Make mental health & well-being for all a priority

from dr Poonam Khetrapal Singh, WHO Regional Director for Southeast Asia

On World Mental Health Day, WHO calls on Member States in the Southeast Asia region to step up action to achieve access to quality mental health care for all, in line with the recently adopted Paro Declaration on Universal Access to Human-Centered Mental Health Care and services. Before the COVID-19 pandemic, around 1 in 8 people worldwide were living with a mental illness. Treatment gaps were unacceptably large, particularly in low- and middle-income countries. In the Southeast Asia region, an estimated 1 in 7 people were living with a mental illness, and in countries where data are available, the treatment gap ranged from 70 to 95%.

The COVID-19 crisis has impacted nearly every area of ​​health, but few are as profound as mental health. In 2020, it is estimated that cases of major depressive disorder have increased by more than 27% and cases of anxiety disorders by more than 25% worldwide, adding to the 1 billion people already living with a mental disorder. In many countries, this has coincided with widespread disruptions in mental health services. Between November and December 2021, more than 33% of WHO Member States worldwide reported ongoing disruptions in mental health, neurological and addiction services.

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To fill remaining gaps and accelerate pre-pandemic progress, in September 2022, at the seventy-fifth session of the WHO Regional Committee for Southeast Asia, countries in the region pledged to take bold and decisive action by unanimously adopting the Paro Universal Declaration Access to person-centred mental health care and services. The Paro Declaration aims to ensure that all people in the region have access to quality mental health care close to where they live, without financial hardship. She places particular emphasis on the need to refocus and integrate mental health services with primary health care (PHC) to complement the new regional primary health care (PHC) strategy launched in December 2021.

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The Declaration recognizes that mental health is a key determinant of social and economic development, an integral part of general health and well-being, and that access to healthcare is a fundamental human right. It aims to help all countries in the Region build on and accelerate long-standing efforts to implement equitable mental health policies, laws, programs and services, in line with the Region’s key prevention and response priorities noncommunicable diseases, to strengthen emergency risk management and to achieve universal health coverage.

The region has several priorities in the coming months and years. First, refocusing mental health services to strengthen primary health care capacity with a focus on expanding the mental health specialist and non-specialist workforce. Second, establishing evidence-based and rights-based community mental health networks and increasing collaboration with civil society and affected communities. Third, strengthen national and subnational programs to combat suicide and self-harm, and drug and alcohol use. And fourth, combating stigma and discrimination related to mental health and protecting and promoting human rights.

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Inaction is not an option. Evidence shows that investing just $1 per capita annually in priority mental health problems could reduce the number of years lived with disability by nearly 5,000 per million residents per year. Increased investment and/or allocation for mental health will therefore not only reduce overall treatment costs but also increase productivity and employment. The Region’s key priorities, the Sustainable Development Goals and the founding Constitution of WHO all agree: there is no health without mental health. Amid the ongoing COVID-19 response and recovery, together we must deepen our commitments, redesign environments and strengthen care to transform mental health for better lives and brighter futures for all.

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