World Mental Health Day 2021 Calls For Mental Health Equality
October 10th, 2021 at 5:09 am
The Covid-19 pandemic has exposed the widening disparities and inequities, especially when it comes to access to mental healthcare services. Many countries underwent longer periods of lockdown and are at present, facing an economic crisis that has negatively affected the mental well-being of the people.
This year as we prepare to mark yet another World Mental Health Day on 10 October, the World Federation for Mental Health (WFMH) has set the theme ‘Mental Health in an Unequal World: Together we can make a difference’ to highlight that mental health care, and the inclusion of persons with mental disorders in all spheres of life, remain unequal.
According to WFMH President Dr. Ingrid Daniels, “Growing inequalities due to race and ethnicity, sexual orientation and gender identity, lack of respect for human rights and, stigma and discrimination against people with mental health conditions have created visible societal divide and injustices”.
She further pointed out that health inequities are grossly unfair and unjust, often violating human rights and failing to protect of the most vulnerable. While inequalities in mental health care can no longer be ignored; regional, country and individual commitment is required to address the harm caused by the layers of systemic and historical inequalities and injustices, which impacts the mental health of all.
The cost of neglecting mental health is significant. Studies have estimated that poor mental health accounted for $2.5 trillion of the global economic burden in 2010 and is projected to rise to $6 trillion by 2030.
Scaling up quality mental health services
WHO Director for Mental Health and Substance Use World, Dévora Kestel, sharing her observations, noted that; “Across the world, far too few people have access to quality mental health services. In high-income countries, nearly 75% of people with depression report not receiving adequate care. In low- and middle-income countries, more than 75% of people with mental health conditions receive no treatment at all for their condition”.
According to Kestel, despite these inequalities, governments spend, on average, just over 2% of their health budgets on mental health, and international development assistance for mental health has never exceeded 1% of development assistance for health. Adding that; “Yet, in the face of these grim realities, there remains reason for hope. Momentum is growing internationally to advance the mental health agenda and governments around the world have recognised that access to these services must be scaled up at all levels”.
A survey conducted by the WHO in mid-2020 indicated that services for mental, neurological and substance use disorders had been significantly disrupted during the pandemic. However, during the World Health Assembly in May 2021, the UN member states had recognised the need to scale up quality mental health services at all levels and endorsed the updated Comprehensive Mental Health Action Plan 2013-2030, including the Plan’s updated implementation options and indicators for measuring progress.
The action plan relies on six cross-cutting principles and approaches:
- Universal health coverage – Regardless of age, sex, socioeconomic status, race, ethnicity or sexual orientation, and following the principle of equity, persons with mental disorders should be able to access, without the risk of impoverishing themselves, essential health and social services that enable them to achieve recovery and the highest attainable standard of health.
- Human rights – Mental health strategies, actions and interventions for treatment, prevention and promotion must be compliant with the Convention on the Rights of Persons with Disabilities and other international and regional human rights instruments.
- Evidence-based practice – Mental health strategies and interventions for treatment, prevention and promotion need to be based on scientific evidence and/or best practice, taking cultural considerations into account.
- Life-course approach – Policies, plans and services for mental health need to take account of health and social needs at all stages of the life-course, including infancy, childhood, adolescence, adulthood and older age.
- Multisectoral approach – A comprehensive and coordinated response for mental health requires partnership with multiple public sectors such as health, education, employment, judicial, housing, social and other relevant sectors as well as the private sector, as appropriate to the country situation.
- Empowerment of persons with mental disorders and psychosocial disabilities – Persons with mental disorders and psychosocial disabilities should be empowered and involved in mental health advocacy, policy, planning, legislation, service provision, monitoring, research and evaluation.
In endorsing this updated Action Plan, Member States have agreed to targets relating to expansion of service coverage, increasing the number of community-based mental health facilities and integrating mental health into primary care.
In addition, they have agreed to develop and strengthen mental health services and psychosocial support as part of universal health coverage, and in preparedness and response to emergencies, with a particular focus on improving the understanding and acceptance of mental health conditions, vulnerable populations and use of innovative technologies. This represents one of many powerful calls to action during the pandemic, that have been made to bring about equal and universal access to mental health services for those in need.
Continued access to support services
It is critical that people living with mental health conditions have continued access to treatment. Changes in approaches to provision of mental health care and psychosocial support are showing signs of success in some countries.
Given the nature of the Covid-19 pandemic, local policy-makers have identified emergency psychiatry as an essential service to enable mental health-care workers to continue outpatient services over the phone. Home visits are therefore organized for the most serious cases. Egypt, Kenya, Nepal, Malaysia and New Zealand, among others, have reported creating increased capacity of emergency telephone lines for mental health to reach people in need.
While the support for community actions that strengthen social cohesion and reduce loneliness, particularly for the most vulnerable, such as older people, must continue. Governments, local authorities, the private sector and members of the general public, should also support with initiatives such as provision of food parcels, regular phone check-ins with people living alone, and organization of online activities for intellectual and cognitive stimulation.
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