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The new edition of the WHO Mental Health Atlas paints a disappointing picture of the world’s inability to provide people with the mental health services they need, at a time when the COVID-19 pandemic puts highlights 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 interest in mental health in recent years has not yet resulted in an increase in quality mental health services in line with needs. .
The Atlas is published every three years and is a compilation of data provided by countries around the world on mental health policies and legislation, funding, human resources, service delivery and collection systems and use of related data. It is also a mechanism for monitoring progress towards the goals set out in the WHO Plan of Action for Mental Health.
Dr Tedros Adhanom Ghebreyesus, WHO Director-General, said: “Despite the obvious and growing need for mental health services, which has become even more acute during the COVID-19 pandemic, it is extremely worrying that good intentions don’t match. with the investment. We must respond to the call for awakening. We are responding to them and dramatically accelerating the increase in investment in mental health, because there is no health without mental health. ”
Lack of progress in leadership, governance and finance
We are not close to achieving the goals of effective mental health leadership and governance, community mental health service delivery, mental health promotion and prevention, and empowerment. information systems.
In 2020, only 51% of 194 WHO Member States reported that their mental health policies or plans complied with international and regional human rights instruments, well below the target of 80%. Only 52% of countries met the target for mental health promotion and prevention programs, which is also well below the target of 80%. The only target achieved in the 2020 targets is a 10% reduction in the suicide rate, but only 35 countries report having a stand-alone prevention strategy, policy or plan.
However, steady progress has been noted in adopting mental health policies, plans and laws, as well as improving the capacity to report on a set of core mental health indicators. . On the other hand, the percentage of spending on mental health in government health budgets in recent years has not seen any significant change, as it is still around 2%. In addition, although policies and plans include estimates of the human and financial resources required, only 39% of responding countries indicated that the necessary human resources had been allocated and 34% indicated that the required financial resources had been provided. .
Bringing care closer to local communities is slow
Although the WHO has long recommended systematic decentralization of mental health care delivery to communities, only 25% of responding countries meet all the criteria for integrating mental health into primary care. Although progress has been made in training and supervision in most countries, the provision of drugs for mental health and psychosocial care in primary health care services is still limited.
This is also reflected in the way public funds are allocated to mental health, highlighting the urgent need to move away from institutionalization. Over 70% of total public expenditure on mental health is allocated to mental hospitals in middle-income countries, compared to 35% in high-income countries. This indicates that central psychiatric hospitals and residential care facilities continue to receive funding amounts that exceed the amounts allocated to public hospital services and primary health care centers in many countries.
However, there has been an increase in the proportion of countries reporting the inclusion of treatment for people with multiple mental illnesses in their national health insurance or reimbursement systems – from 73% in 2017 to 80% (or 55% Member States) in 2020.
Global estimates of people receiving care for specific mental illnesses (estimates used as a proxy to measure the overall level of mental health care) are still below 50%, of which, on a global average, 40% of people with depression and only 29% of people with psychosis receive mental health care.
Increased promotion of mental health, but questionable effectiveness
More encouraging has been 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 the total reported programs did not. not been allocated. financial resources, 27% did not have a clear plan and 39% had no documented evidence of progress and / or impact.
Slight increase in mental health workforce
The global average number of mental health workers per 100,000 people has increased slightly from nine workers per 100,000 people in 2014 to 13 workers per 100,000 people in 2020. However, there is a very large gap between the countries of the world. different income groups, with more than 40 times more mental health workers in high-income countries than in low-income countries.
New goals for 2030
The global goals reported in the Atlas of Mental Health are derived from the Comprehensive Plan of Action for Mental Health adopted by WHO in 2013 and included targets for 2020 approved by the World Health Assembly. The plan, which was extended until 2030, includes new goals to include mental health and psychosocial support in emergency preparedness plans, integrate mental health into primary health care, and conduct research on mental health.
“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 Devora Kestel. , Director of the WHO Department of Mental Health and Substance Use. “But I am optimistic about the renewed enthusiasm shown by governments in the discussions and agreement on the new 2030 goals, and I am convinced that together we can take the necessary steps to take small steps into small steps. by leaps and bounds over the next ten years. “
Note to editors
The atlas is being published in preparation for World Mental Health Day on October 10, which this year will focus on improving access to quality mental health care.
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