Comprehensive Mental Health Action Plan Research Articles

Saving a Life: Suicide Prevention

Introduction: Suicide is considered as a serious and important problem in health and comprehensive health. Every year, approximately 700,000 people around the world die by suicide, which is more than those killed in war. Death by suicide is not only the loss of a life, but it also causes psychological damage to the other family members and friends. Important factors affect suicidal behavior. So much suicide is a serious public health problem. All 194 member states of the World Health Organization have signed the Comprehensive Mental Health action plan 2013-2020, which tasks governments with implementing evidence-based interventions in community settings to prevent suicide at all stages of life. In addition, the guardians of mental health also play an important role in the prevention of suicidal behavior. Conclusion: Based on recent studies, effective treatments based on clinical evidence in the fields of psychology and psychiatry are introduced to save a life for colleagues in the field of mental health.

Rethinking Schizophrenia: Beyond the Voices of Schizophrenia

Introduction Despite improvements and innovation in recent years, people living with schizophrenia face variations in access to optimal treatment and care. There is a lot about schizophrenia that is not fully understood, and the high-quality care and support needed by people living with this condition is often unavailable.Objectives Develop an evidence-based, compelling policy narrative on schizophrenia Engage a pan-European, multidisciplinary group of experts Offer concrete tools to patient and professional advocacy groups Disseminate findings Draw from our findings practical solutions on how to implement recommendationsMethods Based on carefully selected existing literature and available resources, literature review includes but is not limited to: Value of Treatment Recommendations, Global Burden of Disease Study, Comprehensive Mental Health Action Plan, Mental Health Atlas. The aim is to establish state of play, identify problems and solutions and take stock of current recommendations.We established a multi-disciplinary working group to lead the project, and ensured that representation on this group is cross-disciplinary and cross-sector. The expert group includes country-level patient advocates and clinical leads including key opinion leaders (KOLs) to keep the project focused on what is happening at a national level, and to help create ownership at the national level to take recommendations forward within each country.We conducted qualitative semi-structured interviews with people living with schizophrenia where they provided their insights into how to rethink the way we deal with schizophrenia.ResultsProvide clear, concrete and adaptable solutions Joint ownership by key stakeholder groups of a common policy narrative on schizophrenia Sustained policy engagement on schizophrenia at the EU and national levelConclusionsThere is a clear need to rethink the management of schizophrenia and redesign the care pathways to ensure optimal treatment and care for all people living with schizophrenia in Europe. Based around patient testimonies, the aim of the session is to highlight the need to optimise the way we manage schizophrenia by building a strong, coherent, evidence-based policy narrative which speaks to the current priorities in schizophrenia and draws from the current policy landscape in Europe.Experts involved in the Rethinking Schizophrenia project, coordinated by the European Brain Council, have explored the ways in which we can and need to change the way we deal with schizophrenia. The Rethinking Schizophrenia project falls under the Rethinking the management of brain disorders series, research-driven projects offering policy recommendations to make tangible changes with the aim to improve the lives of people living with brain disorders, neurological and mental alike, across Europe.Disclosure of InterestNone Declared

Spatial characteristics of community mental health institutions in urban contexts—Using the architectural design of the Mallet ST Youth Mental Health Centre in Sydney, Australia as a case study

Promoting the Comprehensive Mental Health Action Plan 2013-2030 issued by WHO, there is a global trend to transform the mental health care system from a psychiatric hospital-centred mode to a community-based network. Under this trend, decentralised community mental health institutions are gradually replacing psychiatric hospitals and mitigating the stigma of mental illness in the community. Plus, the operation mode and functions of mental health facilities become different, with their space design emphasising different features and requirements. Especially in urban contexts where it is crowded and people face more stressors and complex environments, mental health facilities have more challenges in dealing with the relationship with the surrounding community, reducing stigma from the community, and the impact of the space on patients’ mental health. The goal is to explore the spatial characteristics of community mental health institutions in cities and to establish architectural design strategies for these institutions. Through a summary of theories on the built environment of community mental health institutions, combined with an analysis of internationally approved projects, five spatial characteristics were identified: (1) community shared space, (2) threshold space, (3) therapy space, (4) activity space, and (5) natural space. The research on the above five spatial characteristics, combined with the local social and cultural background and the specific needs of adolescents’ mental health, was innovatively applied to the architectural design of the Mallet ST Youth Mental Health Centre in Sydney, Australia.

