Hunker mental illness
In a new report, she urges policy makers and mental health advocates to step up their commitment and action to change attitudes, measures and approaches to mental health, its determinants and the care that are dedicated to him.
The World Health Organization today released its broadest overview of global mental health since the early 2000s. This in-depth work offers a blueprint for governments, academics, health professionals health and civil society, among others, which has the ambitious goal of helping the world transform mental health.
In 2019, almost a billion people – including 14% of adolescents worldwide – had a mental disorder. Suicides accounted for more than one in 100 deaths and 58% of them occurred before the age of 50. Mental disorders are the leading cause of disability and are responsible for one in six years lived with disability. People with severe mental disorders have a reduced lifespan of 10 to 20 years compared to the general population, often due to preventable physical pathologies. Among the major causes of depression are childhood sexual abuse and bullying. Social and economic inequalities, public health emergencies, war and the 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.
Around the world, stigma, discrimination against people with mental health conditions and violations of their human rights are common in communities and healthcare systems; suicide attempts are still criminalized in 20 countries. In all countries, it is the poorest and most disadvantaged in society who are most at risk of mental disorders and who are also the least likely to receive adequate services.
Even before the COVID-19 pandemic, only a small fraction of those in need had access to effective, affordable and quality mental health care. Thus, 71% of people with psychosis worldwide do not benefit from mental health services. While 70% of people with psychosis would be treated in high-income countries, only 12% receive mental health care in low-income countries. When it comes to depression, wide gaps in service coverage are observed across countries: even in high-income countries, only a third of people with depression receive formal mental health care and it is estimated that minimum adequate treatment for depression ranges from 23% in high-income countries to 3% in low- and lower-middle-income countries.
This comprehensive WHO report highlights, drawing on the latest available evidence, showcasing examples of good practice and echoing the lived experience of people, why and where change is most needed. imperative and how it can best be achieved. It calls on all stakeholders to work together to raise awareness and commitment to mental health, reshape the environments that influence it, and strengthen the systems that care for people's mental health.
WHO Director-General Dr Tedros Adhanom Ghebreyesus said: “Everyone in their life is close to someone affected by mental health issues. Good mental health translates to good physical health, and this new report makes a compelling case for change. The inextricable links between mental health and public health, human rights and socioeconomic development mean that changing mental health policies and practices can bring real and substantial benefits to individuals, communities and countries around the world. entire. Investing in mental health is investing in a better life and future for all. »
All 194 WHO Member States have endorsed the Comprehensive Mental Health Action Plan 2013-2030, committing them to achieve global targets to transform mental health. Local progress over the past decade proves that change is possible. But this change is not happening fast enough, and the history of mental health remains one marked by destitution and neglect: Of the meager government spending on mental health, two out of every three dollars goes to psychiatric institutions. independent rather thanto community mental health services closer to the people. For decades, mental health has been one of the most neglected areas of public health, receiving only a tiny fraction of the attention and resources it needs and deserves.
Dévora Kestel, Director of the Department of Mental Health and Substance Use at WHO, called for change: “Every country has great opportunities to make significant progress towards better mental health for its people. Whether it is developing stronger mental health policies and laws, integrating mental health into health insurance schemes, establishing or strengthening community mental health services or introducing mental health into general health care, schools and prisons, the many examples presented in this report show that policy changes can make a big difference. »
The report urges all countries to implement the Comprehensive Mental Health Action Plan 2013-2020. Several recommendations for action are made: they are grouped into three "pathways to transformation" focusing on changing attitudes towards mental health, addressing mental health risks and strengthening mental health care systems, as follows:
1 Identify the importance given to mental health and the commitment to it. For instance :
- Increase investment in mental health, not only by securing appropriate funding and human resources in health and other sectors to meet mental health needs, but also through committed leadership, implementing evidence-based policies and practices and establishing strong information and monitoring systems.
- Integrate people with mental health issues into all aspects of society and decision-making to overcome stigma and discrimination, reduce disparities and promote social justice.
2 Reshaping the environments that influence mental health, including homes, communities, schools, workplaces, health care services and natural environments. For instance :
- Scale up engagement across sectors, including to understand the social and structural determinants of mental health and intervene in ways that reduce risk, build resilience, and remove barriers that prevent people with mental disorders from fully participating to the society.
- Implement concrete measures to improve environments for mental health, including scaling up action against intimate partner violence and child and elder abuse and neglect; promoting nurturing care for early childhood development; establishing livelihood support for people with mental health issues; introducing social and psychological learning programs while tackling bullying in schools; changing attitudes and strengthening mental health care rights; improving access to green spaces, and banning highly hazardous pesticides associated with a fifth of all suicides worldwide.
3 Strengthen mental health care by making changes to where, how, who provides and who receives mental health care.
- Build community networks of interconnected services that move away from custodial care in psychiatric hospitals and cover a range of care and support through a combination of mental health services integrated with mainstream health care; community mental health services; and services beyond the health sector.
- Diversify and expand care options for common mental health conditions such as depression and anxiety, knowing that the benefit/cost ratio is five to one. This requires adopting a task-sharing approach that expands evidence-based care that will also be offered by general health workers and community providers. Digital technologies should also be used to support guided or unguided self-help and provide remote care.
