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WHO event addressing public health priorities

Citation: World Health Organization. Regional consultation on enhancing the capacity of Member States to implement anti-stigma programmes in the Eastern Mediterranean Region. East Mediterr Health J. 2023;29(5):412–413. https://doi.org/10.26719/2023.29.5.412

Copyright © Authors 2023; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

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Introduction

Mental health is an integral part of our general health and wellbeing and a basic human right (1,2). However, the economic downturns, social polarization, public health emergencies, widespread humanitarian emergencies, forced displacement, climate crises, and even COVID-19 are major threats to mental health in the Eastern Mediterranean Region. During the first year of the COVID-19 pandemic, there was more than 25% increase in anxiety and depressive disorders globally (3). Mental disorders are leading causes of years lived with disability (YLD) and account for 1 in every 6 YLD cases globally (4).

There are major gaps and imbalances in information, research, governance, resources, and services for mental health worldwide (5). Stigma and discrimination are among the major contributors to these imbalances, mainly at home, school, workplace, and even within the mental healthcare system. Stigma and discrimination can cause social isolation and impact a person’s ability to earn income, enjoy social interactions, access quality healthcare, and, ultimately, it can hinder recovery (6).

In June 2022, the WHO Regional Office for the Eastern Mediterranean held a regional consultation involving representatives of ministries of health, civil society organizations, and experts, to enhance the capacity of countries to implement anti-stigma programmes. Participants received updates on efforts to tackle mental health-related stigma. They discussed available tools and resources for setting up anti-stigma programmes and the support that countries require to design and implement evidence-based anti-stigma interventions.

Summary of discussions

Egypt, Islamic Republic of Iran, Jordan, Lebanon, Morocco, Pakistan, Tunisia, and United Arab Emirates have implemented several interventions to reduce mental health-related stigma (7). These include mental health training for healthcare workers to improve service parity and equality, case management, communication, and respect for patients’ rights, thus increasing awareness and health-seeking behaviour. Although country contexts are diverse politically and socioeconomically in the Region, mental health-related challenges remain largely similar.

The increased awareness about the importance of mental health during the COVID-19 pandemic is a unique opportunity to bridge service gaps and reduce the related stigma and discrimination. The Comprehensive Mental Health Action Plan 2013–2030 (8), the Regional Framework to Scaleup Action on Mental Health in the Eastern Mediterranean Region (9), the World Mental Health Report (10), and the associated tools and resources published by WHO provide strategic directions for addressing stigma and discrimination.

Although there are cost-effective interventions to reduce stigma and discrimination, these interventions need to be implemented efficiently and adapted to specific contexts (11). When conducted under optimal conditions, social contact interventions are the best in reducing stigma and discrimination, especially for immediate impact. Indirect social contact interventions, such as watching testimonial videos of people who experience mental health disorders, are as effective as direct contact. However, strong involvement of civil society organizations in planning and implementation is essential for success of such interventions. The power of social media, including the use of celebrity stories, can be leveraged in combating stereotypes, conducting advocacy, and reducing prejudice.

Effective stigma reduction campaigns must be evidenced-based, creative, multifaceted, and focused on empathy and tackling negative stereotypes. Generating local evidence is essential to ensure continuity, improve learning, and secure funding. Lessons can be drawn from efforts to raise political commitment, mobilize resources, combat stigma, and enhance access to HIV/AIDS services.

Recommendations

Through outreach activities and advocacy at national and subnational levels, Member States are to strengthen multisectoral partnerships, including with people who experience mental health disorders and their support networks, to leverage scarce resources for mental health and integrate anti-stigma actions into mental health law, policies, and interventions.

WHO is to facilitate national, regional and global consultations to identify and document emerging challenges and how to overcome them, support Member States in developing or refining their national mental health anti-stigma plans, and facilitate the creation of a mental health advisory group to support implementation of the regional mental health framework.

References

1. World Health Organization. Mental Health. Geneva: World Health Organization, 2022. https://www.who.int/news-room/fact-sheets/detail/mental-health-strengthening-our-response#:~:text=It%20is%20an%20integral%20component,community%20and%20socio%2Deconomic%20development.
2. Alwan A, Saeed K. A new agenda for mental health in the Eastern Mediterranean Region. East Mediterr Health J. 2015;21(7):459–460. https://www.emro.who.int/emhj-volume-21-2015/volume-21-issue-7/a-new-agenda-for-mental-health-in-the-eastern-mediterranean-region.html.
3. World Health Organization. COVID-19 pandemic triggers 25% increase in prevalence of anxiety and depression worldwide. Geneva: World Health Organization, 2022. https://www.who.int/news/item/02-03-2022-covid-19-pandemic-triggers-25-increase-in-prevalence-of-anxiety-and-depression-worldwide.
4. Arias D, Saxena S, Verguet S. Quantifying the global burden of mental disorders and their economic value. eClinicalMedicine 2022;54:101675. DOI: https://doi.org/10.1016/j.eclinm.2022.101675.
5. World Health Organization. HO enhances country capacity to implement anti-stigma programmes in the Eastern Mediterranean Region. Cairo: World Health Organization Regional Office for the Eastern Mediterranean. https://www.emro.who.int/ar/mnh/news/who-enhances-country-capacity-to-implement-anti-stigma-programmes-in-the-eastern-mediterranean-region.html.
6. Brand L,Liu S Heim C,Heinz A. The effects of social isolation stress and discrimination on mental health. Translational Psychiatry 2022;12(1):2158-3188. DOI: https://doi.org/10.1038/s41398-022-02178-4.
7. World Health Organization. Summary report of the regional consultation on enhancing the capacity of Member States to implement anti-stigma programmes in the Eastern Mediterranean Region. Cairo: World Health Organization Regional Office for the Eastern Mediterranean. https://applications.emro.who.int/docs/WHOEMMNH228E-eng.pdf.
8. World Health Organization. Comprehensive Mental Health Action Plan 2013-2030. Geneva: World Health Organization, 2021. https://www.who.int/publications/i/item/9789240031029.
9. World Health Organization. Regional framework to scale up action on mental health in the Eastern Mediterranean Region. Cairo: World Health Organization Regional Office for the Eastern Mediterranean, 2016. https://applications.emro.who.int/dsaf/EMROPUB_2016_EN_18700.pdf.
10. World Health Organization. World mental health report: transforming mental health for all. Geneva: World Health Organization, 2022. https://www.who.int/publications/i/item/9789240049338.
11. World Health Organization. WHO menu of cost-effective interventions for mental health. Geneva: World Health Organization, 2021. https://apps.who.int/iris/rest/bitstreams/1357978/retrieve.

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