The Swiss Brain Health Plan 2023–2033

The brain and its health are essential for our (physical mental, social, and spiritual) wellbeing, for being able to realize our potential as individuals, and also for a fair, well-functioning, and productive society. However, today the world is facing a healthcare crisis related to the very high (and increasing) burden of brain disorders. As a response to this crisis, the “Swiss Brain Health Plan” (SBHP) was conceptualized in the context of other initiatives launched to value, promote, and protect brain health over the entire life course. In the first section of this position paper, the following fundamental considerations of the SBHP are discussed: (1) the high (and increasing) burden of brain disorders in terms of prevalence (>50% of the population suffers from a brain disorder), disability, mortality, and costs; (2) the prevention of brain disorders; (3) the operational definition of brain health; (4) determinants of brain health; (5) international initiatives to promote brain (including mental) health including the World Health Organization (WHO) intersectorial global action plan on epilepsy and other neurological disorders (NDs) (IGAP) and the WHO comprehensive mental health action plan. In the second section of the paper, the five strategic objectives of the SBHP, which has the vision of promoting brain health for all across the entire life course, are presented: (1) to raise awareness; (2) strengthen cross-disciplinary and interprofessional training/educational programs for healthcare professionals; (3) foster research on brain health determinants and individualized prevention of brain disorders; (4) prioritize a holistic (non-disease-specific), integrated, person-centered public health approach to promote brain health and prevent brain disorders through collaborations across scientific, health care, commercial, societal and governmental stakeholders and insurance providers; (5) support, empower, and engage patients, caregivers, and patient organizations, and reduce the stigma and discrimination related to brain disorders. In the third section of the paper, the first (2024) steps in the implementation of the SHBP, which will be officially launched in Zurich on 22 November 2023, are presented: (1) a definition of the overall organization, governance, specific targets, and action areas of the SBHP; (2) the patronage and/or co-organization of events on such specific topics as brain research (Lausanne), dementia (Geneva), stroke (Basel), neurohumanities (Bellinzona), sleep (Lugano), and psychiatry (Zurich); (3) the conduction of a new study on the global burden of brain disorders in Switzerland; (4) the launching of an international Certificate of Advanced Studies (CAS) on Brain Health at the University of Bern. In the fourth section of the paper, there is a concise executive summary of the SBHP.

Mapping priorities in Swedish suicide prevention policy: What, how and who are prioritized. A qualitative document study

BackgroundSuicide is a serious public health problem. All 194 member states of the World Health Organization have signed the Comprehensive Mental Health action plan 2013–2030 which tasks governments with implementing evidence-based interventions in community settings to prevent suicide at all stages of life. This study aims to map the priorities in suicide prevention policy in community-settings in Sweden, one of the World Health Organization's member states. MethodA document study, using data from suicide prevention policy documents in the 21 counties in Sweden. Data was analyzed using qualitative content analysis. ResultsSuicide prevention interventions at the universal, selective and indicated prevention levels were prioritized. Most of the suicide prevention interventions intended to be implemented at each prevention level was evidence-based. Most of the suicide prevention interventions at all prevention levels did not prioritize any specific age group, however when age groups were targeted there were some emphases on children and adolescents. ConclusionThere is a need to improve suicide prevention interventions prioritizing age-groups who have high suicide rates. As educational interventions that encourage young people to develop their ability to face life challenges related to adolescence are found to be appropriate suicide prevention interventions, so too could educational interventions aimed at other age-groups be developed, to enable them to develop their ability to face life challenges related to their age.

