Global Mental Health

 “Let us recognize that there can be no health without mental health.”  -U.N. Secretary General Ban Ki-moon (2008)

Mental health is fundamental to physical health, economic success, and general well-being. Yet, across the globe, gaps in treatment for mental health and substance abuse are significant. In the early 1990s, it became possible to measure the global burden of disease in disability-adjusted life-years (DALYs).  DALYs are the total number of years lost to illness, disability, or premature death within a given population.  This represents the overall disease burden.  The global burden of disease attributable to mental disorders has steadily increased from the time of the first report on DALYs in 1996. 

Despite the high burden, few countries devote sufficient resources to mental health.  As a result, many people who need care do not receive it. The quality of care received by many people also is generally poor in all countries and is often associated with violations of their fundamental human rights.   

Developments in Global Mental Health

Helpful to understanding the scale and scope of the global mental health crisis is a series of papers that appeared in The Lancet in 2007. The series identified gaps in the evidence base for depressive disorders, alcohol and substance-use disorders, child and adolescent mental disorders, and psychotic disorders, with a focus on developing countries.  The  high burden of mental disorders combined with gaps in treatment constituted a global mental health crisis.  

Convention on the Rights of Persons with Disabilities

The first comprehensive treaty for persons with disabilities was adopted by the United Nations in 2008 and quickly ratified by most countries.  It came into force in 2008.  

Movement for Global Mental Health

Initiated in 2007, the MGMH is an online network of mental health practitioners, researchers, policymakers, consumers, funders, and other stakeholders who are committed to improving services for people living with mental health problems and psychosocial disabilities worldwide.  The MGMH is especially concerned with improving services in low and middle-income countries where effective services are often scarce.  The Movement embeds its advocacy in human rights.   

mhGAP  

The World Health Organization's Mental Health Gap Programme was established in 2008 for the purpose of scaling up services for mental, neurological and substance use disorders especially in low- and middle-income countries.  The WHO provides resources to help countries reduce the treatment gap and respond to the high burden of mental health disorders.

The Grand Challenges in Global Mental Health

Sponsored by the National Institute of Mental Health and the Global Alliance for Chronic Disease in partnership with the Wellcome Trust, the McLaughlin-Rotman Centre for Global Health, and the London School of Hygiene and Tropical Medicine, the Grand Challenges Initiative was initiated in 2011 with the goal of identifying research priorities that, if addressed in the next decade, could lead to significant improvement in the lives of people living with neuropsychiatric illnesses.  A grand challenge was defined as a specific barrier that, if removed, could improve the lives of people living with mental, neurological or substance use disorders.   

WHO's Mental Health Action Plan

The 66th World Health Assembly adopted WHO's comprehensive mental health plan 2013-2020 in 2013.  It was adopted by all 194 ministers of health in the World Health Assembly.  The plan calls for changes in attitudes that perpetuate stigma and discrimination and for expansion of services to promote greater efficient in the use of resources.   The plan has 4 major objectives:

  • strengthen leadership and governance for mental health
  • provide comprehensive, integrated and responsive mental health and social care services in community-based settings
  • implement strategies for promotion and prevention in mental health
  • strengthen information systems, evidence and research for mental health.  

Sustainable Development Goals 

With the adoption of the Sustainable Development Agenda by the United National General Assembly in 2015, world leaders - for the first time - recognized the promotion of mental health and well-being and the prevention and treatment of substance abuse as health priorities. Specifically, Goal 3 of the 17 Sustainable Development Goals focuses on ensuring healthy lives and promoting well-being for all at all ages. World leaders have committed to “prevention and treatment of noncommunicable diseases, including behavioral, developmental and neurological disorders, which constitute a major challenge for sustainable development.”

Out of the Shadows

This was a two-day series of events, co-hosted by the World Bank and the World Health Organization during the World Bank-International Monetary Fund Spring Meetings.  The purpose of the meeting was to recognize mental health as a global development priority.  

Disease Control Priorities-3

The Disease Control Priorities was funded in 2010 by the Bill and Melinda Gates Foundation.  It is a multi-year project managed by the University of Washington's Department of Global Health and the Institute of Health Metrics and Evaluation.  It provides a periodic review of the most up-to-date evidence on cost-effective interventions to address the burden of disease in low-resource settings. 

The 3rd edition of Disease Control Priorities provides a review of evidence on cost-effective interventions to address the burden of disease in low- and middle-income countries (LMICs). It published recommendations for cost-effective packages of care for the prevention, treatment, and care of mental disorders that are feasible for delivery through a range of platforms and that can be prioritized as the mental health component of universal health coverage.  

Lancet Commission on Global Mental Health and Sustainable Development 

The  Lancet Commission on Global Health and Sustainable Development  released a report in October 2018 proposing a reframing of mental health in the context of the Sustainable Development Goals.  The purpose of the effort is to address prevention and gaps in the quality of services while also addressing the treatment gap in an effort to reduce the global burden of mental disorders.  Learn more about the Commission.    

Our Work on Global Mental Health

In 2016, the Global Alliance formed a task force to help us discern how we can best support efforts to promote mental health across the globe. In 2017, the Board of Directors for the Global Alliance approved a resolution on global mental health and substance use disorder developed by the task force. In 2019, the task force will be presenting a panel session at the Society for Community Research and Action's biennial conference, which is being co-sponsored by the Global Alliance.

Our Spotlight features research in AJO on global mental health.  

Want to learn more?

What can you do? 

  • Learn more about the mental health challenges faced in countries across the globe and share what you have learned with others.
  • Support organizations that address global mental health.
  • Join in the World Health Organization's promotion of World Mental Health Day every year on October 10.