Physical and mental health must be treated the same: experts at WHA

Governments are finally waking up to the world’s growing mental health crisis but countries must make substantial reform, and not just in their health sectors, to make headway, health experts said during the 76th World Health Assembly in Geneva. Three years of the COVID-19 pandemic have seen huge increases in global levels of anxiety and depression, triggering governments worldwide to confront the need for urgent action on mental health, which has long been neglected by global lawmakers. Furthermore, with conflict and violence on the rise globally, the need for mental health support is set to increase as people face the associated trauma and loss, such as is being seen in Ukraine. But despite these huge needs, in 2020, governments worldwide spent on average just over 2% of their health budgets on mental health and many low-income countries reported having fewer than one mental health worker per 100,000 people, according to the World Health Organization. Mental health may now be a major talking point, but serious action is needed to tackle the growing epidemic, experts agreed during a Devex-hosted panel as part of Devex CheckUp @ WHA 76 in Geneva. “Physical and mental health should be at parity, they should have been treated equally together and available for everyone and that national government should invest in this. The time is not tomorrow but now,” Yves Miel Zuñiga, senior officer at the United for Global Mental Health said during the panel. Dévora Kestel, director of mental health and substance use at WHO, said she is encouraged to see growing interest in mental health from member states but worried she is yet to see the kind of “solid, higher-level reform” needed. Furthermore, the prevailing presentation of mental health in the media still risks stigmatizing and discriminating against people with severe mental illness, Kestel said. She called on governments at WHA to make a “serious commitment to, and a decision to initiate, the needed changes in health systems and beyond to ensure there is going to be increased capacity to answer to the needs of people with mental health conditions.” Mental health should be a core component of any Universal Health Coverage approach, she said and called on governments to flip their thinking to view mental health support as part of their preparedness plans, instead of only thinking about it after an emergency strikes. “You can’t relegate mental health for after because you need mental health to be better prepared to confront the situation you are facing,” Kestel said during the Devex panel. In terms of delivery strategies, integrating mental health services into existing programming can bring huge benefits, according to Zuñiga. He cited recent research which estimates that combining mental health and psychosocial services into HIV and tuberculosis programming could prevent 1 million people from contracting HIV and avert 14 million TB infections globally. Kestel agreed, adding that mental health should be seen as cross-sectoral and integrated into other sectors too, such as protection. Lyla Schwartz, senior mental health adviser at USAID, talked about integrating mental health into the agency’s wider programming. She drew attention to the need for robust evaluation beyond the number of people who receive services to include elements such as behavior change and quality of care. “It’s important not to just always look at how many people received services but what happened after and how did they utilize them,” Schwartz told the panel. Digital tools also have a role to play, the panelists agreed while acknowledging that access can be an issue in some contexts. Self-help tools can be particularly effective for treating anxiety and depression, Kestel said, pointing out that WHO’s most downloaded document is a self-help guide on how to deal with stress. Such digital tools work best when combined with some form of human interaction, she added. Given that social media can be a “double-edged sword,” it is also important to make sure digital interventions offer a safe space for people, Zuñiga added.