Determining the Burden of Suicidal Behaviors Using the DALY Approach: A Case Study in Iran (2018-2021).

Suicide is a significant and growing concern in health systems worldwide. It is considered a crucial part of the comprehensive mental health action plan in every country. Kerman, one of the largest provinces of Iran with a relatively high population, has witnessed an increasing trend in this phenomenon, especially during the COVID-19 pandemic. This was a cross-sectional study conducted in urban and rural areas of Kerman. Suicide data for 2018-2021 were acquired from the Psychosocial Health and Addiction Prevention Group of the Deputy for Health at Kerman University of Medical Sciences. The burden resulting from suicide during these years was measured using the disability-adjusted life years (DALY) index. During these four years, 23701 suicide attempts were recorded in Kerman, with 59% and 41% of the suicide attempts made by men and women, respectively, and 668 (2.82%) attempts leading to death. The highest rate (68%) was observed in the 15-29 age range and the lowest rate (1.1%) was seen in people older than 60. Poisoning (89.3% of the attempts) was the most common suicide method. The suicide burden in Kerman in 2021 was 4417 according to the DALY index, which is 162.6 per 100000 people; men and women endure 38% and 62% of this burden, respectively. The highest DALY rates were seen in the 15-29 and 30-44 age groups. The burden resulting from suicide highlights the necessity of taking immediate measures to prevent this behavior, especially among vulnerable groups.

A Rising Endemic within a Pandemic: Impact of Inflation on Mental Health

Madam, Inflation describes the increment in the cost of living over a certain period, occurring in light of extreme events that impact the economy. The current wave of inflation results from the coalition of events mainly stemming from the COVID-19 pandemic, producing a myriad of economic disruptions. Rising food insecurity, hikes in electricity prices, and fuel costs leave families facing an unprecedented financial crisis. Moreover, the turmoil created by the recent flooding due to record-breaking rainfall affecting Sindh, Balochistan, and Khyber Pakhtunkhwa has fuelled the current inflation wave in Pakistan. The impact of such issues can be devastating in multiple respects. The convulsion of the economy has given rise to mental health disorders nationwide, resulting in a decline in physical health. Those suffering from mental illnesses are more likely to suffer from chronic physical conditions, including Alzheimer’s disease, diabetes mellitus, thyroid disorders, and more1. A survey conducted by the American Psychological Association (APA) illustrated that 9 in 10 individuals perceive financial hardships as a major source of stress – notably greater than the perception during the pre-pandemic era2. Furthermore, it is common for stressed individuals to resort to unhealthy coping mechanisms, such as smoking3 – increasing the risk of pulmonary diseases and cancers, providing the evident association between mental and physical health. This shows the undeniable impact of the pandemic on financial constraints across the world. Pakistan’s overall disregard for mental health has recently been corroborated. The World Health Organization (WHO) introduced the “Comprehensive Mental Health Action Plan 2013-2020” to improve mental health globally. However, as per WHO’s “World Mental Health Report” analysis, most countries, including Pakistan, did not adhere to the plan, highlighting the lack of consideration towards mental health4. Moreover, Pakistan lacks sufficient resources to handle an endemic wave of mental disorders. Having one of the lowest psychiatrist-to-patient ratios worldwide – with only 500 psychiatrists serving a colossal population of 220 million. These statistics substantiate the urgency to emphasize the indispensability of psychiatry as a career opportunity5. Local authorities must invest in effective relief programs, especially for the impoverished disproportionately affected by the economic crisis. As a nation, it is paramount to possess readiness for intervention at times of psychological distress, and if left rampant, may enter a vicious cycle of deteriorating mental health, precipitating to deteriorating physical health, further crippling the economy.

