Deinstitutionalisation

When institutional care takes priority over primary and community-based care, human rights violations, as well as accessibility issues, become particularly prevalent. The WHO recommends scaling down and closing psychiatric institutions and shifting mental health care towards primary and community-based care.

The Challenge

In most countries, mental health care still heavily focuses on psychiatric institutions and tertiary-level treatment facilities, despite the fact that most mental health conditions do not require inpatient care or can be addressed in a shorter time than the average stay in a facility. The WHO Comprehensive Mental Health Action Plan points out that, approximately 67% of the already limited budget allocation for mental health goes to institutional care and psychiatric hospitals in low-income countries. The WHO recommends a gradual shift towards scaling down and closing long-stay institutions, redirecting investments towards strengthening primary health care. There have been documented instances of human rights abuses in long-stay institutions in a number of countries, along with experiences of coercion, discrimination and isolation. Therefore, transitioning away from institutions will also ensure a better quality of life and protection for individuals who require mental healthcare. 

Despite the increasing acknowledgement of the importance of person-centric and human rights-based primary and community-based health care, mental health legislation continues to be heavily focused on institutional care. 

We provide our civil society partners with evidence and technical support to bolster their call for:

  • Deinstitutionalisation of mental health care
  • Protection of the legal rights of people with mental health conditions and their reintegration into the community
  • The right legal framework to support families and caregivers.

 

Our Approach

Our approach will be to work through national partners to encourage their governments to update existing legislation and policy and increase financing to move away from institutional care, prioritising primary and community-based care, secondary care, and, where needed, short-term care in hospitals. We will create avenues for them to advocate directly at the national level, as well as at the global level, through participation in key moments and in official UN Review Cycle processes. We will also work at the global level to secure commitments towards deinstitutionalisation of mental health care at key global moments and advocate directly to bilateral donors, multilateral funding mechanisms and donor organisations/foundations to increase available financing for deinstitutionalisation.

 

To learn more read

Read the World Health Organisation’s report on Deinstitutionalisation.

Read case studies of different approaches towards deinstitutionalisation:

 

Get Involved

The Global Mental Health Action Network (GMHAN) is the world’s leading advocacy network for better global mental health. If you would like to get involved in GMHAN’s work on advocacy, register to become a member of the network today. 

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