2021: A year in review for United for Global Mental Health

By Sarah Kline, CEO and co-founder, United for Global Mental Health

As 2021 draws to a close, at United for Global Mental Health we have taken some time to reflect on the powerful impact we have had and the key learnings we have gathered through our efforts as an organisation and in partnership with the wider global mental health community.

With much of the world’s attention focused on questions around vaccine equity and pandemic recovery, this year we have worked hard to find new ways to ensure that mental health remains at the top of the global agenda and a core component of Covid-19 management and recovery plans. From joining the WHO in the development and launch of their official 2021 World Mental Health Day campaign, to advocating for greater prioritisation of mental investment at the World Bank and IMF Annual Meetings, we have leveraged key global moments to highlight the ongoing need for urgent action on mental health. We have also developed important relationships with new global and national partners, expanding the Global Mental Health Action Network to over 1580 members, and encouraging collaboration to achieve change and raise the profile of national partners on the global stage.

To guide our future work, we also developed and launched our new 3 year strategy. Outlining our priorities for 2021-2024, the strategy details how we will focus our work on the areas in which we have built unique knowledge and expertise, and remain committed to our vision for a world where everyone, everywhere has someone to turn to for their mental health.

In particular, our Theory of Change maps how we see the world achieving this vision and where we fit in delivering this. We have identified four areas of strategic impact against which we will measure our success. These are:

Rights – Everyone’s right to enjoy the highest attainable level of mental health is upheld

Education – Decreased stigma and discrimination and promoted rights, achieved through empowered populations

Systems – Quality, comprehensive and person-centred mental health services are accessible for all

Finance – Optimal finance is in place for mental health systems

 

Below are some of our key highlights from this year.

Rights

So that everyone’s right to enjoy the highest attainable level of mental health is upheld.

Suicide Decriminalisation

Suicide remains a criminal offence in 20 countries around the world. This is despite the fact governments agreed to reducing suicide as part of the UN Sustainable Development Goals, and committed to decriminalising suicide through their endorsement of the extended WHO Global Mental Health Action Plan 2013-2030.

In response to the requests of our national level partners, we developed a report that provides an in-depth analysis of the legislative structures that criminalise suicidal behaviour in these 20 countries. Launched in the run up to World Suicide Prevention Day 2021, our report, Decriminalising Suicide: Saving Lives, Reducing Stigma, was produced with the support of Thomson Reuters Foundation’s TrustLaw programme, an international law firm who led and conducted the research, and the International Association for Suicide Prevention. It is designed as a tool for campaigners and advocates seeking to decriminalise suicide around the world, helping them to tackle this urgent human rights issue on a national level through legislative change.

The launch of the report drew international media coverage, including from The GuardianBBC Radio 4 (Thought For the Day), TRT WorldThe Economic Times and Periodico Daily. This was coupled with the launch of the Suicide Decriminalisation Working Group of the Global Mental Health Action Network, which was set up to connect those working towards the decriminalisation of suicide and suicidal behaviour, and to seek greater investment in suicide prevention. The group has already attracted over 150 members who are working together to exchange their experiences and strategies to decriminalise suicide.

The report, coupled with the excellent work of our Working Group members from Taskeen, saw Senator Shahadat Awan from Pakistan table a bill to decriminalise suicide in the senate. Senator Awan then participated in a webinar on the subject and remains in contact with updates of the situation. With the support of the Working Group and the IASP, we are hoping to impact movement on decriminalisation in several other partner countries heading in 2022. We are also working with the WHO on the drafting of a policy brief on the subject of decriminalisation and rights based legislation. We have utilised our network to get Working Group members as part of the consultation group for the brief, and we hope it will prove useful in their advocacy efforts.

Countdown Global Mental Health 2030

In 2018 The Lancet Commission on Global Mental Health and Sustainable Development was launched (with our support) to catalyse action to make mental health care a greater priority around the world. One of the core recommendations from the Commission was the creation of an independent monitoring and accountability mechanism that uses a broad and integrated set of indicators to monitor progress for mental health. In response to this we helped promote the concept (with the help of Bill Gates and Melinda French), raise funds and develop the first phase of the project.

This year we launched Countdown Global Mental Health 2030 with the WHOUNICEFGlobalMentalHealth@HarvardGlobal Mental Health Peer Network and The Lancet. It is a free and accessible database and dashboard that lets users search mental health data by country using a range of indicators. Combined with an annual monitoring report on what the latest data shows, this initiative fulfils the vision of the world’s first independent, multistakeholder monitoring and accountability collaboration for mental health. This first version of Countdown Global Mental Health 2030 has a special focus on the critical issue of child and caregiver mental health.

