The World Health Organization (WHO) has adopted a draft comprehensive mental health action plan to be phased in by 2020. Paradoxically, the proposal is an outgrowth of a WHO plan on the prevention and control of noncommunicable diseases enacted in 2011—a plan that did not cover mental illnesses.
In response, several U.S. physicians, including Jeffrey Lieberman, M.D., now president of APA, organized a letter-writing campaign early in 2012 to the WHO Executive Board asking that mental health and mental illness issues be included in all health systems, said Eliot Sorel, M.D., a professor of global health and of psychiatry and behavioral sciences at George Washington University School of Medicine and School of Public Health, who was a cosigner of one letter (Psychiatric News, May 18, 2012).
At last year’s World Health Assembly, WHO set in motion the mechanism to produce the action plan that was approved in May.
The new plan will “provide guidance for national action plans” and complements WHO’s existing mental health gap action program, the goal of which is to expand mental health services in “low-resource settings.”
The document noted that about 4 out of 5 people who need mental health care in low- or middle-income countries and nearly half of those in high-income countries do not receive such care.
APA’s role should extend beyond gaining passage of the action plan, given the plan’s seven-year horizon, said Sorel.
“It’s important that the U.S. and APA be involved in the plan’s implementation,” he said. “WHO has only technical and advisory authority, so each WHO member country will track implementation and monitor the allocation of human and financial resources.”
The new plan’s goals include preventing mental disorders, providing care, enhancing recovery, and reducing mortality, morbidity, and disability for people with mental disorders. Accomplishing that will require improving countries’ mental health care infrastructure while providing “comprehensive, integrated, and responsive mental health and social care services in community-based settings,” according to the plan.
Implementation calls for the following six approaches to better mental health care:
Universal health insurance
A life-course approach
Coordination with the general health, education, employment, housing, and other social sectors
Empowering people with mental disorders in policy planning, service provision, research, and evaluation.
On a related front, in May 2012, the APA Assembly unanimously passed a resolution calling for creation of a new APA Council on Global Psychiatry that would “focus systematically on international membership, education, and advocacy.” The resolution has been forwarded to an APA work group that is reviewing issues related to international psychiatrists, with a report from the work group to the Board of Trustees scheduled for 2014.
In other international action, the Assembly also asked APA to apply for consultative status as a nongovernmental organization to the United Nations. That request is under review by the United Nations, said Ricardo Juarez, senior program manager for international affairs in APA’s Office of Minority and National Affairs. ■