Reflections of SIDS meeting on NCDS and mental health

A meeting of health ministers of the Small Island Developing States (SIDS) took place last week. The SIDS are 52 small island developing states from the Caribbean, the Pacific, Africa, the Indian Ocean, the Mediterranean and the South China Sea. The focus of the meeting was Non-Communicable Diseases (NCDs) and mental health.

There was widespread agreement among heads of state, ministers and officials present that people living in the SIDS need have mental and physical health needs and the key solution must be improvement of primary or community based health services for both.

The chief mental health concerns of SIDS ministers and officials were that mental health remains heavily stigmatised and there are not enough people trained to support the mental health needs of their populations.

We heard how much the SIDS are struggling to produce enough local food, a challenge accelerated by climate change. The SIDS are increasingly reliant on imported food of which the cheapest are foods that are highest in fats, sugar, and salt, bad for physical and mental health. In some countries it is leading to  declining life expectancy.

Climate change is also significantly affecting the SIDS in other ways: forcing communities off their ancestral lands, devastating economies heavily reliant on tourism, leaving people contemplating a bleak outlook, and confronting governments with impossible choices.

“There is not a small island state that has not had to make a choice between rebuilding our island and spending on health.” Hon Sir Molwyn Joseph, Minister of health, Wellness, Social Transformation, Antigua and Barbuda

“It is climate distress; when people labour under the threat of the loss of their ancestral lands and their livelihoods.” Joe Bejang, Minister of Health, Marshall Islands

The ministers issued the Bridgetown Declaration on NCDs and Mental Health. 

The ministers agreed to increase domestic investment in mental health, decriminalise suicide and prohibit coercive practices in the treatment of mental health conditions. These commitments need to be fully realised to uphold the rights of everyone to good mental health in line with international human rights policies and practice.

Here is a list of some of the important, mental health related commitments by SIDS:

• To strengthen engagement and funding for community organisation and youth and women’s groups; and the meaningful engagement of people with lived experience in decision making
• To increased domestic investment in mental health; the decriminalisation of suicide and prohibition of coercive practices in the treatment of mental health contisions 
• To develop a SIDS-specific NCD and Mental Health Implementation Roadmap;
• To establish financial and social protection programmes for mental health and NCDs
• To invest in policies that reduce greenhouse gas emissions with health co-benefits, including via the reduction of air pollution levels, and in health promotion policies
• To implement early warning and response systems, and heat action plans, as well as necessary national health related adaptation action identified through climate change and health Vulnerability and Adaptation assessments
• To urgently develop a whole of government and whole-of-society SIDS action plan for climate change and health resiliency that fully incorporates NCDs and mental health
• To strengthen surveillance and monitoring to obtain reliable and timely data at national levels, as well as health facility level, on NCD and mental health
• To use available global and regional tools to develop and facilitate a SIDS mutual accountability framework for the implementation of prevention and management of NCD and mental health conditions

Read the Bridgetown Declaration here. 

“Mental health is not an add on – it is an intrinsic part of the problems that SIDs face… We have the tools to make the difference now.” Sir George Elleyne, Director Emeritus, WHO/AMR/PAHO 

“Climate anxiety hangs heavy in our hearts. Your decisions today will have a profound impact on lives tomorrow. It will affect more of my future than it does yours. Decisions you make affect my future; my children’s future.” Pierre Cook Jr, Mental health advocate and person with lived experience