Mental health disorders are constantly on the rise worldwide and could cost the global economy to lose up to US$16 trillion (S$22 trillion) between 2010 and 2030 driven in part by the early age of onset and loss of productivity across the life course, according to a report by The Lancet Commission.
The Lancet Commission report by 28 global specialists in psychiatry, public health and neuroscience, as well as mental health patients and advocacy groups, presented undermining principles such as the need for an expansion of mental health from the existing focus on clinically defined mental disorders to a broader dimensional approach to mental health; convergence with diverse fields to include the genetic, developmental, social, and biological determinants of mental health; and lastly, to uphold mental health as a universal and basic human right.
Recognising the diversity of settings across countries as well as within countries, the Commission recommended seven ways to reframe mental health:
1. Incorporate mental health into the sustainable development framework
Mental health has often been considered as a concern exclusive to people with biomedically defined mental disorders. The Commission suggests for countries to view mental health as a universal human attribute and an indivisible component of overall health— important to all people in all countries and at all ages.
2. Recognise that mental health care is an essential component of universal health coverage
More than 10 years since The Lancet issued a call for action to scale up services for mental disorders in 2007, access to mental health services remains very poor and fragmented for most people in the world. Although effective interventions exist and affordable methods for their delivery have been shown to work, the scale-up of quality mental health services has not happened in most countries. Therefore, the Commission re-emphasises the call for action to scale up mental health care with even more urgency. Mental health care should be included as an essential component of universal health coverage, and access to quality care and financial risk protection should be ensured.
3. Protect mental health with public policies and development efforts
To promote mental health and wellbeing, and prevent and treat mental and substance use disorders, there needs to be action taken on the other Sustainable Developmental Goals (SDG). The table below links the various SDGs with the relevant actions countries can take.
4. Strengthen public awareness and engagement of people with mental disorders
Countries should increase the engagement of civil society with mental health, particularly of people with lived experience of mental disorders. This engagement is likely to enhance both self-help and demand for services when needed. More people who have lived with mental disorders should be encouraged to be leaders, advocates, and peers to address barriers to accessing mental health care, social inclusion, and full citizenship.
5. Enhance investments for mental health
Countries at all income levels allocate a far lower proportion of their health budget to mental health care than is warranted on the basis of proportional burden and cost effectiveness estimates. Health budgets need to have an increased allocation of funds for mental health care.
6. Continue knowledge creation about mental health
Converging knowledge from diverse disciplines is crucial for mental health science as which they offer the promise of new understanding of the nature of mental disorders and how they develop, more effective psychosocial and pharmacological interventions, and an understanding of how to implement these effective interventions at scale.
7. Implement monitoring and accountability frameworks
For an all-round effect on global mental health, robust, long-term, and comprehensive monitoring and accountability mechanisms are needed. Monitoring and accountability in an era of global mental health and sustainable development needs an oversight body with a broad inter-sectoral representation and mandate. Within countries, accountability can be enhanced through an autonomous body charged with a focus on reducing mental health disparities nationally.
While the recommendations above are targeted at the national level, the team at Human Resources feels organisations should also reframe the way they view mental health and enhance investments for it to benefit employees' wellbeing.
Table / The Lancet
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