Mental health research and policy consortium welcomes the endorsement of global mental health action plan by WHO decision making body

23 May 2013 - 09:15

The 66th World Health Assembly (WHA), WHO’s decision making body, has endorsed a global mental health action plan for the next 8 years, which will provide an evidence-based guideline for member states to better integrate mental health into domestic policies, plans and strategies.       

The PRogramme for Improving Mental health carE (PRIME), an international consortium of mental health researchers and policy makers, has today welcomed the approval of the WHO Global Mental Health Action Plan. PRIME maintains that such an endorsement will help member states, particularly those in low and middle-income countries where services are mostly needed, to improve the scale up of mental health care based on evidence. The decision, endorsed overwhelmingly by all 194 WHO member states with minor changes, is significant as LMIC account for almost 90% of the membership. PRIME has made a significant contribution to this policy making process led by the World Health Organisation’s Department of Mental Health and Substance Abuse.

PRIME CEO A/Prof Crick Lund said: “This is a major milestone for many people who have worked tirelessly to give greater policy attention to mental health. We believe that mental health is both a means and an end of social and economic development, and this action plan commits UN Member states to making this a reality”. The Comprehensive Mental Health Action Plan (latest version available here ComprehensiveMental Health Action Plan 2013-2020) was developed in response to an invitation by the previous 65th WHA (resolution WHA 65.4) for the WHO Secretariat to develop such a plan. This policy progress is the result of extensive advocacy, and inputs from the global mental health fraternity, including academic institutions and civil society organisations. Those in civil society that made representations included the World Federation for Mental Health, CBM, World Vision, the People’s Health Movement and 2 pharmaceutical coalitions. According to the NGO Forum for Health at the WHA, civil society made “very supportive statements” for the plan. 

The comprehensive action plan broadly identifies 6 cross-cutting principles and approaches, including: 1) universal health coverage, 2) human rights, 3) evidence-based practice, 4) taking cognisance of the life-stages of people (infancy, childhood, adolescence, adulthood and old age) during recovery, and their corresponding health and social needs such as income generation and educational opportunities, 5) a multisectoral approach, which calls for other public sectors (and private sectors in some countries) beyond health, including educational, employment, judicial, housing and social sectors.to integrate mental health into their plans, and 6) the empowerment of persons with mental disorders and psychosocial disabilities.         

The plan sets important new directions for mental health including a central role for provision of community based care and a greater emphasis on human rights.  It introduces the notion of recovery, moving away from a pure medical model, and addresses income generation and education opportunities, housing and social services and other social determinants of mental health in order to ensure a comprehensive response to mental health. The action plan also emphasises the empowerment of people with mental disabilities and the need to develop a strong civil society, and the need to undertake promotion and prevention activities including for preventing suicides.

The document also proposes specific actions for Member States, international, regional and national level partners, and the WHO Secretariat. For instance, 20% increase in service coverage for severe mental disorders and a 10% reduction of the suicide rate in countries by the year 2020 have been identified as targets that can be used to evaluate levels of implementation, progress and impact.

More specifically, the four major objectives of the Action Plan are to:

1) strengthen effective leadership and governance for mental health;

2) provide comprehensive, integrated and responsive mental health and social care services in community-based settings;

3) implement strategies for promotion and prevention in mental health, and;

4) strengthen information systems, evidence and research for mental health

Led from the University of Cape Town, South Africa, PRIME is working actively to implement and evaluate packages of care in primary health care settings in 5 countries: Ethiopia, India, Nepal, South Africa and Uganda. This work is directliy aligned with the objectives of the WHO Action Plan (particularly objectives 2 and 4), and results of PRIME research will provide UN member states with the evidence that they need to scale up mental health care.

See Research Paper Published in The Lancet

World Health Assembly adopts Comprehensive Mental Health Action Plan 2013-2020 The Lancet

Authors: Shekhar Saxenaa, Michelle Funk, Dan Chisholm