By Dr Poonam Khetrapal Singh, WHO Regional Director for South-East Asia
On World Mental Health Day, WHO is calling on Member States in the South-East Asia Region to intensify action to achieve access for all to quality mental health care, in line with the recently adopted Paro Declaration on universal access to people-centred mental health care and services. Globally, before the COVID-19 pandemic, around 1 in 8 people lived with a mental health condition. Gaps in treatment were unacceptably large, especially in low- and middle-income countries. In the South-East Asia Region, an estimated 1 in 7 people lived with a mental health condition, and in countries where data are available, the treatment gap ranged from 70–95%.
The COVID-19 crisis has impacted almost all areas of health, but few as profoundly as mental health. In 2020, cases of major depressive disorder are estimated to have increased by more than 27% globally, and cases of anxiety disorders by more than 25%, adding to the 1 billion people who were already living with a mental disorder. In many countries, this occurred alongside widespread disruptions to mental health services. Between November and December 2021, more than 33% of WHO Member States globally reported ongoing disruptions to mental, neurological and substance use services.
To close remaining gaps, and to accelerate pre-pandemic progress, in September 2022, at the Seventy-fifth Session of the WHO Regional Committee for South-East Asia, countries of the Region committed to take bold, decisive action, unanimously adopting the Paro Declaration on universal access to people-centred mental health care and services. The Paro Declaration aims to ensure that all people in the Region can access quality mental health care, close to where they live, without financial hardship. It places specific emphasis on the need to reorient and integrate mental health services into primary health care (PHC), complementing the new Regional Strategy for PHC, launched in December 2021.
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 care is a basic human right. It aims to help all countries of the Region build on and accelerate longstanding efforts to implement equitable mental health policies, laws, programmes and services, in line with the Region’s Flagship Priorities on preventing and controlling noncommunicable diseases, strengthening emergency risk management and achieving universal health coverage.
In the months and years ahead, the Region has several priorities. First, reorienting mental health services to strengthen PHC capacity, with a focus on expanding the specialized and non-specialized mental health workforce. Second, establishing evidence-based and rights-oriented community mental health networks, and increasing collaboration with civil society and affected populations. Third, strengthening national and subnational programmes to address suicide and self-harm, as well as drug and alcohol use. And fourth, combatting mental health-related stigma and discrimination, and protecting and promoting human rights.
Inaction is not an option. Evidence shows that investing just US$ 1 per capita annually for priority mental health conditions could reduce years lived with disability by close to 5000 per million population each year. Increased investments and/or allocations towards mental health will therefore not only reduce overall treatment costs, but also increase productivity and employment. The Region’s Flagship Priorities, the Sustainable Development Goals, and WHO’s founding Constitution all agree: There is no health without mental health. Amid the ongoing COVID-19 response and recovery, together we must deepen commitment, reshape environments, and strengthen care to transform mental health, for a better life and future for all.