The launch of this long awaited tool was marked with a comment piece in the Lancet Psychiatry and featured in the Devex daily newswire, reaching hundreds of thousands of people. It has received lots of feedback and powerful testimonials to its value.

Countdown Global Mental Health 2030 has been developed to inform action: action to campaign, to advocate, to communicate and to change policy and practice so that everyone, everywhere, is able to exercise their right to the highest attainable level of mental health. It has already been used to launch a new brief in partnership with the Bernard van Leer Foundation and the Vitol Foundation, Child & Caregiver Mental Health: Using data to Make Progress. By using the framework of Countdown 2030, the brief incorporates social determinants for mental health, factors affecting mental health service demand and need, and factors affecting the strength of mental health systems.

The Global Mental Health Summit

This year we were pleased to represent global civil society in the design and delivery of the Global Mental Health Summit, which was hosted by the French Government and took place in Paris.

The “Mind Our Rights, Now!” mental health summit focused on three key areas: accelerating the international momentum for human rights in the field of mental health; promoting services that protect the dignity and rights of all; and sharing positive lessons learned across the field. With participants including professionals, civil society representatives and policy makers in psychiatry and mental health, the summit saw a series of plenary sessions and workshops taking place over the two days. Our role in this included writing a paper and organising a multi-stakeholder panel to highlight future ways to accelerate progress in achievement of better mental health for all.

Following on from the summits in London in 2018 and Amsterdam in 2019, this third summit was a milestone moment in mobilising the global community to accelerate progress on rights in mental health, and promote quality care systems. We were pleased to see that as a result of the summit the French government made significant pledges to reform mental health nationally.

Education

Empowering the general population decreases stigma and discrimination and promotes rights.

World Mental Health Day

In 2020, the outbreak of Covid-19 put mental health on the global agenda like never before. As research into the pandemic’s impact continued to show its devastating effect on mental health, and inequalities in accessing support were exacerbated, the need to prioritise this urgent issue became increasingly clear.

In light of this the 2021 World Mental Health Day theme focused on ‘Mental Health in an Unequal World’. This year we were pleased to work with WHO once again to develop the theme of their official campaign and support our global and national partners from around the world in amplifying their World Mental Health Day messages, making new connections and helping to drive progress.

A greater range of groups across more countries than ever before took part in the campaign this year. This included people with lived experience, civil society organisations, academics, governments and the private sector. Many groups, particularly among civil society, saw the day as an opportunity to highlight the many factors that impact mental health – from poverty to human rights abuses – and to call for action to address the inequalities in accessing good quality, rights-based mental health and psychosocial support around the world. An encouraging number of governments also used the opportunity to make their own statements on their plans to improve mental health. We intend to continue to make sure World Mental Health Day grows in size and impact.

Global Mental Health Action Network

Three years since we launched the Global Mental Health Action Network to help build collaboration on mental health advocacy, communications and financing, we have reached a membership of over 1580 from more than 110 countries. This is thanks to a combination of efforts and activities to build a community through webinars, meetings and the formation of various Working Groups. In recent months we have been pleased to launch two new Working Groups – the first focusing on Universal Health Coverage to help accelerate efforts on this critical issue, and the second a Francophone Working Group to bring together French speaking communities working on different aspects of mental health. By the end of the year a Youth Engagement group will also be added, run by young people, for young people, to ensure they have ownership of their own space within global mental health advocacy.

The Network has continued to launch a series of briefings and engagements around key global moments across 2021, including an open source Global Moments Calendar, which can be inputted into by all our partners, acting as a key resource for coordination across countries and issue areas. The GMHAN monthly newsletter and bi-weekly blog series also continue to deliver key topical and timely updates on all areas that the global mental health advocacy community is active within, and amplify the voices of our members.

In June, the Network also hosted its Annual Meeting – a key opportunity for network members to engage with one another, learn from others and inspire advocacy for the coming year. With experts including lived experience advocates from around the world, the meeting had a fantastic lineup of speakers for its ten virtual events.

Speak Your Mind

In May we held our Speak Your Mind Annual Meeting, bringing together campaigners from around the world for three days of cross-country action and strategizing on mental health.

