6.3 Draft comprehensive mental health action plan 2013–2020

In May 2012, the 65th World Health Assembly adopted resolution WHA65.4 on the global burden of mental disorders and the need for a comprehensive, coordinated response from health and social sectors at the country level. A “zero draft” of the action plan, covering the period 2013–2020, was written and used as the basis for consultation with Member States, civil society and international partners. Consultations were held through five regional meetings, a Global Forum on Mental Health (Geneva, 10 October 2012), a web-based consultation (from 27 August to 19 October 2012) and an informal consultation with Member States (Geneva, 2 November 2012).

During the discussion at the EB, several Member States took the floor expressing their support and appreciation for the multi-sectoral action plan, recognizing the efforts made for a real comprehensive implementation.

Myanmar pointed out that developing countries do not recognize the attention to mental health issues as developed countries do, and highlighted that it is necessary to strengthen human resources through a community based approach. Cuba followed reporting its national plan implemented in 1995 based on a PHC approach, and stressed the importance of health promotion through and within the community. This approach was strongly supported also by Ecuador, Iran, Croatia, Timor-Leste.

Qatar, Papa New Guinea and China put the emphasis on the need of strengthening human resources and capacity-building. Senegal, speaking on behalf of the African Region, stated that in low income countries more than 80% of those suffering from mental health don't receive any treatment and there are few specialist centres, only in urban areas. Finally, Senegal strongly called for strengthening health care systems, as the first necessary step to implement each action plan.

Maldives focused on the access to drugs as it represents a challenging issue for developing countries, and asked WHO for support. Switzerland stressed the need to reorient resources into small community care through a social determinants approach, as a useful tool to tackle discrimination, and finally guaranteed support to facing the lack of human resources through its efforts in the international cooperation. USA affirmed that they have submitted some task changes for indicators' improvements, as Senegal and Canada did, and launched a new fund for research on Alzheimer's Disease.

EU called for the necessity of a full social inclusion as a strategy to prevent mental health disorders through a “health in all policies” approach, that has to be adopted in actions, health promotion and research, and in health care provision inspired by PHC principles. Finally, EU highlighted that NCDs and mental health plans should become more concrete.

An interesting point was raised by Lebanon, that reported that the multisectoral approach would benefit from including the schooling sector in promotion, prevention, education and treatment. And finally it mentioned the possibility to reflect on mental health insurance, opening the floor to the private sector.

Mongolia wanted to raise the fact that the issue of mental health has to be contextualized under diverse social and cultural patterns, between and inside countries, and called for international mobilisation of financial resources.

While the majority of Member States was stressing the importance of a comprehensive approach, Australia reported that it has a dedicated Minister for mental health. It was followed by Croatia which came back to the emphasis on a community-based approach and added the importance of the cooperation between health systems and civil society. The role of the civil society was fully supported by Timor-Leste, too. UK focused on the efforts to tackle the stigmatization, mentioned the “Time to change” campaign and highlighted the impact of austerity policies on mental health.

The final comment made by Thailand closed the debate with a strong call to concrete actions that could take into account the mental health gap existing between States, the different attitudes and socio-economical-environmental conditions that influence the real implementation of the plan and clouted that all these issues could be tackled only with a societal approach, otherwise each measure would be meaningless.

This “call to action” opened the floor to the civil society, with CBM, which stressed the necessity of a joint process between governing bodies and civil society, and the World Federation for Mental Health, that announced they have developed a civil society charter for mental health.

The Secretariat response highlighted the importance of integrating physical and mental health.

The DG closed the session saying that this is the first action plan and it has to be included in an ongoing learning process and with the proposal, immediately approved, to have an online consultation on the plan until the end of February; the document will then be revised and submitted to the 66th WHA.