14 COVID-19 and Mental Health: Comparing the mental health between African Americans and Whites in 2019 (before COVID-19) and 2020 (during COVID-19) using NSDUMH in the United States

OBJECTIVES/GOALS: The purpose of this study is to compare the mental health of African Americans to Whites during 2019 and 2020 using the a National Survey on Drug Use and Mental Health (NSDUMH). METHODS/STUDY POPULATION: Secondary data analysis from the National Survey on Drug Use and Health. The data consisted of 55,772 observations, 3,090 variables. This study will consist of the United State adult data population from 2019 and 2020 using the National Survey on Drug Use and Mental Health (NSDUMH). RESULTS/ANTICIPATED RESULTS: The results of this research will be produced from the following analysis. The analysis will consist of a secondary data analysis from the National Survey on Drug Use and Mental Health (NSDUMH). The primary independent variable of interest is race. All the indicator (race, sex, insurance, etc). Dependent variable is the mental health of African Americans and Whites. This is the variable in the NSDUMH labeled as the Major Depressive Episodes (MDE). The data analysis will be conducted using univariate analysis describing the study population. Bivariate analysis will be performed using chi-square. Since our dependent variable will be dichotomous we will be using several logistic regressions. DISCUSSION/SIGNIFICANCE: Strengthen mental health and psychosocial support services as part of strengthening preparedness, response and resilience to COVID-19 and future public health emergencies. Also adopt the updated Comprehensive Mental Health Action Plan for the future.

Psychotropic medicine consumption in 65 countries and regions, 2008–19: a longitudinal study

The WHO Comprehensive Mental Health Action Plan 2013-2030 encourages routine collection and reporting of a set of essential mental health indicators, including the availability of psychotropic medicines. The global monitoring of country-level psychotropic medicine consumption trends can provide information on the extent of the availability of psychotropic medicines. The primary objective of this study was to investigate global trends in psychotropic medicines consumption from 2008 to 2019 across 65 countries and regions according to country income level and geographical region. In this longitudinal trends study, we used pharmaceutical sales data from the IQVIA-Multinational Integrated Data Analysis System (IQVIA-MIDAS). We analysed monthly sales data of psychotropic medicines between Jan 1, 2008, and Dec 31, 2019. Total psychotropic medicine consumption included sales of antidepressants, antipsychotics, tranquilisers, sedatives or hypnotics, and mood stabilisers. Population estimates of each country or region (eight lower-middle-income countries, 19 upper-middle-income countries, and 38 high-income countries) were based on the UN World Population Prospects 2019 report. Average annual sales trends of psychotropic medicines, expressed as defined daily dose (DDD) per 1000 inhabitants per day, were estimated using a random-effects model adjusted for income level and region. Relative changes in the annual consumption of psychotropic medicines by income, expressed as DDD per 1000 inhabitants per day, were assessed as percentage change for each medicine class. Psychotropic medicine sales increased from 28·54 DDD per 1000 inhabitants per day in 2008 to 34·77 DDD per 1000 inhabitants per day in 2019, corresponding to a 4·08% (95% CI 2·96-5·21) relative average increase annually. The absolute annual increase was greater in high-income countries (3·31 DDD per 1000 inhabitants per day, 95% CI 3·01-3·61) compared with upper-middle-income countries (1·94 DDD per 1000 inhabitants per day, 1·45-2·44) and low-middle-income countries (0·88 DDD per 1000 inhabitants per day, 0·62-1·13; p<0·0001). The relative average annual increase in psychotropic medicine sales from 2008 to 2019 was greater in upper-middle-income countries (7·88%, 95% CI 6·99-8·77) than in lower-middle-income countries (2·90%, 2·40-3·39) and high-income countries (1·02%, 0·80-1·24). In 2019, the regional consumption of psychotropic medicines varied greatly, with the highest sales of all psychotropic medicine classes reported in northern America (167·54 DDD per 1000 inhabitants per day) and lowest sales reported in Asia (5·59 DDD per 1000 inhabitants per day). 17 countries had very low consumption of psychotropic medicines in 2019, including high-income countries and countries with a high prevalence of mental disorders. The consumption of psychotropic medicines has increased over a 12-year period, and although the absolute growth rate was highest in high-income countries, the relative growth is highest in middle-income countries and especially upper-middle-income countries. Disparities in psychotropic medicine consumption of countries can only partly be explained by geographical location and income. Greater efforts are needed to increase the availability of psychotropic medicines in countries with very low consumption, which is probably due to financial or cultural reasons as well as scarcity of trained health-care professionals to prescribe psychotropic medicines. None.

