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(2019-2023): Universal Health Coverage for Mental Health

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(2019-2023): Universal Health Coverage for Mental Health The WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health “The world is accepting the concept of universal health coverage. Mental health must be an integral part of UHC. Nobody should be denied access to mental health care because she or he is poor or lives in a remote place.” Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization ental health conditions contribute to poor health by a clear goal, the initiative seeks to ensure universal health Moutcomes, premature death, human rights violations, and coverage involving access to quality and affordable care for global and national economic loss. The WHO Director-General, mental health conditions in 12 priority countries to 100 million Dr Tedros Adhanom Ghebreyesus, has identified mental health more people. The WHO Special Initiative for Mental Health for accelerated implementation of the 13th General Programme will advance mental health policies, advocacy and human of Work (GPW13), covering 2019-2023. The time to act is rights, and scale up quality interventions and services for now to empower communities and individuals to attain the individuals with mental health conditions, including substance highest standard of health, which can only be achieved when use and neurological disorders. For continued scale up and their mental health and well-being is ensured, and their rights global learning, WHO will implement this work in 12 priority respected. The vision of the WHO Special Initiative for Mental countries, working in partnership with Member States, local, Health is that all people achieve the highest standard of mental and international partners, as well as organizations of people health and well-being. with lived experience. This WHO Special Initiative for Mental Health is summarized in Figure 1, which demonstrates how To implement the WHO Special Initiative for Mental Health the programme will contribute towards the wider goals of the over 5 years, WHO aims to raise US$ 60 million. Anchored GPW13 and the Sustainable Development Goals (SDGs). The WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for Mental Health THEORY OF CHANGE THE PROBLEM : GOAL: By 2023 universal health coverage (UHC) ensures access to quality and affordable care • There can be no health or for mental health conditions in 12 priority countries to 100 million more people sustainable development without mental health • Depression and anxiety disorders cost the global economy STRATEGIC US$1 trillion per year ACTION 1: Contributes to WHOs GPW13 Triple Billion Targets to achieve: 1 billion more people benefiting from UHC • 800 000/year deaths from suicide, Advancing mental which is a leading cause of death health policy, 1 billion more people supported during emergencies 1 billion more people enjoying better health and well-being in young people advocacy and STRATEGIC human rights • Mental health conditions cause ACTION 2: 1 in 5 years lived with disability Scaling up interventions and services across • Common among people affected by community-based, communicable (e.g. HIV and TB) and general health WHO GPW13 TARGET 1: WHO GPW13 TARGET 2: non communicable diseases (e.g. and specialist Coverage of severe Reduced suicide cancer and cardiovascular disease) settings mental health conditions mortality by 15% • Treatment coverage is extremely low increased to 50% • Especially common in populations affected by humanitarian crises and other forms of adversity SDG Target 3.4 when, by 2030, (e.g. sexual violence) SPECIAL INITIATIVE there is a one third reduction of • People with mental health TARGET: premature mortality from NCDs VISION: conditions often experience By 2023, access to through prevention, treatment severe human rights violations, mental health care and promotion of mental health All people achieve discrimination, stigma for 100 million and well-being the highest standard • Lack of sustained financing for more people services at scale SDG Target 3.5 to strengthen of mental health the prevention and treatment • Effective evidence-based of substance abuse, including and well-being care is available but In partnership with WHO Member States and local, narcotic drug abuse and provision of services international and global implementing partners harmful use of alcohol is lacking (e.g. UN, NGOs, user groups, professional associations) Figure 1. The WHO Special Initiative for Mental Health Theory of Change Why a WHO Special Initiative What will the WHO Special Initiative for for Mental Health? Mental Health do? Health is a state of complete physical, mental, and social well- Embedded in the GPW13 and contributing towards the being, and not merely the absence of disease or infirmity1. SDGs, the WHO Special Initiative for Mental Health will However, mental health remains a neglected part of global work towards a vision where all people achieve the highest efforts to improve health. People with mental health conditions standard of mental health and well-being; experience widespread human rights violations, discrimination and aligns with the global WHO and stigma. More than 80% of people experiencing mental Mental Health Action Plan 2013- health conditions, including individuals experiencing neurological Universal health 20202. The Goal of the WHO and substance use disorders, are without any form of quality, coverage (UHC) means Special Initiative for Mental affordable mental health care. This is despite mental health that all people receive Health also corresponds with conditions accounting for 1 in 5 years quality health services recommendations of the lived with disability globally, leading that meet their needs, recently published Lancet to more than US$ 1 trillion per without exposing them Commission on Global Mental Mental health year in economic losses. It is to financial hardship in Health and Sustainable conditions include well known that people living paying for them. Development3. It centers on mental, neurological and with mental health conditions scaling-up mental health care substance use disorders, are more likely to face other Quality mental health as part of universal health suicide risk and physical health problems (e.g. care refers to care that coverage, leaving no one associated psychosocial, HIV, TB, noncommunicable is safe, effective, timely, behind. cognitive and diseases), causing early mortality efficient, equitable intellectual disabilities. of 10-20 years. Suicide mortality and people-centered. By 2023, the WHO Special is high (close to 800 000 deaths This includes ensuring Initiative for Mental Health per year), disproportionately affecting interventions and will support access to quality young people and elderly women in low- and middle-income services are evidence- and affordable community- countries. Mental health conditions are especially common for based and respect based mental health care for people affected by humanitarian crises and other forms human rights. 100 million more people. In of adversity (e.g. sexual violence). reaching the programme goal, WHO will contribute to (a) two To date, mental health care has had many advocates but GPW13 targets, coverage of severe there has been limited commitment and funding for sustained mental health conditions increased to 50% and reduced implementation and scale-up of services. For WHO to realise its suicide mortality by 15%4; and (b) two SDG indicators, suicide 2019-2023 mission to Promote health, keep the world safe, serve mortality (3.4.2) and treatment coverage for substance use the vulnerable, mental health has been flagged as a priority area disorders (3.5.1). for accelerated implementation. Such implementation will benefit from the many resources WHO has recently developed, including: Two strategic actions will be implemented, each with different evidence-based guidelines, technical packages of interventions, expected outputs, shown in the table. rights-based frameworks, implementation guidance and training resources. WHO staff have extensive field experience, informing what works for supporting quality and affordable mental health care, and what is needed for scaling up services. STRATEGIC ACTION 1: STRATEGIC ACTION 2: ADVANCING MENTAL HEALTH POLICIES, SCALING UP INTERVENTIONS AND SERVICES ADVOCACY AND HUMAN RIGHTS ACROSS COMMUNITY-BASED, GENERAL HEALTH AND SPECIALIST SETTINGS 1. Globally, mental health is positioned high on the 1. Quality, affordable mental health care is scaled up development and humanitarian agendas across health and social services 2. Local champions, people who use mental health 2. Quality, affordable mental health care is integrated services, and their organizations are empowered to in relevant programmes (e.g. for HIV, gender-based participate in the development and implementation of violence, disabilities) mental health policies, strategies, laws and services 3. Mental health and psychosocial support is included 3. Mental health policies, strategies and laws are for preparedness, response and recovery in developed and operationalized based on international emergencies human rights standards 4. Priority interventions for groups in positions of 4. Media and community awareness about the importance vulnerability (e.g. women, children, youth, older of mental health across the life course is raised people, staff) are developed and implemented 5. Human and financial resources for mental health are 5. Implementation is documented, monitored and brought in line with the needs evaluated to improve services 1 Constitution
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