Making Person-centered Mental Health Care a Reality
October 18th, 2022 | Viewpoint
October 18th, 2022 | Viewpoint
One in every eight people lives with a diagnosable mental illness, and nearly three-quarters do not receive the mental health services that they need. This global burden contributes to one in every 100 deaths resulting from suicide. In 2019, one-tenth of all disability adjusted life years were due to mental health disorders, and approximately 12 billion work days a year are lost due to depression and anxiety.
Despite these shocking statistics, mental health continues to be neglected within the global health arena. Almost universally, other health conditions are prioritized over mental health. Countries dedicate less than 2 percent of their health care budgets to mental health, and community-based, person-centered mental health care is consistently underfunded, though it has great potential to meet people where they are. Funder agencies also deprioritize mental health, which further diminishes its visibility as a critical public health issue.
JSI was pleased to participate in the WHO Mental Health Forum 2022. Over the course of the two-day virtual meeting, government, academia, private sector, and civil society representatives expressed urgency for global investments in mental health to overcome challenges that have arisen during the COVID-19 pandemic. The meeting included the following highlights.
At the Launch of The Lancet Commission on Ending Stigma and Discrimination in Mental Health, participants were reminded that: 1) mental health is not important to the individual and to the family only; it is a global health good; 2) the presence or absence of mental health is not binary; it occurs along a continuum across the life course; 3) mental health is a fundamental human right that affects our ability to access all other human rights; and 4) there are important social and environmental factors that serve as drivers, protectors, and risk factors of mental health. The Lancet Commission, developed in collaboration with people with lived experience, calls for ending all forms of stigma and discrimination against people with mental health conditions, which many describe as worse than the condition itself. In addition to exacerbating social exclusion, stigma and discrimination reduce access to needed care and diminish educational and employment opportunities. An overview of 216 systematic reviews examining anti-stigma interventions demonstrated that the most effective way to reduce stigma and discrimination is through culturally appropriate social contact between people who do and do not have lived experience with mental health conditions. The Lancet Commission had an explicit call to all media organizations to remove content that portrays people with mental health conditions as dangerous. It instead suggests that media organizations reduce stigma through accurate, responsible, and nuanced portrayals of individuals living with mental health conditions.
In the overview of the new report, WHO urged supporting mental health programs that are people-centered, recovery-oriented, and human-rights based. Person-centered care can have lasting benefits for individuals, families, communities, and systems. Its application to mental health can enhance trust, improve access to and quality of mental health services, and strengthen health literacy and decision-making skills to promote independence. To achieve this type of care, we must cater to the spectrum of mental health needs, including integrating mental health services into primary health care, and community-based and social services outside the health sector. This is a priority within JSI’s person-centered care framework.
The report further elaborates on community-based services needed to fully support person-centered mental health care. These include:
Below is a model of a comprehensive network of interconnected formal services that, with enough resources, can be achieved.
Beyond the health care setting, other sectors have important roles, including detection and mental health interventions in schools and within the justice system. Providing housing and employment opportunities benefit mental health, too.
The WHO Mental Health Forum called on member states and other stakeholders to:
To support population health and well-being, we must find creative ways to prioritize mental health, even when funding is scarce and it is not a priority within the global public health sphere. The adage is true: there can be no health without mental health. JSI is personally committed to the following—