Mental Health Care to Take Centre Stage at the General Assembly

© UNICEF/Anush Babajanyan/VII Photo — Kazakhstan has the third highest youth suicide rate in the world.

For the first time, mental health care will be a focus of an official meeting of the General Assembly on Thursday 25 September. World leaders are expected to agree on a set of principles designed to drive global action to help sufferers.

Although the subject of mental health has been raised in previous years, it will get top billing at the event, which will also cover the prevention and control of other noncommunicable diseases (NCDs), such as cardiovascular illnesses, cancer, diabetes and chronic respiratory diseases. NCDs remain the leading causes of death and disability worldwide. They are closely connected: for many people, physical and mental conditions overlap, demanding integrated approaches to care.

The scale of the challenge

“This is the first time that we can report more than one billion people have a mental health condition,” said Dr. Devora Kestel, Director ad interim of Noncommunicable Diseases and Mental Health (NMH) at the World Health Organisation (WHO). “Only nine per cent of people with depression, the most common mental health condition, receive support. Only 40 per cent of people with psychosis receive help. This means then that countries need to come up with more and better ways to develop services to make sure that care is available and easy to access.”

Even where services do exist, they are often inaccessible due to costs, distance, or lack of integration with other health support. Stigma is also a significant factor dissuading those living with mental health conditions from seeking help.

UNICEF is providing women in Sierra Leone with mental health counselling and psychosocial support.

The Political Declaration due to be adopted at the meeting also aims to encourage knowledge sharing and expanded funding. “Member States have decided to emphasise some issues that are common to all non-communicable diseases, but some that are very specific to mental health, like child and youth mental health, suicide prevention, and efforts to develop services at community level,” Dr. Kestel noted.

Clear links between mental and physical illness

The spread of NCDs is largely driven by five main risk factors: tobacco use, harmful use of alcohol, insufficient physical activity, unhealthy diets, and air pollution. Limited access to diagnosis, treatment and care services also contributes significantly.

Risk factors between mental and physical illness overlap significantly, according to Dr. Kestel. “The promotion of lifestyle interventions that encourage physical activity, healthy diet, or cutting out tobacco and alcohol, are valid for both types of illnesses.

Now, she says, it is time for politicians to act. “We have heard a lot about the importance of mental health over the last few years. We need commitment. We need leaders to understand that there are issues, processes, mechanisms that can be put in place to ensure that there is going to be access to mental health care, from promoting healthy lifestyle to ensuring a person-centred approach to treatment and care with a clear role for people with lived experience.”

Migrants and refugees can be exposed to various stress factors which affect their mental health and well-being.

A chance for global commitment

The upcoming UN High-Level Meeting represents an opportunity to put mental health and NCDs firmly on the global agenda. The declaration will not be, as Dr. Kestel herself noted, a “magic document,” but it can set a new course, unite countries, and demonstrate that accessible and fair mental health care is possible in every corner of the world.

What the declaration will propose

Some of the priority directions identified in the draft declaration include:

Primary health care: ensuring access to basic services for prevention, diagnosis and treatment for everyone.

Essential medicines and health technologies: guaranteeing they are safe, effective and of high quality.

Sustainable financing: especially for low- and middle-income countries.

Recognition of shared risk factors: and treatment needs between NCDs and mental health, while amplifying the voices of people living with these conditions.

Cross-sectoral cooperation: health depends not only on medicine but also on nutrition, environment, legislation, and economics.

Tackling external drivers: such as air pollution, unhealthy food marketing, tobacco promotion, and adverse social and economic conditions.

Raising global awareness.