Strengthening mental health measures

The concept of mental health

Mental health is a state of mental well-being that enables people to cope with stressful situations in life, fulfill their potential, successfully learn and work, and contribute to society. It is an integral component of health and well-being that underpins our individual and collective abilities to make decisions, build relationships, and shape the world in which we live. Mental health is a fundamental human right. It is also crucial to personal, social and socio-economic development.

Mental health is not limited to the absence of mental disorders. It is an individualized continuum for each individual, within which the individual encounters a set of factors of varying degrees of complexity and experiences varying levels of stress, resulting in very different potential social and clinical consequences for each individual.

Mental health impairment is a collective concept encompassing mental disorders, various types of psychosocial disabilities, and other psychiatric pathological conditions involving significant distress, functional impairment, or risk of self-harm. Generally, individuals with mental health problems are more likely to experience lower levels of mental well-being, although exceptions are possible.

Determinants of mental health

Throughout our lives, numerous individual, social and structural determinants can combine to protect or undermine our mental health and alter our position on the mental health continuum.

Various individual psychological and biological factors, such as emotional skills, substance use, and genetics, can make a person more susceptible to mental health problems.

Exposure to adverse social, economic, geopolitical, and environmental circumstances, including poverty, violence, inequality, and adverse social conditions, also increases the risk of mental disorders.

Risk factors can appear at all stages of life, but those that occur during the most important periods for human development, especially in early childhood, have a particularly strong negative impact. For example, harsh parenting and physical punishment are known to undermine the mental health of children, and bullying at school is one of the main risk factors for the development of mental health disorders.

Similarly, protective factors also emerge throughout a person's life and contribute to mental resilience. These factors include our individual social and emotional skills and qualities, as well as experiences of positive social interaction, quality education, decent jobs, living in a safe neighborhood, community cohesion, and more.

The impact of risk and protective factors can be of different magnitudes. For example, local-level threats increase the risk to individuals, families, and communities. Global threats, such as economic downturns, disease outbreaks, humanitarian emergencies, forced population displacements, and the worsening climate crisis, increase the level of risk for entire populations.

The impact of each individual risk or protective factor is difficult to predict. For most people, exposure to a risk factor will not result in the development of a mental disorder, whereas many people may develop mental disorders even in the absence of known risk factors. Nevertheless, the complex of different interacting determinants of mental health can both enhance and undermine mental health.

Promoting mental health and preventing mental disorders

Interventions to promote mental health and prevent mental disorders are based on identifying individual, social and structural determinants of mental health and intervening to reduce risks, increase mental resilience and create a supportive environment for mental health. Interventions can target individuals, specific populations or whole populations.

Reshaping the determinants of mental health often requires interventions beyond the health sector, so mental health promotion and prevention programs should include the education, labor, justice, transportation, environment, housing and social welfare sectors. The health sector can contribute significantly by incorporating mental health promotion and prevention into the scope of care and by promoting, initiating and, where appropriate, supporting multisectoral collaboration and coordination.

Suicide prevention is a global priority included in the Sustainable Development Goals. Great strides in suicide prevention can be made by limiting access to the means to commit suicide, responsible media coverage of such cases, social and emotional skills training for adolescents, and early intervention. A particularly inexpensive and cost-effective intervention to reduce suicide rates is the banning of highly hazardous pesticides.

Promoting the mental health of children and adolescents is another priority that can be accomplished through policies and legislation that promote and protect mental health and support parents and caregivers in providing caring and respectful child care, school-based programs, and a supportive and safe environment for children in the community and online. School-based social and emotional learning programs are among the most effective mental health promotion strategies in countries of all income levels.

There is increasing interest in promoting and protecting mental health in the workplace; legislation and regulation, organizational strategies, supervisor training, and the implementation of worker-level interventions can also be addressed in this area.

Care and treatment for mental health problems

In the context of national efforts to promote mental health, it is critical not only to protect and promote the mental well-being of the entire population, but also to take steps to address the needs of people with mental disorders.

This should be addressed through community-based mental health care, as it is more accessible and acceptable to the population than inpatient care, helps prevent human rights violations and leads to better mental health outcomes. Community-based mental health care should be embedded in a continuum of linked services:

• Mental health services integrated into the general health care system, usually operating at the general hospital level and in a task-sharing capacity with non-specialist primary care providers;
• Community mental health services, which may include community mental health centers and teams, psychosocial rehabilitation services, support groups, and foster care services;
• Services that provide mental health services in social welfare and non-medical settings, such as child protective services, school health services, and prison facilities.

The huge gap in care for common mental health disorders such as depression and anxiety disorders makes it necessary for countries to find innovative ways to diversify and scale up care for these conditions, such as through non-specialized psychological counseling or self-help using digital platforms.

WHO activities

All WHO Member States have committed to implementing the Comprehensive Mental Health Action Plan 2013-2030, which aims to improve mental health by strengthening effective leadership and governance, providing comprehensive, integrated and flexible community-based care, implementing strategies to promote mental health and prevent mental disorders, and developing information systems, evidence and research. According to an analysis of countries' performance in implementing the action plan presented in WHO's 2020 Atlas of Mental Health. "The Mental Health Atlas 2020, published by WHO, shows that progress on achieving the objectives of the agreed action plan remains insufficient.

The World Mental Health Report, published by WHO, calls on all countries to accelerate the implementation of the action plan. The report argues that all countries have the potential to make significant progress in improving mental health through action on three main areas of transformation:

• Increasing the value of mental health as perceived by individuals, society as a whole and public authorities; in line with this value, ensuring the necessary commitment, cooperation and investment from all stakeholders and in all sectors;
• transforming the physical, social and economic characteristics of the environment - in the home, in schools, in the workplace and in the community at large - to better protect mental health and prevent mental disorders;
• Strengthening the mental health system so that the full range of mental health needs are addressed through a network of accessible, affordable, quality services and community support.

WHO focuses on the protection and realization of human rights, empowering people to share their personal experiences, and ensuring a multisectoral and multi-stakeholder approach.

WHO continues to work at the national and international levels, including in humanitarian emergencies, to provide policy advice, evidence, tools and technical support to governments and partners to strengthen the collective response to mental health and effect change to improve mental health for all people worldwide.