Long Ignored in Global Development, Mental Illness Is Declared a Top Priority

On April 13 and 14, the World Bank and World Health Organization did something that no institution of their size has ever done before: they put mental health squarely on the global development agenda.

At Out of the Shadows, a jointly hosted high-level event leading up to the bank’s annual spring meetings with finance ministers from all over the world, the two organizations promoted cost-effective treatment for anxiety and depression, declaring that failure to treat these two most common mental illnesses can contribute to poverty and diminish economic growth. This is a groundbreaking move that could have enormous positive implications for people with mental illness worldwide—but only if grounded in a human rights–based approach.

“We need to put the same energy into mental health as we did into HIV,” said World Bank President Jim Yong Kim. “Let’s put mental health in the spotlight and keep it there. I give my personal commitment that we will not forget mental health.” At the same event, WHO Director General Margaret Chan declared, “In mental health, we must approach with compassion, in solidarity with the people. As long as I am director general, I won’t be a lame duck.”

This is excellent news because, to date, mental health has been virtually absent from the global development agenda. In most countries—including in developed countries—government spending on mental health is woefully inadequate. Millions of people with mental illness have poor or no access to the services and support they need to exercise their right to live in the community.

The World Bank and WHO’s declaration seeks to rectify this. However, the people who need support the most will fall through the cracks of a global development agenda that is not approached from a standpoint of human rights. The developing world raises special concerns, since developing countries are eager to become “developed countries,” and infrastructure, whether financed through loans from the World Bank or funded by international development agencies, is alluring to governments.

New buildings look good, and allow politicians to cut ribbons with television cameras rolling. The danger is that, in mental health, this translates into more asylums that segregate people with mental illness from their communities.

Take the case of Burma, where mental health care is provided in isolated institutions, and only to those who can access the two that exist in the country. The government is now adding 200 beds to the decrepit psychiatric hospital outside Yangon, where people languish—often for decades—with very few ever being successfully rehabilitated.

This is one example of poor investment in mental health care, but it is an unfortunate trend in many countries. More beds in archaic mental hospitals are not what people with mental illness need. What they need are services and support, and a system that protects their human rights. What they need is compassion, and a sense of being valued citizens in inclusive communities. A rights-based approach to mental health need not pump millions of dollars into new infrastructure that will only segregate and isolate people, and focus on their “pathologies.”

There is an alternative to this grim scene, and it, too, exists in Burma. Aung Clinic is a model of what the future of mental health could look like. It is a community-based general practice medical clinic into which mental health services are fully integrated. This is collaborative care: an evidence-based approach to caring for chronic mental illness in primary care settings.

People with mental illness receive holistic care for their physical and mental health, including talk therapy, crisis intervention, family support, and medication if they need it. Clients and doctors agree on treatment plans together. It is a low-cost, effective health care service that should be replicated everywhere.

We are seeing the results already. People have the services and the support that they need to get jobs, repair relationships, and establish friendships. They are once again citizens who have regained dignity and self-respect. In rolling out its development plan, it is critical that the World Bank and WHO look at the progressive, rights-based mental health care that already exists in target countries and then invest in scaling those models up.

If we keep human beings and human rights at the center of the effort to put mental health on the global agenda, we will make meaningful change. If the focus is on the system and the infrastructure, the people who need help will be an afterthought, falling through the cracks yet again.

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Mental Illness can affect anyone at any time. If you feel infallible, family, friends, neighbors, can fall prey to mental disability which can impact your life. To marginalize those with mental illness instead of fully support them is no different than if we were to turn our backs on broken limbs or internal diseases. Illness is one and the same, no matter if it's the body, brain, or psyche.

of a truth countries and communities in developing countries like mine in Nigeria see mental health as people whose own is already written off thus most them resort to spiritual approach which entails abuse of human right due to the method they employ in their treatment.

This is a wonderful news. Thanks for keeping us informed


That's big achievement! I hope Alzheimer's disease is included.. - they need help also

Hello WHO,

Taking on the issue of mental health around the globe is, I believe, one of the most important decisions you have made in centuries. Now, spend the money and use your political capital to see it through.
Thank you.

Dear Colleagues,
Many thanks to World Bank and WHO for pushing Mental health on the global development agenda. This situation is critical for key intervention for our people living in mental illness over a long period of time without support from other government. We really need a right-based approach to save the lives of people around the world.

Now to conclude , World Bank and WHO need to support the awareness campaigns on Mental Health by providing fund to civil society organizations in various around the world to engage their government to invest in Mental Health in the national budget.

