Abstract

The World Health Organization (WHO)'s Comprehensive Mental Health Action Plan 2013–2020 (MHAP),1 adopted by the World Health Assembly in May 2013, aims to promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability of persons with mental disorders. It is the first action plan on mental health in the history of the WHO, and all 194 of the WHO's member states have agreed to commit, in their own ability, to improve mental health in their country and to contribute to the attainment of six global targets by 2020 (Table 1). 80% of countries developed/updated mental health policy/plan in line with international/regional human rights instrument 50% of countries developed/updated mental health law in line with international/regional human rights instrument 80% of countries has at least two functioning national, multisectoral, mental health promotion and prevention programs The rate of suicide in countries reduced by 10% The MHAP has four objectives with a set of proposed actions for the countries, the WHO, and international and national partners. To monitor the progress of the implementation, the WHO will collect the relevant data from all countries and report back to the World Health Assembly in 2015, 2018, and 2021. As stated in the vision and the goal, the MHAP not only aims to provide health care but also to promote the provision of social care to the persons in need and introduces the concept of recovery. It also emphasizes the importance of promotion and prevention of mental disorders and highlights the importance of protection of human rights. The proposed actions are not only aimed at low- and middle-income countries, but many of the actions are also applicable to high-income countries, and they are urged to take those actions. Let us consider Japan as a case example of a high-income country with a relatively well-developed mental health system. For objective 1, Japan has already revised the Mental Health and Welfare Act in preparation for the ratification of the Convention of the Rights of Persons with Disabilities;2 however, Japanese health authorities will also need to monitor and evaluate the implementation of this Act, in view of their adoption of the MHAP. For objective 2, as Japan has a large number of psychiatric beds in mental hospitals, service reorganization becomes a high priority, in view of the MHAP objective of providing care in the community. Similarly, for objectives 3 and 4, Japan may need to review its existing activities and strengthen some of them, as feasible. Japan may also need to make advances in involving persons with mental disorders and their families in decision-making on policies and service provision, at all levels, including national, local, and facility levels. In addition to implementing activities in their own countries, high-income countries are expected to support low- and middle-income countries to achieve the targets in the MHAP. They can share their experience about making mental health law and policies, promotion and prevention strategies and their expertise on innovative methods of service delivery, including the use of information technology. Japan may also like to share its experience on suicide prevention with other countries that are struggling with this issue. Working together, we can achieve the targets and we will all benefit from better mental health globally in 2020.

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