Report
No health without mental health
Mental health is an integral part of health and well-being, and in May 2012 the World Health Assembly acknowledged this fact by requesting the Director-General to develop a comprehensive mental health action plan, in consultation with Member States, covering services, polices, legislation, plans, strategies and programmes. The resulting global action plan, adopted by the Assembly in 2013, takes a multisectoral approach across the life course to promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability for persons with mental disorders.
Scaling up mental health action in the Region
The Comprehensive Mental Health Action Plan 2013–2020 has set out a clear road map for all stakeholders with agreed-upon targets and indicators. It provides the foundation for the development of a regional framework for action to scale up mental health in the Region.
To chart the way forward in consultation with Members States for a regional framework to scale up action on mental health in the Eastern Mediterranean Region, in line with the Action Plan 2013–2020, a meeting was held in Cairo, Egypt from 15 to 17 September, 2014. The participants included mental health focal points from Member States supported by experts who had, in preparation for the meeting, developed evidence briefs on priority areas to guide the drafting of the regional frame work and to facilitate discussions.
The meeting had the following specific objectives:
Review currently available resources & capacities in the Region, and identify the main facilitators and barriers to implementing the provisions of the Action Plan and a regional strategy.
Review the best available evidence and practices for addressing priority mental health needs.
Agree on a regional framework for action based on the global action plan and priority next steps for scaling up national action on mental health.
Key areas of focus
The meeting programme was organized around the key domains, broadly mirroring the objectives of the Comprehensive Action Plan 2013–2020: governance; health care; promotion and prevention; and surveillance, monitoring and research.
The following major issues/challenges were identified.
1- Gvernance
Financial protection of families and persons suffering from mental health conditions from sliding into poverty
Availability of transitional/bridge funding for reorganization of mental health services from institutional to community-based
Involvement & empowerment of user/family associations in developing and implementing policies, legislation and services
2- Health care
Premature closure of mental hospitals, without parallel development of community services
Organization of services based on the delineated catchments
Enhancement of a mental health component in pre-service teaching /training needs of health professionals as opposed to the current reliance on in-service training
Deinstitutionalization by changing attitudes and dismantling the culture of institutionalization of mentally ill persons rather than just reducing beds.
3- Mental health and psychosocial support in humanitarian emergencies
Embedding of a mental health and psychosocial support component in emergency preparedness
4- Promotion and prevention
Ensuring buy in from other sectors---what will be their gain
Step-based approach to prevention and promotion, focusing on actions the health sector can directly influence, such as recognition and management of maternal postnatal depression, parenting skill training and nutritional interventions, expanding gradually to other sectors, e.g. education, poverty reduction
Expansion of the scope of prevention to include early recognition and management of childhood disorders
Availability of packages targeted at specific groups, e.g. adolescents, women, refugees
5- Surveillance, monitoring and research
Cultural sensitivity about suicidal behaviours, while strengthening vital statistics registration systems to capture suicide-related deaths
Paucity of research, in general, and implementation research, in particular, to guide policy and service developments
Capacity for undertaking research
Regional consortium for research into emergencies.
The way forward for mental health in the Region
Following the three days of deliberations, the framework based on the principles underpinning the comprehensive action plan was modified to capture the needs and priorities of the Member States of the Region (see Box 1 for the strategic intervention proposed in the regional framework).
The next step is for each country to begin working on prioritizing the strategic interventions agreed upon in the regional framework and monitoring their progress using the set of proposed indicators. A deliberate and concerted effort will be needed to actively involve all stakeholders, from decision-makers to the users of services in order to achieve vision of the action plan of a world in which mental health is promoted and protected and mental disorders are prevented, and persons affected by these disorders are able to exercise the full range of human rights, participate fully in society and at work free from stigmatization and discrimination and access high quality, culturally-appropriate health and social care in a timely way to promote recovery.