Mental health promotion: the facts – ZimEye

Mental Health Promotion: The Facts

The World Health Organization’s new Mental Health Atlas paints a disappointing picture of a global failure to provide people with the mental health services they need, at a time when the COVID-19 pandemic is underway. evidence of a growing need for mental health support.

The latest edition of the Atlas, which includes data from 171 countries, makes it clear that the increased attention to mental health in recent years has not yet resulted in a scaling up of quality mental services that correspond to the needs.

Published every three years, the Atlas is a compilation of data provided by countries around the world on mental health policies, legislation, funding, human resources, availability and use of health services and systems. data gathering. It is also the mechanism for monitoring progress towards achieving the targets of the WHO Comprehensive Plan of Action for Mental Health.

“It is of great concern that, despite the obvious and growing need for mental health services, which has become even more acute during the COVID-19 pandemic, good intentions are not being met with investments,” said Dr Tedros Adhanom Ghebreyesus, Director General of the World Health Organization.

“We need to heed this red flag 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, governance and funding
None of the goals for effective leadership and governance for mental health, the delivery of mental health services in community settings, the promotion and prevention of mental health, and the strengthening of information systems came close. be achieved.

In 2020, only 51% of WHO’s 194 Member States reported that their mental health policy or plan complied with international and regional human rights instruments, well below the target of 80%. And only 52% of countries met the target for mental health promotion and prevention programs, also well below the 80% target. The only target achieved for 2020 was a reduction in the suicide rate by 10%, but even then only 35 countries reported having a stand-alone prevention strategy, policy or plan.

Steady progress, however, was evident in the adoption of mental health policies, plans and laws, as well as in improving the capacity to report on a set of core mental health indicators. However, the percentage of government health budgets spent on mental health has hardly changed in recent years, still hovering around 2%. Moreover, even when policies and plans included estimates of the human and financial resources required, only 39% of responding countries indicated that the necessary human resources had been allocated and 34% that the required financial resources had been provided.

Transfer of care to the community is slow
While systematic decentralization of mental health care to community settings has long been recommended by WHO, only 25% of responding countries met all the criteria for integrating mental health into primary care. While progress has been made in training and supervision in most countries, the supply of drugs for mental health disorders and psychosocial care in primary health care services remains limited.

This is also reflected in the way government funds are allocated to mental health, underscoring the urgent need for deinstitutionalization. Over 70% of total public spending on mental health has been 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 still receive more funds than services provided in general hospitals and primary health care centers in many countries.

There was, however, an increase in the percentage of countries reporting that treatment for people with specific mental disorders (psychosis, bipolar disorder and depression) is included in national health insurance or reimbursement schemes – from 73% in 2017 to 80% (or 55% of Member States) in 2020.

Global estimates of people receiving care for specific mental health problems (used as a proxy for mental health care as a whole) have remained below 50%, with a global median of 40% of people with depression and just 29. % of people with psychosis receiving worry.

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

Slight increase in 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 population in 2020.

However, there was a huge variation between countries of different income levels, with the number of mental health workers in high-income countries more than 40 times higher than in low-income countries.

New goals for 2030
The global targets reported in the Mental Health Atlas are taken from the WHO Comprehensive Plan of Action for Mental Health, which contained targets for 2020 approved by the World Health Assembly in 2013. This plan has now been adopted. been extended to 2030 and includes new targets for the inclusion of mental health. health and psychosocial support in emergency preparedness plans, 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 very long way to go to ensure that everyone, everywhere, has access to quality mental health care,” said Dévora Kestel. , Director of the Department of Mental Health and Substance Use at WHO. “But I am heartened by the renewed vigor we have seen from governments as the new 2030 goals have been discussed and agreed upon and I am confident that together we can do what is necessary to take small steps. by leaps and bounds over the next 10 years. “

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