. The two must go together and complement each other.
Changing individuals’ perceptions is paramount
Undoubtedly, implementing the WHO action plan will take a considerable amount of time, resources, and money. A complete shift in attitudes and perceptions will be the biggest challenge in most countries.
The transformation of individuals’ perceptions and social stigma around mental health needs to be targeted first. Thus ensuring the action plan has both a long-lasting impact and far-reaching benefits through the generations.