The World Health Organization defines good mental health as a state of well-being in which a person realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Mental illnesses, of any type, have an impact on that well-being. They may be caused by the genetic, biological and psychological make-up of the person and/or factors in their surrounding society or environment.
The WHO’s evidence case for investing in mental health, published in 2013, states that governments have the lead responsibility for ensuring the mental health of the whole population is promoted, and intervening to help people and families who find that they are unable to cope.
Mental illness affects people in all groups of society but is more common among the poorest. Poverty, in itself, causes more difficulty in life and people with mental illnesses can make unwise and unhealthy choices which can lead to poverty. The link between poverty and mental health is seen as a “significant justification for state intervention” in mental health. Governments are encouraged to:
• provide better information, awareness and education about mental health and illness;
• provide better (and more) health and social care services for currently underserved populations with unmet needs;
• provide better social and financial protection for persons with mental disorders, particularly those in socially disadvantaged groups; and
• provide better legislative protection and social support for persons, families and communities adversely affected by mental disorders.
The WHO does not prescribe policies as these will depend on the political context in each country. Governments “do not need to pay the entire mental health budget or provide all services themselves” but they do have an obligation to ensure that “appropriate institutional, legal, financing and service arrangements” are put in place address the mental health needs of the population.
Four main reasons for investing in mental health are set out: enhancing individual and population health and well-being; reducing social inequalities; protecting human rights; and improving economic efficiency.
Mental health, it says, should be seen as a global priority and the evidence base should not only include strategies for treatment but tackling stigma, the social causes of mental illness, and the impact of mental health improvements on economic development and social well-being.
It is recognised that negative cultural attitudes towards mental illness persist and governments tend to emphasise the creation or retention of wealth rather than the promotion of societal well-being. In response, the WHO wants to see a “stronger and more unified voice” insisting that the health and human rights of people with mental health problems can and should be appropriately protected.
For each year of inaction and under-investment in mental health, the health, social and economic burden will “continue to rise.” Conversely, investment in better mental health can give dignity and help people, societies and economies develop.