Mental health prevention in children and adolescents in the European Union and measures taken in Poland – good practices and limitations

Mental health of children and adolescents is one of important issues managed as part of preventive interventions not only in Poland, but throughout the European Union. Many studies have shown continuous deterioration of mental health among children and adolescents. Alarming data have been published by the World Health Organization, which show that up to 20% of children suffer from various types of mental problems, hence the need for interventions that will put an end to this process. The most important target set by the European Union countries is to introduce large-scale multilevel preventive measures aimed at the total population, referred to as universal prevention. In addition to universal prevention, European Union countries, including Poland, implement targeted interventions for those at risk and those already diagnosed, as part of preventive mental health care. These measures are part of the WHO Comprehensive Mental Health Action Plan 2013–2030, which encompasses the following objectives: promote mental well-being, enhance recovery, and reduce the mortality, morbidity and disability for persons with mental disorders. This plan was intended to focus on improving mental health care and implementing comprehensive actions at the local level in all European Union countries, which often requires legislative changes in member states. Mental health is becoming the focal point of national and local interventions in Poland. Fast and free access to specialists close to one’s place of residence becomes crucial.

PROTOCOL: Social interventions to improve well-being of people with mental disorders: Global evidence and gap map.

Introduction: Mental illnesses play a role in poor health outcomes. Mental health is just as vital as physical health for an individual's total well-being. Alterations in mental health can have a significant impact on all aspects of life, including school or work performance, relationships with family and friends, and community participation. As a result, we would like to provide an overview of psychosocial interventions that are available to improve the well-being of people with mental health conditions and map available studies on the effectiveness of interventions provided in framework. Methods: This Evidence Gap Map will feature systematic reviews of the effects of interventions and effectiveness studies that used either: (a) randomised experimental design, or (b) rigorous quasi-experimental design, (c) natural experiments, (d) regression discontinuity, (e) propensity score matching, (f) difference in difference, (g) instrumental variables, (h) and other matching design, (I) Single subject design. We will include qualitative studies, relevant working papers will also be included. Also, language restricted to english from any country will be reviewed for inclusion. Electronic Search will be conducted with the help of a relevant databases in our area of study. Outcomes: Will be focused mainly on the basis of community-based Rehabilitation matrix adapted from the comprehensive mental health action plan, 2013-2020.

Challenges of facing coronavirus disease 2019: Psychiatric services for patients with mental disorders