Together campaigners shared their learnings from 2020, drew out key lessons and insights for the months ahead, and discussed potential moments of global collaboration in 2021. Sessions covered a range of topics, from corporate partnerships to advocacy on youth and disability rights, with partners opting in to learn more about their areas of interest.

In May many of our partners came together again to celebrate the first ever Mental Health Action Day, an open-source movement to encourage tangible action on mental health spearheaded by MTV Entertainment Group. This was the largest cross-sector effort to move the dial on mental health and emotional wellbeing, with prominent supporters of the movement including CBS, NAACP, Nickelodeon, Selena Gomez & Rare Beauty, TikTok, World Health Organization (WHO) and YMCA.

Finally in October Speak Your Mind partners united behind the official World Mental Health Day campaign from the WHO and World Federation for Mental Health. Many saw this as an opportunity to highlight the many factors that impact inequalities in mental health and demand action to address these issues. We were proud to help support our partners in this, amplifying their messages and making new connections to drive progress.

Global Business Collaboration for Workplace Mental Health

January 2021 saw the launch of The Global Business Collaboration for Better Workplace Mental Health – the first business-led global collaboration of its kind focused on advocating for, and accelerating, progress in workplace mental health.  The initiative was incubated by a group of committed global companies, supported by UnitedGMH.

Since launch, the business-led Collaboration has worked together with academic experts, multilateral institutions, and not-for-profit organisations, towards a shared aim of creating a world where all workplace leaders commit to taking tangible action to enable their workforce to thrive. It is encouraging all employers to pledge to improve workplace mental health. So far, 97 employers have signed the Leadership Pledge, covering 1.6 million employees and spanning 17 industries in 62 countries. The Collaboration has also launched a Pledge with Us webinar series, a Leading to Better Workplace Mental Health video series, and a series of Spotlight blogs, all sharing insight on tangible ways employers can help accelerate progress on workplace mental health.

By helping to develop and share best practice on mental health in the workplace, we are proud to have played a role in stepping up advocacy efforts around the world. We look forward to supporting the Collaboration in the future.

#MHForAll webinar series

April marked one year since the launch of our #MHForAll webinar series. Launched in 2020 in collaboration with The Lancet Psychiatry, Mental Health Innovation Network, MHPSS.net, the series was initially a way to provide policy makers and the wider health community with the latest evidence on the mental health impact of COVID-19.

Since then the series has continued to grow, reaching above and beyond its initial scope. We have now run over 40 sessions,  and expanded the series’ focus to explore a range of critical intersectionalities in the field of global mental health. More than 160 speakers have taken part, including governments, politicians, UN agencies, international and national civil society organisations, researchers, campaigners and people with lived experience.

The series continues to play an important part in our ability to bring together key stakeholders from across the field, explore the intersectionalities in mental health, and amplify the work and voices of those with lived experience of mental health issues. As pointed out by Ying Ying Lee in one session, the mental health community too often fails to properly meet the standard set by the slogan “nothing about us without us”.

By ensuring that our webinars, as far as possible, include diversity in both geography and experience of speakers, we hope to allow those most affected by the issues discussed to speak for themselves and share their expertise. We look forward to continuing to do this in 2022 and working closely with our national partners in doing so.

SYSTEMS

So that quality, comprehensive and person-centred mental health services are accessible for all.

HSBC

HSBC is a long standing supporter for our work at United for Global Mental Health. Our partnership dates back three years, when HSBC launched a global mental health education programme in September 2019 at Bill & Melinda Gates Foundation’s Goalkeepers event. Since then we have worked with HSBC around key global moments. In October 2019, we also worked with HSBC and Speak Your Mind to launch The Museum of Lost and Found Potential, which opened its doors to the public in London’s Covent Garden.

We work closely with the HSBC team, year round, to support in the delivery of their workplace mental health programme. This year, to mark World Mental Health Day, HSBC Global shared a powerful video highlighting the stories of three individuals, Craig, Huda and Gina, who opened up about their experiences of mental health. They each discussed how they have tried to challenge the stigma of mental health through sharing their stories of lived experience to raise awareness. They also emphasised how important this was to getting help, and explained how they were supported in the workplace. Just prior to World Mental Health Day HSBC also launched their updated mental health training programme and resources for all 200k+ staff worldwide. We are grateful to HSBC for their ongoing support and partnership, and look forward to continuing to work together next year.

