A post-2015 development agenda that leaves nobody behind must include mental health
The Sustainable Development Goals must not neglect a quarter of the world’s population, argues Nicole Votruba, Co-ordinator of the FundaMentalSDG initiative.
In just a few weeks United Nations (UN) member states will formally adopt a major new set of targets which will guide the next 15 years of global development – the Sustainable Development Goals (SDGs) and the wider post-2015 agenda.
While this could have a crucial impact on most of the world's population, the policy forming, negotiation and decision making processes are taking place relatively unnoticed by the global public and with very little influence from, or consultation with, civil society. On top of this, mental health, one of the biggest global health issues which affects one in four persons, and poses a serious development challenge, has strangely been neglected.
One quarter of the world's population is being ignored
While certain development issues have gained prominence on the public agenda, such as climate change or HIV/AIDS, mental health still remains an internationally neglected subject, which is surprising considering that 25 per cent of the world's population will experience a mental health problem in their lifetime.
Mental disorders and psychosocial disabilities are the biggest single causes of burden of disease, far more frequent than cancer or cardiovascular diseases. In high income countries alone mental illness essentially reduces lifespan by up to 20 years for men and 15 years for women, in low income countries this gap is likely to be much higher.
Getting it right on mental health is crucial for sustainable development and a prerequisite for achieving many of the SDGs' priorities.
Most people with mental health problems live in low and middle income countries (80 per cent), and the same proportion receive inadequate treatment, or no treatment at all. In addition, people are often severely stigmatised and discriminated against, frequently having their human rights violated by being chained, caged or exposed to inhuman and degrading treatment.
Mental health in the Sustainable Development Goals
So far, people with mental disorders and psychosocial disabilities have been neglected in two ways by the post-2015 processes: By not being represented adequately in civil society, national governments, international organisations or the UN in the first place, and secondly, by the structural ignorance of the SDG negotiation process.
Civil society organisations like FundaMentalSDG have been advocating for two separate mental health targets on universal health coverage and suicide. In the final draft of the SDGs, the UN member states have agreed to include at least some basic references to mental health: a mention in the Preamble (paragraph 26) as well as retaining the mental health element in Target 3.4 of Goal 3: Ensure healthy lives and promote well-being for all at all ages. This is a positive sign, but it is not enough.
The World Health Organization (WHO) has suggested two mental health indicators, which are supported by FundaMentalSDG and the UN Sustainable Development Solutions Network (UNSDSN):
1. Indicator 23: Probability of dying between exact ages 30 and 70 from any of cardiovascular disease, cancer, diabetes, chronic respiratory disease, or suicide
2. Indicator 28: Proportion of persons with a severe mental disorder (psychosis, bipolar affective disorder, or moderate-severe depression) who are using services
These two indicators are already included in WHO’s Mental Health Action Plan-2013-2020, as adopted by the World Health Assembly in 2013. The WHO will be tracking them and no additional effort will be needed by member states if/when these are included as SDG indicators.
The SDGs shall not stay an empty promise. They will be a means by which to hold UN member states accountable and can change our world and improve the lives of millions of people. The UN now needs to recognise the importance of mental health for global development in order to truly leave nobody behind.
FundaMentalSDG aims to strengthen mental health targets in the post-2015 SDG agenda. It proposes three edits to SDG 3, and two indicators, which are all fully aligned with the WHO Global Mental Health Action Plan 2013-2030. www.fundaMentalSDG.org
Photo: Woman in Hallway in Agra, India. By Louis Vest, under a CC License.