As a public health emergency of international concern as declared by the World Health Organization (WHO), the current outbreak of coronavirus disease (COVID-19) in China has captured the world's attention.1 The global COVID-19 outbreak can now be characterized as a pandemic, and the number of confirmed cases all over the world has increased to 416 686 as of 04:34 hours, 26 March 2020, according to data released by the WHO.1 International journals for general medical and specialty fields are working closely with experts across the globe to raise comment and provide advice on measures to protect mental health in this epidemic.2, 3 We have enormous respect for those who have most recently published the latest content on this new virus; however, it is time for a change in focus. In addition to the challenges faced by medical professionals and the general public, the mental health services for patients suffering from mental disorders have several challenges to face. To this end, a guideline document was recently issued by the government of the People's Republic of China with respect to strengthening the management of treatment for patients with severe mental disorders during the outbreak of COVID-19.4 Afterwards, an expert consensus on the managing pathway and coping strategies for patients with mental disorders during prevention and control of the outbreak of a serious infectious disease (novel coronavirus pneumonia) was published by the Chinese Society of Psychiatry together with other psychiatry-related academic organizations.5 However, we are under challenging conditions to effectively deal with the realistic problems in the psychiatric domain caused by the COVID-19 outbreak. A nationwide epidemiological survey reported that the lifetime prevalence of any psychiatric disorder is 16.6% in China.6 Many patients need ongoing support in outpatient clinics, and many require repeated readmissions to inpatient wards, and vice versa. Psychiatrists assess patients, advise them and their guardian, and provide long-term treatments at hospitals. The difficulty in maintenance treatment of individual patients with mental disorders is currently increased for several reasons. First, under strict control due to the epidemic, most of the general hospitals in Hubei province and elsewhere are temporarily unable to care for psychiatric patients to lower the possibility of COVID-19 transmission. Second, because of the need to establish special wards for patients who have a fever, specialized hospitals have had to reduce the number of ordinary hospitalizations. Third, patients undergoing hospitalization and outpatients seeking help or undertaking follow up have had to discontinue their treatment due to suspended public transport in a number of areas. At present, there are few measures as to how long maintenance treatment in mental disorders should last after an episode. Failure to directly resolve these problems prevents us from achieving our goal, despite its importance in the clinical management of mental disorders. Given that many more medical comorbid factors occur in patients with mental disorders, another challenge is addressing the effects of medical comorbidity in patients; for instance, respiratory diseases are more common in schizophrenia patients than in the general population, and patients with schizophrenia and concomitant influenza or pneumonia have higher mortality rates (see Wang et al.7 for a review). There so far appears to be no attention paid to these vulnerable individuals, that is, psychiatric patients with comorbid COVID-19. Here, we would like to share response suggestions. The World Health Assembly in 2013 endorsed an action plan, the WHO's ‘Comprehensive Mental Health Action Plan 2013–2020.’8 A key recommendation is to shift services from institutions to the community, highlighting the steps required to provide appropriate psychiatric services for patients in the current COVID-19 epidemic. In addition to this, the development of artificial intelligence techniques in clinical settings, attempts to speed up constructing the framework of online consultation and Internet hospitals, and the provision of telemedicine are all valuable. As a fundamental component of mental health services, psychiatric health-care professionals based in large top-class tertiary hospitals play critical roles in the comprehensive health of the population with mental disorders. This can be leveraged through large data analyses and harnessed via updated clinical practice guidelines and algorithms to improve policy-making. The COVID-19 epidemic has now spread across China and affected the world for almost 3 months. It poses many problems not only with the provision of psychiatry care, but also public health, prevention and control, preclinical and clinical research, health policy, and even health law. We are writing to draw attention to the challenges regarding maintenance treatment and concomitant COVID-19 in patients with mental disorders. The positive response is increasingly expected to explore and address the issues that affect patients with mental disorders on the basis of available evidence. The authors declare no conflicts of interest.

Towards a National Policy on Suicide Prevention

Suicide is a global phenomenon and occurs throughout the life span. It is recognised as a critical public health issue by the World Health Organization (WHO) in its Comprehensive Mental Health Action Plan 2013-2020.1 In the year 2016, it was estimated that globally 817000 population committed suicide. This means world wide one person commits suicide in every 40 seconds.

Psychological Disorder Identifying Method Based on Emotion Perception over Social Networks.