Thanks a Million
Benjamin Tarnue
Executive Secretary/Director
National Coalition of Civil Society Organizations of Liberia

This is encouraging news. So many people are falling through the cracks of a broken mental health system everyday. Human rights and the restoration of dignity and self respect must be at the center of care and access. The commitment to persons living with mental illnesses and advocates must be citizens included in the planning and design of services as well. Policies must need to be put in practice that can protect those who speak up about equity in mental health care -- they need the protection of the hunan rights centered services they are trying to provide but to getting much if any financial supports. Also, we must attend to human rights protection of those living with mental illnesses and chronic health conditions and ensuring they have the supports necessary to remain in community, providing accommodations and other support to be contributing members within our societies and not isolated or discriminated against or ignored and allowed to endure years of prolonged suffering while waiting for government institutions and systems to prioritize more of a do whatever it takes attitude to ensure access to quality care /reduce the burden of lack of social support, illnesses and suffering. It's been a hard and lonely road for our clinic that has been lead by a person living with both mental illness and chronic health conditions - a clinic heavily committed to human rights based approaches for low income/disadvantaged women of color living with mental health challenges and illnesses and attempting to rear children in poverty/trying to recover/health and grow. with mental and physical health needs. The notion of advancing or scaling up less costly and effective treatment and prevention is so encouraging -- and a culturally humble, human rights approach is a major policy shift. This is all so hope inspiring and encouraging. Thank you for sharing this news!

Indefinite Detention of People with cognitive and psychiatric impairment, the type of persons being detained under Mental Health Legislation in some countries are defined as "Mental Health Persons", in many cases these either are perceived to be people who represent a danger to either themselves or to the community.

Happy to note that at last the economists and bankers have realized that the problems with this world are not in money, stocks & shares, Stock Exchanges, exchange rates but more deep rooted, in the mind. But if you do not know what mind is then you are up the wrong path. West only know of mind and consciousness. But the working of the mind is not just in consciousness but in name/form & consciousness. The name/form illustrate the consciousness forming either greed, hatred or delusion. It is the delusion of a self that drives it. Functional consciousness uses the illustrations. For example someone curse you, the name/form, name (feeling, preception, thinking, touch and attention) form (form perception wil illustrate the consciousness. later if you see that person again, like in computer the curser will click on the loaded data in consciousness and the ram will bring it out. In this case the illustration surfaces in your consciousness and your thoughts start and may be you will curse him or at least think here is the man who cursed me 20 years ago. The way out of this mental illness for the whole world is meditation, Vipassana Meditation and Mindfulness Meditation. If you want to know more I will be most happy to write further on tjis so that people who are in deep stress today can be helped to be happy.

This is a positive step. Hoping that our government here in uganda will prioritise mental health.

I have started a community based organisation for a community where mental health is not understood because of lack of awareness. Infact people with mental health are discriminated against.my dream is to see people access services and regain their confidence and dignity.

Это благое и нужное дело.

This is a good move.

I am about to prepare and send to Moscowian Russian language Intern. J. Appl. & Fund. Res. an article wanted there entitled 'Theoretical-Psychological Approach to Etiology of Psychical Disorders'. If you are interested in knowing this quite new glance at the new subject I am ready to take a part in your program and for beginning to give you English version for it to be accessible for your experts.
Vladimir Tretyakov, DSc (philosophy), IAIT FM,
Director, web IntelTech.by IAIT:

At last! Hopefully it will change the situation of the patients and their families!

Thank you for bringing this to the forefront!

i totally agree. treatment for people with mentally diffable is really different with all physical diffabilities. So, it must have a very specific treatment and approach. political will for this issues is very much needed.

I think the two jaint institutions couldnt have done better than this. mental health perhaps is the most important concern across the world in todays time. No development can be said progressive unless depression, anxiety, anger and isolation are considered as the roadblocks in individual well bein and attended to. Inatitution providing holistic care and comprehensive treatment should be supported with resources to provide cost effective treatment. Families and societies should be educated to identify the symptoms of deteriorating mental health and take early steps to ask for support. individuals need to be educated to consider mental illness as one of the many illnesses which can be handled if assistance is sought. And finally social stigma attached to mental health requires to be removed for previous lives to be saved.

Finally mental illness alert in global agenda, we are here in Timor-Leste hope its bring a changes to condition of mental illness people in this country. Every year government spent million to HIV/AIDS program while forget this huge number of people who continue life in disgraceful condition in the country.

a very informative article which lead the practioners to keep it a priority if they actually see for overall development. a healthy mind can invest a lot in development. thank OSF

Thanks for the great effect you have made to see that mental health patients are been prioritized in the countries. our country Liberia, have numbers of mental health people roving in the Street with no prepared attention being paid to them. To be frank you have done a great work. we can also consider other priority diseases such as Hepatitis B which is killing our people easily in west Africa countries.

