UN prioritises mental health in Development Agenda2030

UCT's Professor Crick Lund, director of the Alan J Flisher Centre for Public Mental Health, believes the inclusion of specific mental health targets in the new United Nations Sustainable Development Goals is a major breakthrough to get mental health on the global development policy agenda.

This follows the UN's announcement that its member nations had adopted the new Development Agenda2030, which will lead global development policy over the next 15 years, and that mental health would be a development priority.

The 17 Sustainable Development Goals will guide efforts across the globe to reduce poverty and increase both physical and mental health by 2030.

“People living in poverty have increased risk for a range of mental health conditions through a number of causal pathways. Conversely, people living with mental illness are at risk of drifting into or remaining in poverty,” said Lund, who is based in the Department of Psychiatry and Mental Health.

“Including mental health in international development targets provides an opportunity for countries to implement and monitor efforts to break the cycle of poverty and mental illness.”

Huge burden

With this historic decision the UN is addressing the needs of millions of people with mental health problems. One in four people worldwide experiences a mental health condition in their lifetime.

In most countries people with mental health problems are not treated because of a paucity of mental health systems and services. In low-income countries up to 80% of people do not receive treatment, and many are subject to inappropriate treatment, human rights violations and isolation.

In 2012, suicide was the 15th leading cause of death and 75% of suicides occurred in low- and middle-income countries. The social and economic costs to nations and society are huge.

“We now need to work closely with governments and international development agencies to implement the mental health indicators, which are related to suicide rates and treatment coverage for severe mental illnesses,” said Lund.

Major achievement

“The clear inclusion of mental health as a priority within the Sustainable Development Goals is a major achievement,” added Graham Thornicroft, Professor of Psychiatry at the Institute of Psychiatry, Psychology and Neuroscience at King's College London, and director of the global initiative FundaMentalSDG to promote mental health in the UN Development Agenda2030.

FundaMentalSDG is a global initiative, of which UCT is a part, to strengthen mental health in global development and include mental health in the UN Sustainable Development Goals (SDGs) and indicators.

Lund is one of a 26-member steering group and represents South Africa through two UCT-led multi-country programmes across eight countries in Africa and Asia: the Programme for Improving Mental health care (PRIME) funded by UKAID, and the Africa Focus on Intervention Research for Mental Health (AFFIRM), funded by the US government's National Institute for Mental Health.

Poor to benefit

The consequences of the new mental health priority in the Development Agenda 2030 are far-reaching: The 2030 Agenda is a global policy defining international development priorities, and will lead countries to set priorities for mental health in their national policies and resource planning.

Low- and middle-income countries will increase their efforts to reach the targets in mental health, and higher income countries will support less developed nations with financial, human and knowledge resources.

To make the Sustainable Development Agenda and mental health targets work the UN member states now need to agree on strong and robust indicators to ensure measurable, actionable, attainable results.

Thornicroft said: “The most important next step is for the UN to adopt two specific indicators [referring to treatment coverage for people with severe mental illness, and to suicide rates]. Tracking these measures for every country worldwide will allow us to quantify progress to universal mental health coverage in the future.”

These indicators are crucial because they will make progress in mental health measurable and will help to hold countries and their governments to their promised commitments and achievements.

(On 8 and 9 October global leaders in mental health met in Geneva at the WHO mhGAP Forum to discuss, among other things, targets and indicators for mental health in relation to the Sustainable Development Goals. Lund and colleagues presented a special session sharing the latest findings from the PRogramme for Improving Mental health carE (PRIME), published on 7 October in the British Journal of Psychiatry.)

Story by Helen Swingler. Image courtesy of Creative Commons.