The Institute for Health Metrics and Evaluation (IHME) has stated that over 1.1 billion people suffered from mental disorders globally in 2016, and the burden of mental disorders has continued to grow with impacts on social development. Despite the implementation of strategies for promotion and prevention in mental health WHO’s Comprehensive Mental Health Action Plan 2013–2020, the difficulty of diagnosis of mental disorders makes the objective “To provide comprehensive, integrated, and responsive mental health and social care services in community-based settings” hard to carry out. This paper presents a mental-disorder-aided diagnosis model (MDAD) to quantify the multipolarity sentiment affect intensity of users’ short texts in social networks in order to analyze the 11-dimensional sentiment distribution. We searched the five mental disorder topics and collected data based on Twitter hashtag. Through sentiment distribution similarity calculations and Stochastic Gradient Descent (SGD), people with a high probability of suffering from mental disorder can be detected in real time. In particular, mental health warnings can be made in time for users with an obvious emotional tendency in their tweets. In the experiments, we make a comprehensive evaluation of MDAD by five common adult mental disorders: depressive disorder, anxiety disorder, obsessive-compulsive disorder (OCD), bipolar disorder, and panic disorder. Our proposed model can effectively diagnose common mental disorders by sentiment multipolarity analysis, providing strong support for the prevention and diagnosis of mental disorders.

Global mental health: A call to action.

Mental health needs have been recognized as a priority area by the World Health Organization (WHO), and a Comprehensive Mental Health Action Plan (2013) was proposed to address the needs of millions of people around the world. Concerns have been raised about the degree to which current global efforts are appropriate and sufficient for promoting mental health (MH), reducing the risk for common MH disorders, and addressing the needs of individuals experiencing mental illness. This commentary expands on the presentation of the Global Alliance for Behavioral Health and Social Justice's Task Force on Global Mental Health at the 16th Biennial Conference of the Society for Community Research and Action, held in Ottawa, Ontario, Canada June 21-24, 2017, "Building Capacity to Address Mental Illness and Emotional Distress in Low-Resource Settings and Among Refugee Populations." Utilizing a socioecological framework, this commentary offers a call to action in addressing global mental health by emphasizing the need for greater investments in wellness promotion, prevention, treatment, and recovery. Importantly, such efforts need to value local knowledge and culture, harness natural existing resources and assets, and ensure equitable distribution of key resources for MH. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Mental health comorbidity in low-income and middle-income countries: a call for improved measurement and treatment

Considerable progress has been made over the past decade in epidemiological and intervention research, service delivery, and increasing awareness of and appreciation for the importance of mental health in low-income and middle-income countries (LMICs). A key example of this progress is the WHO's Comprehensive Mental Health Action Plan 2013–2020. 1 Saxena S Funk M Chisholm D World Health Assembly adopts comprehensive mental health action plan 2013–2020. Lancet. 2013; 381: 1970-1971 Summary Full Text Full Text PDF PubMed Scopus (129) Google Scholar As global mental health moves forward into areas of implementation science, health systems strengthening, and policy making, we believe it is necessary to highlight what, in our opinion, is a major gap in the field: the lack of information on the prevalence and treatment of co-occurring mental health, substance use, and other psychosocial problems.

Preventing deaths from pesticide self-poisoning-learning from Sri Lanka's success.

Preventing deaths from pesticide self-poisoning-learning from Sri Lanka's success.

Developing community mental healthcare: Kosovo case

BackgroundCommunity mental healthcare in Kosovo is still in its developmental stage and thus pose an ongoing challenge for the health system and population.ObjectivesThe purpose of this study is to describe the processes of preparation, implementation, challenges and future of community mental health service in Kosovo as an economically struggling society with underdeveloped health care system.MethodsReview of the current state of community services provision for mentally ill peoples in Kosovo in the light of the objectives and targets of the WHO comprehensive mental health action plan 2013–2020.ResultsThe implementation of a new community mental health service in Kosovo still is characterized by considerable shortages, beside substantial effort on various levels. On the policy and financial level, it was made possible by a clear intent/initialization of international bodies and coordinated commitment of all responsible national stakeholders and authorities. Obstacles remain regarding improvements of service development indicators: financial and human resources; capacity building; stakeholder involvement and service availability. Lack of strategies for promotion and prevention in mental health and lack of information systems, evidences and research for mental health is vital need.ConclusionsCommunity mental healthcare in Kosovo despite struggles faced is successfully installed and represents one of Kosovo health system achievements. Comprehensive, integrated and responsive mental health services in community-based settings in line with international and regional human rights instruments is goal to be addressed.Disclosure of interestThe author has not supplied his/her declaration of competing interest.

