Union 2024 takeaways: Bringing mental health at the heart of TB and lung health conversations

This year’s World Conference on Lung Health was about more than just lung health and TB; it was also about the people who face these issues. Set against the backdrop of global conversations on integrated person-centred care, the Union Conference 2024 provided an excellent opportunity to spotlight an often-overlooked but highly relevant issue: mental health.

Mental health and TB 

People with tuberculosis (TB), for example, frequently endure stigma, social isolation, and economic challenges, all of which can exacerbate mental health problems. Despite this, TB interventions still largely lack mental health support among those services. 

Neglecting mental health leads to poor physical health consequences. Depression, for example, can lead to poor treatment adherence, which reduces the effectiveness of even the finest treatments. Furthermore, the stigma associated with mental health and respiratory problems can deter patients from getting the necessary care.

The solution is to approach this holistically, which recognises that the lungs and the mind are inextricably related. Time and again, policies, interventions, and programmes that address both physical and mental health result in better patient outcomes, lower healthcare costs, and better quality of life.

The need to carve out more spaces for mental health and TB integration

For the first time in the Union’s TB and Mental Health Working Group history, mental health dialogues were given the limelight through a plenary session. Chaired by UnitedGMH, panelists shared diverse perspectives from research/academia, civil society, and persons with lived experience. The session also highlighted best practices and lessons learned at the country level, taking examples from Bangladesh, Cambodia, Pakistan, the Philippines, and South Africa. The outcome is a more comprehensive picture of the gaps and a description of practical and effective ways to move closer to the 2030 goals through TB and mental health integration.

Innovation, inclusion, and intersectoral action for an impactful integration 

TB-related stigma was one of the central themes across various sessions. Seeing the need for mental health integration gaining such traction and emerging as a firm call to action was encouraging. The message was clear: we need to invest in mental health integration in order to improve outcomes, reduce incidence, and achieve cost savings. This was creatively captured in an interactive art session in which volunteers were invited to finish the painting and write their key asks.

Moving Forward: An invitation to collaborate

Building on the momentum of this year’s Union Conference, let us continue to be advocates for a more inclusive vision to ending TB. It’s high time to prioritise mental health alongside debates about drug development, smoking cessation, air pollution reduction, and TB elimination.

We hope we are all energised enough to sustain this momentum and translate to actual tangible solutions on the ground so that people at risk or living with TB don’t have to suffer in silence. Lest we forget, there will be no end to TB without fully integrating mental health. The data are out there and real action is left upon us. 

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We are pleased to share that the Gamechanger film, a docu-series that aims to change how we think about mental healthcare, what it is, and how we can deliver it in the context of TB care, is now available on its newly launched website: https://www.gamechangerdoc.org/ 

Gamechanger was created by Annika Sweetland and Nacho Guevara. 

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Annika Sweetland is an Assistant Professor of Psychiatry and Public Health at Columbia University and Co-Founder and Co-Chair of the Union TB and Mental Health Working Group. Her expertise includes TB and depression, integrating mental health services into primary care in low resource settings, implementation science, and using technology to improve data-driven high quality care.

Yves Miel Zuñiga is a Policy and Advocacy Advisor (Health Systems) at United for Global Mental Health. He concurrently serves as the Co-Founder and the Board of Trustees Chair at MentalHealthPH, Inc in the Philippines.