An historic moment for mental health

Mental Health took a leading role at the 148th session of the World Health Organisation’s Executive Board this month.

“This is the first time, ladies and gentlemen, that mental health is being discussed in the Executive Board within the emergency agenda…therefore this is a historic moment”

Dr Zsuzsanna Jakab, Deputy Director-General.

Over the past year a multitude of activities from a range of people and organisations from across the world have contributed to mental health being a key feature in this year’s WHO Executive Board Meeting. Commanding its own agenda item, mental health, in relation to the COVID-19 pandemic, could be properly discussed and considered by the world’s health authorities; with over 40 member states co-sponsoring the report..

Key moments that have shown the world that mental health needs to be properly addressed in order to strengthen global health includes: the unfaltering support of the UN Secretary General for mental health, particularly in the context of the COVID-19 pandemic, leading to a specific UN policy briefing and accompanying statement, as well as the SG’s ‘behind the scenes’ conversations with a variety of lived experience advocates; an open letter from thousands of leaders, citizens and advocates calling on governments to ‘build back better’; and a group of 95 member states signing a letter to support the appeal by the United Nations Secretary General, calling on countries to put mental health front and centre of their responses to, and recovery from, the COVID-19 pandemic. The tragedy of the COVID-19 pandemic is, it appears, pushing mental health to the forefront of the international community. But nevertheless it is encouraging to see mental health getting the attention it has so desperately lacked in the past, particularly with such positive recognition for the need for integrated, person-centred mental health services.

The call for community-based, person-centred mental health care was a strong theme throughout all of the member states’ statements, and non-state actors’ statements, with a focus on ensuring mental health care is accessible for all through its integration into universal health coverage. A key component to achieving this is integrating mental health services into primary health care, as part of the drive towards UHC, with many speakers also highlighting the ways that their governments have innovated to create interventions that are accessible even in the context of a lockdown, such as hotlines, online counselling and community psychological first aid training.

The Executive Board was also an opportunity to discuss the extension of the Comprehensive Mental Health Action Plan, with Devora Kestel, Director, Mental Health and Substance Use, WHO, highlighting new recommendations for incorporating measures into mental health systems, and updated targets, as well as developing new technical tools to focus on each of these issues. As well as mental health and COVID-19 resources from WHO, UNAIDS shared news of a guide that they have developed with WHO for the integration of mental health and HIV programmes and services for the use of countries, service providers, programme implementers, development partners and communities.

UNAIDS looked to the HIV response for inspiration of how the mental health crisis should be tackled:

“We have learned that when there is a lack of specialized health service providers, task-shifting and capacity building of lay health workers is a good solution. Countries should develop, build capacities of, and train a cadre of both specialist and non-specialist providers for prevention, treatment and care for mental health conditions and substance use services.”

The mental health of frontline workers has also been a key concern for those participating in this year’s Executive Board, with many taking time out of their precious three minute slot to thank the perseverance and resilience of WHO staff and health workers. The International Federation of the Red Cross and Red Crescent summed up the issue, citing the “triple burden of trauma, exhaustion and fear.” Ensuring all health workers have access to substantial psychosocial and mental health services, must be an absolute priority so that they can continue to serve communities in need.

We are delighted to see that ‘mental health preparedness for and response to the COVID-19 pandemic’ is due to be further discussed at the 74th World Health Assembly (agenda item 17). Arguably there is also space for mental health to be included in other key agenda items such as: the social determinants of health section (21.1); Sustainable health financing structures and universal coverage (Pillar 1,A); Promoting the health of refugees and migrants (Pillar 1,C).

The mental health community should continue to push member states, and non-state actors to prioritise mental health in their work, and in the lead up to the World Health Assembly, with a particular focus on person-centred, community based mental health services, as part of the push towards UHC. It is crucial that when we come out of the other side of this pandemic we will be able to proudly say that we have built back better, and quality mental health services are more accessible than ever before.