Thanks for the great effect you have made to see that mental health patients are been prioritized in the countries. our country Liberia, have numbers of mental health people roving in the Street with no prepared attention being paid to them. To be frank you have done a great work. we can also consider other priority diseases such as Hepatitis B which is killing our people easily in west Africa countries.

How might mental illness play a role in the war on terrorism? What if, many of the terrorists on kill lists, suffer from mental illness--how does one determine the faculties of a uniformed/state versus a non-uniformed/non-state actor and how many would-be terrorists are simply suffering from mental illness or emotional issues stemming from PTSD and other psychological enigmas as a result of generations of violence? Perhaps there is a link between terrorism, jihad and institutions of religion that offers a suicide solution to those suffering from the stresses of societal violence and tragedies that lack substantive peaceful resolve? Perhaps there is a way to fight the war on terror that is more intellectual and less militaristic since military solutions have not proven to stop an act but to breed future ones. Tough stuff--since drones seek to limit unintended casualties and the U.S does its best to NOT blanket bomb as some lesser intellects suggest it move its bombing to that of the ho chi-min trail of yore? Perhaps bombing with mental health services, economic inclusivity and compassion for others stuck in a endless war, are victims of themselves more than of U.S policy or the lack thereof? The world bank might be onto something en-masse if it looked at the link between mental fatigue/PTSD and its role in creating terrorists who simply suffer from mental illness?

the disease of power and accumulating money is at the root of the pain and suffering ... we take care of them and life will be more beautiful for everyone

This is very encouraging and a long overdue step in promoting total health and consequently development.

Good News! Please never stop advocating for community, evidence based programs. This is my passion too. Founder of www.momslikeus.ca advocating to bring a Clubhouse International to my community. In our beautiful, west coast city where tourists flock - we have the highest death rate per capita in our Province of homeless individuals. Lack of service is discrimination. Now we have a large tent city! Thank you for vowing to never give up the fight - and I will not either!

I represented the World Council for Psychotherapy at the 66th Conference of the UN DPI / NGO, which took place in South Korea, earlier this month.
All material of this conference is available here: http://outreach.un.org/ngorelations/conference-2016/
The main theme was:“Education for Global Citizenship: Achieving the Sustainable Development Goals Together”
The Conference was divided into five round tables to facilitate discussion of all the associated angles, all related to the development goals to be achieved by 2030.
To my discomfort, mental health was only mentioned once, in relation to the trauma, in one of the sub-themes of the round tables. I attended this roundtable and at any time the mental health and wellbeing was discussed.
I and a colleague from the World Federation of Mental Health intervene with relevant issues.
Mental health was not considered as an active issue in the discussion.
However, informally, I was allowed to ensure the understanding that there is no real education, quality and inclusive, that does not leave anyone behind, without health is considered (physical and mental).
The final action document, although not refer to mental health directly, puts it as implied when talking about inclusion, equal rights and minority groups, a global family that "leaves no one behind."

The final document, which deserves to be read by all citizens of the world, is here: http://outreach.un.org/ngorelations/files/2016/05/FinalAA.pdf

So for me (I'm a psychotherapist, completely focused on health and mental well-being, education of society about mental health so that no longer exist stigmas or false beliefs about therapy as well as in education of the institutions) who live and work in an underdeveloped country in Africa, which has about 24 million inhabitants, everything takes on an urgent character and almost calamity. For if the health and mental well-being is an essential asset to any country, it shall be for a country that continues to live a political and social instability, with localized armed conflict and refugees in neighboring countries, malnutrition, weddings and early motherhood, with one of the highest HIV rates in the continent?

Urge the approach of organizations such as the WHO (which is part of the United Nations), the other operating organs of the United Nations, the World Bank and all other relevant organizations, including civil society.

A holistic approach is needed, and great compassion. Off all.
I was not born in this country but I'm trying to do my part. We all have that responsibility. And we can choose to be where, in fact, we can contribute with our humanity and love.

The diffusion of knowledge and perception of responsibility is something we can all do.
Because there are many people who can not speak for themselves.

Thank you Judith, and thank you all.

Metal Health Peer Support Groups such as Uganda Mental Health Fellowship could provide a meaningful example of promoting the mental wellbeing and human rights of people living with mental illness in a low cost community based setting. There a need to support this noble cause!

mental health needs to be taken seriously. unfortunately, my experience as a professional tells me that the finances are seldom available despite lots of good intentions...

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