Mental Health Policy and Service Guidance Package
Mental health policy and service guidance package. Providing tool to improve the mental health of population (8 modules) (World Health Organization, Geneva) 2003. Price: Sw. fr. 120.00 / US $ 108.00
There has been an escalation in the number of people with mental disorders worldwide posing a major challenge to global development. The burden is higher in developing countries which have poor resources to respond to such demands. At a given time, worldwide figures point to 450 million people being affected with mental and brain disorders. No particular group of population is immune to mental illness, the risk however being higher among children and adolescents, abused women, unemployed persons with low or little education, the poor, the victims of violence, migrants and refugees.
Provision for mental health care system is urgently needed. Modern methods of intervention seldom offer clinical cure for mental disorders. There is however, an improvement in the social functioning with improved quality of life besides symptom control and relapse prevention. Programmes for mental health promotion and prevention of mental ill health can mitigate the population of vulnerability to such disorders.
In 2001, 115 WHO member countries organized activities including delivering important addresses by political leaders and adoption of new mental health legislation. The same year World Health Assembly with over 130 ministers responded positively with clear and unequivocal messages. The theme of the World Health Report 2001 was on mental health and its 10 recommendations have been well received by all Member States. As a result of these activities in 2001, a Mental Health Global Action Programme was organized to put strategic directions in place for addressing the findings presented in the World Health Report. Global Action Plan is based on four strategies: (i) focussing and improving information for decision making one should know more about the magnitude of mental disorders around the world and more about the resources; (ii) creating awareness on mental disorders through education and advocacy involving a sense of responsibility of human rights and towards lessening the stigma attached to mental disease; (iii) assisting countries in designing policies and developing comprehensive and effective health services; and (iv) building local potential for public mental health research in poor countries.
The WHO is aware that action plans run the risk of remaining merely theoretical exercises with little impact on mental health, unless vigorous action is initiated. Therefore, the WHO Division of Mental Health has strengthened the work on information and policy by developing WHO Mental Health Policy and service guidance package. This package comprises eight modules which are: (i) The Mental Health Context; (ii) Mental Health Policy, Plans and Programmes; (iii) Mental Health Financing; (iv) Mental Health Legislation and Human Rights; (v) Advocacy for Mental Health; (vi) Quality improvement for Mental Health (viii) Organization of Services for Mental Health; and (viii) Planning and Budgeting to Deliver Services for Mental Health. Each module indicates the purpose of the guidance package, contents of the package for whom it is meant, and method of using the package. The packages are useful to the policy makers and health planners, Government departments of central and state levels, mental health professional groups representing people with mental disorders, representatives or organisations of families, carers of people with mental disorder, advocacy organizations representing the interest of mentally ill people and non-governmental organizations involved or interested in the provision of mental health services.
Each module offers a succinct summary to highlight the message given. Summary of the module The Mental Health Context states ‘Efforts to improve mental health must take into account recent developments in the understanding, treatment and care of people with mental disorders, current health reforms and government policies in other sectors’.
For Mental Health Policy, Plans and Programmes, it is given as ‘A mental health policy and plan is essential to coordinate all services and activities related to mental health. Without adequate polices and plants, mental disorders are likely to be treated in an inefficient and fragmented manner’.
The module Mental Health Financing states, ‘Mental health financing is a powerful tool with which policy-makers can develop and shape quality mental health systems. Without adequate financing, mental health policies and plans remain in the realm of rhetoric and good intentions’.
Summary given for Mental Health Legislation and Human Rights states, ‘All people with mental disorders have the right to receive high quality treatment and care delivered through responsive health care services. They should be protected against any form of inhuman treatment and discrimination’.
In Advocacy for Mental Health, the summary highlights, ‘Advocacy is an important means of raising awareness on mental health issues and ensuring that mental health is on the national agenda of governments. Advocacy can lead to improvements in policy, legislation and service development’.
Quality Improvement for Mental Health states ‘A focus on quality helps to ensure that scarce resources arc used in an efficient and effective way. Without quality there will be no trust in the effectiveness of the system’.
The module Organization of Services for Mental Health states, ‘Mental health care should be provided through general health services and community settings. Large and centralized psychiatric institutions need to be replaced by other more appropriate mental health services’.
The summary of Planning and Budgeting to Deliver Services for Mental Health highlights, ‘Rational planning and budgeting can help build effective mental health services. Methods are now available to help determine physical and human resource requirements necessary to deliver high quality mental health services’.
The central message that the package delivers is the integration of mental health services into mainstream health, and it emphasizes deinstitutionation with moving away from the monolithic closed mental institutions towards general hospital, community and primary care and the legislative measures and advocacy strategies to uphold the dignity and basic human rights of mentally ill people. Each module offers a glossary of important tenus used in the text. The document details examples of mental health services in many countries. Comments on the appalling status of mental institutions in some country are mentioned.
The WHO has contributed towards the understanding of mental health needs of developing countries offering guidelines towards the organization of appropriate services. Other complex issues such as human rights legislation, advocacy, quality etc., related to mental health have been pointed out. This package has been brought out very effectively and is elegantly designed. How much of the package materials will be utilized by the policy makers, planners and others to whom these have been addressed to remains to be seen.
A. Venkoba Rao
‘Tilak’ 506, IV Makin Road
K. K. Nagar
Madurai 625020, India
Copyright Indian Council of Medical Research Dec 2004