Universal Health Coverage

Through the Global Mental Health Action Network this year we launched a new Working Group on Universal Health Coverage, recognising the importance of working towards integrating mental health into UHC. The group has just under a 100 members, with representation from across the globe, and aims to bring members together for joint advocacy, national campaigning, networking, resource sharing, learning and capacity building geared towards the integration of Mental Health into UHC plans. The Working Group is looking to target joint advocacy around key global moments including the G20, the World Federation for Mental Health’s annual congress and UNGA, with a particular focus on developing momentum ahead of the UN High Level Meeting on UHC in 2023.

In December we also launched a new policy briefing, ‘Mental Health as a Matter of Rights’, to mark Universal Health Coverage Day. Building on last year’s  UHC report, the  briefing lays out some of the key evidence around the links between mental health, human rights and UHC, and makes five recommendations on how to integrate mental health into UHC using a rights-based approach. Next year we will continue to build on this work by launching a further set of policy briefings on UHC Systems, UHC Financing and Education and UHC.

FINANCE

So that optimal finance is in place for mental health systems.

The Global Fund to Fight AIDS, Tuberculosis and Malaria

With the support of the Elton John AIDS Foundation, this year we continued to work hard to encourage the Global Fund to Fight AIDS, Tuberculosis and Malaria to include mental health in the Global Fund’s next five year strategy for the first time. To achieve this we worked with multiple stakeholders – bilateral and multilateral, trusts and foundations, CSOs and individual campaigners.

In February 387 signatories from 75 countries signed our Open Letter, uniting behind our call laid for the Global Fund to seize this crucial opportunity to integrate mental health into HIV and TB approaches. We continued to highlight the urgency around this issue, launching groundbreaking new research confirming that integrating mental health and psychosocial services into HIV and TB programmes will end these co-epidemics at a faster rate, and in a cost-effective way. We also shared suggested text to fit the Fund’s strategic framework on how health and psychosocial support can be fully integrated into the new strategy, as well as a full set of recommendations to the Global Fund Strategy Committee in a new briefing.

In November we were delighted to see huge progress in this advocacy as the Board of the Global Fund approved its new organisational strategy to guide the Fund from 2023 to 2028. The new strategy meaningfully includes mental health for the first time ever, and so provides a significant step forward in the integration of mental health in HIV and TB approaches world wide. In 2022 we will be working with national partners to turn the strategy into impact through ensuring that mental health is included in the Global Fund 2023 funding cycle to countries and so dramatically increasing financing for mental health.

World Bank and Global Financing Facility

With the level of public finance for mental health so low in many countries, international finance is critical to initially fill financing gaps and provide a catalyst for adequate, efficient and sustainable public mental health finance. This year the IMF and World Bank Annual Meetings provided a timely platform for a high-level discussion around this urgent issue.

To coincide with the meetings we launched a brief to examine two key financing mechanisms within the World Bank Group and the immediate opportunities for significant increase and improvement of finance for mental health across the world. We also hosted a panel event in partnership with the WHO, UNICEF, the Government of the Netherlands, and the Government of Pakistan. The speakers explored the importance of mental health financing, the progress made to date and the potential it can unlock.

As one of the largest financiers of global health in the world, the World Bank Group has the potential to play a unique and game-changing role in increasing and improving finance for mental health. Such investment in mental health by governments and international organisations will be critical to stepping up progress across the development agenda, and we look forward to continuing to work on this important issue in 2022.

LOOKING AHEAD TO 2022

Since we were established, mental health has risen quickly up the global agenda, accelerated by the impact of COVID-19. A large cross section of society is now calling for greater action, and there is more discussion of mental health in political fora, the workplace, on social media and among friends and families than ever before.

But stigma still exists, and the dramatic rise in levels of discussion are not reflected in the still woefully limited levels of funding nor in the arcane policies that still guide mental health service provision and restrict human rights. COVID-19 has both increased demand for mental health support and restricted access, while Climate Change brings new challenges and a further rise in mental ill health.

Our actions and advocacy in 2022 and beyond will be critical to addressing these issues. This year has seen greater integration of mental health in policy discussions and several new key political commitments at national and global level. But now is the time to ensure that this increased attention is translated into action. Policy reform and greater investment, underpinned by the upholding of human rights is essential. Further efforts to educate people, to reduce stigma and discrimination, and to address mental health as a multi-sector, whole of society issue is critical. We are determined to advance this work and ensure everyone, everywhere, has someone to turn to for support.

We look forward to sharing more of our plans for 2022 in January.