Mapping actions to improve access to medicines for mental disorders in low and middle income countries.

In recent years a number of intergovernmental initiatives have been activated in order to enhance the capacity of countries to improve access to essential medicines, particularly for mental disorders. In May 2013 the 66th World Health Assembly adopted the World Health Organization (WHO) Comprehensive Mental Health Action Plan 2013-2020, which builds upon the work of WHO's Mental Health Gap Action Programme. Within this programme, evidence-based guidelines for mental disorders were developed, including recommendations on appropriate use of medicines. Subsequently, the 67th World Health Assembly adopted a resolution on access to essential medicines, which urged Member States to improve national policies for the selection of essential medicines and to promote their availability, affordability and appropriate use. Following the precedent set by these important initiatives, this article presents eleven actions for improving access and appropriate use of psychotropic medicines. A 4 × 4 framework mapping actions as a function of the four components of access - selection, availability, affordability and appropriate use - and across four different health care levels, three of which belong to the supply side and one to the demand side, was developed. The actions are: developing a medicine selection process; promoting information and education activities for staff and end-users; developing a medicine regulation process; implementing a reliable supply system; implementing a reliable quality-control system; developing a community-based system of mental health care and promoting help-seeking behaviours; developing international agreements on medicine affordability; developing pricing policies and a sustainable financing system; developing or adopting evidence-based guidelines; monitoring the use of psychotropic medicines; promoting training initiatives for staff and end-users on critical appraisal of scientific evidence and appropriate use of psychotropic medicines. Activating these actions offers an unique opportunity to address the broader issue of increasing access to treatments and care for mental disorders, as current lack of attention to mental disorders is a central barrier across all domains of the 4 × 4 access framework.

Adolescent mental health: new hope for a “Survive, Thrive and Transform” policy response

Purpose– Mental health problems make a significant contribution to morbidity and mortality in adolescents worldwide. To address mental health in adolescents policy response should intertwine the life course approach and the ecological model that positions adolescents in the context of multifactorial influences. The purpose of this paper is to describe policy response at four levels: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress. It aims to analyse the implications for adolescent mental health of key recent global commitments including the sustainable development goals (SDGs) and the Global Strategy for Women’s, Children’s and Adolescents’ Health.Design/methodology/approach– Multisector policies and interventions on determinants of adolescent mental health and well-being are drawn from the Global Strategy for Women’s, Children’s and Adolescents’ Health. Key health systems actions are derived from the Comprehensive Mental Health Action Plan (2013-2020). In both cases, policies and interventions are made specific for provisions relevant to adolescents. Examples of implementation of policies and interventions are drawn from a World Health Organization (WHO) review of national policy documents found in WHO MiNDbank. A list of indicators to monitor progress is being proposed based on Mental Health Atlas and WHO indicators for adolescent health.Findings– With some notable exceptions, the mental health of adolescents is not adequately addressed by national health policies. There is a considerable body of evidence on the effectiveness of policies and interventions, and recent global commitments give new hope for promoting adolescent mental health through a multisectoral response, within which the health sector has an important role to play. Global reporting mechanisms, including the Mental Health Atlas, should be “adolescent-sensitive”, meaning that adolescent specific impact, outcomes, inputs and determinants should be measured, reported and acted upon.Originality/value– This paper analyses the meaning specific to adolescents in the policies and interventions promoted in the SDGs, the Global Strategy for Women’s, Children’s and Adolescents’ Health and the Comprehensive Mental Health Action Plan (2013-2020). For the first time a four-levels policy response specific to adolescent mental health is put together: multisector policies and interventions, health systems policies and interventions, evidence-based clinical interventions and actions to monitor progress.