Reflections on the multi-stakeholder hearing on the Financing Dialogue on NCDs and Mental Health: What did we learn and what next?

WHO and the World Bank are hosting a Financing Dialogue on NCDs and Mental Health in June 2024. Ahead of this meeting, civil society was invited to a multi-stakeholder hearing to learn more about the process and ask questions on March 15. 

From 26 April to 24 May there is an online consultation where CSOs can share their views.

UnitedGMH is the mental health CSO partner responsible for ensuring the mental health community is well informed and represented throughout the process alongside the NCD Alliance for the NCD community.  We have already written to a number of mental health networks and encouraged the Global Mental Health Action Network financing working group to get involved.

 

So what did we learn and what next?

 

We learnt the details of how the process will work

  • The financing dialogue is being co-organised by the World Bank and WHO. The process and outcome need to ensure governments use the opportunity to learn from the financing dialogue; and identify and commit to better ways to fund NCDs and mental health, integrated through stronger primary and community health systems.

 

  • There are a number of background papers written by WHO and the World Bank, and one written by UnitedGMH and the NCD Alliance, that will inform the discussion. CSOs will be asked to provide feedback from 22 April to 30 May. UnitedGMH will promote ways CSOs can feed into the consultation process as soon as it opens.

 

  • The Financing Dialogue will be an in person meeting in June at the World Bank. But the participant numbers will be limited so most CSOs will want to register for online participation and keep in touch with the NCD Alliance and UnitedGMH on potential ways to participate.

 

And what should we be calling for?

 

Each mental health organisation will want to determine what they want to call for. Here is a summary of what UnitedGMH believes are important points to raise during the consultation process.

NCD and mental health finance should be integrated where possible, and always complimentary

  • Integrated, person-centred care: We all have physical and mental health. It is person-centred care we should be aiming for, not simply a response to one particular physical or mental health condition or NCDs as a whole versus mental health as a whole. How health systems are financed can drive this approach.
  • Human rights must be upheld including the right to good physical and mental health for all. People at risk or living with a mental health condition can see their rights eroded: the financing dialogue needs to acknowledge this and advocate for financing solutions that uphold human rights.
  • Addressing NCDs and mental health co-morbidities to deliver better results and more cost-effective outcomes. People living with mental health conditions such as bipolar disorders are also at greater risk of physical health conditions such as heart disease and respiratory disease. A smart approach to financing is to tackle both prevention as well as the processes of diagnosis and treatment. We need to make mental health prevention measures freely available to all, especially those at higher risk of NCDs. And if the policy is to encourage healthier lifestyles by taxing unhealthy foods, then recognise this as a mental health benefit too.

 

Domestic resources need to be increased and improved

  • Financing the integration of mental health into primary and community health care needs to be the priority not spending most money on mental institutions. Right now in many countries, the majority of funds for mental health are spent on locking people up – this needs to change. 
  • The 2018 Lancet Commission’s government spending targets of at least 5 and 10% of health budgets on mental health should be met by all governments. These targets should also be reviewed to continue progress and a cross-government spending guideline considered.
  • Mental health is a multi-sectoral issue. To support better mental health for all requires “mental health in all policies” (as set out by WHO, UNICEF and many other organisations). It is important to work with the education, judicial, social protection, environmental and other sectors and to focus on primary and community care. This needs to be reflected in how funding for mental health is approached, in both emergency and non-emergency settings.

 

Where domestic resources are not enough, catalytic donor finance is needed to create systemic change and sustainable financing solutions

  • Bilateral and multilateral donors should provide at least 0.5% of their DAH to mental health, with this increasing to 1% by 2028, and aligned with the mental health disease burden by 2030.
  • Bilateral and multilateral donors, and private donors working in health, should develop dedicated global mental health strategies which recognise mental health as both a fundamental goal in and of itself as well as a critical enabler of wider sustainable development. The strategies should incorporate mental health prevention and promotion; integration of NCD and mental health care; mental health as a critical component of universal health coverage; mental health as a critical component of humanitarian responses; and global mental health research. They should also be fully integrated into wider ODA strategies as part of a mental-health-in-all-policies approach.
  • Mental health financing for emergencies needs to increase, be well coordinated, and span the humanitarian-development nexus. This means greater investment in addressing emergencies must be committed by the World Bank along with bilateral and multilateral donors.

 

Finances for mental health and NCDs must be transparently monitored and tracked through participatory processes

  • There should be a universally agreed upon definition for development assistance for mental health (DAMH) and this definition should be used to systematically report on and analyse DAMH flows. This could take the form of a policy marker in the OECD DAC Creditor Reporting System.
  • CSOs must be key participants in multisectoral national, regional and global budget-planning and priority-setting; and in monitoring implementation. This has to include those with lived experience of mental health and NCDs.
  • Governments and donors should invest in developing civil society’s capacity to support community engagement and people with lived experience in mental health and NCD responses, establishing collaborative and mutually supportive policymaking processes.

 

UnitedGMH will be working with a range of mental health organisations and networks to ensure that mental health stakeholders are engaged fully in the process and the outcomes. 

We will also be directly engaging governments, as well as bilateral and multilateral donors to ensure they make full use of the Financing Dialogue to deliver meaningful financial commitments underpinned by a rights-based approach.

Look out for a new UnitedGMH policy paper shortly on the Global Financing Dialogue here.

Join the Global Mental Health Action Network and be a part of the Financing Working Group to get involved.

Look out for updates on UnitedGMH and GMHAN social media channels.

For more information:

Financing Mental Health: The Current Situation and Ways Forward (UnitedGMH, 2023)

Finance Policy Brief and Donor Profiles: Official Development Assistance