Improving health systems and services for mental health

This document outlines a comprehensive strategy for how to improve mental health policy and service development.  It shows that lack of political support, inadequate management, overburdened health services and, at times, resistance from policy-makers and health workers, have hampered the development of coherent mental health systems. In addition, the scant resources that are dedicated to mental disorders are often inappropriately deployed.

Key messages include:

• mental health issues should be incorporated within general health policies and plans, and supplementary mental health policies and plans also should be developed to provide the details required for implementation
• mental health legislation is essential to complement and reinforce mental health policy, and extends beyond the health sector and includes issues related to education, housing, and employment
• policy-makers should consider their country’s current mental health system through drafting, implementing, and evaluating mental health policies and legislation
• quality improvement for mental health requires the active participation of all stakeholders on an ongoing basis, and the careful monitoring and evaluating of applied mental health policies.

Policy implications include:

• the provision of good-quality mental health care often necessitates a transformation of the roles and responsibilities of both mental health specialists and general health workers
• governments should achieve mandatory coverage for mental health services through either national tax-based or social insurance
• psychotropic medicines, when used in combination with psychosocial interventions, reduce disability and prevent relapse of many mental disorders
• adherence to long-term medication therapy is important for mental disorders, though presents unique challenges and considerations
• psychiatric hospitals are outdated, ineffective, and result in human rights violations.