Mental health is an essential component of health. The WHO Constitution defines health as follows: "Health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity". The important corollary of this definition is that mental health is more than the absence of mental disorders or disabilities.
Mental health is a state of well-being in which a person can realize themselves, overcome the normal stresses of life, perform productive work and contribute to the life of their community. In this positive sense, mental health is the foundation of an individual's well-being and the proper functioning of a community.
Mental health and well-being are essential for human beings to think, feel, interact with others, earn a living, and enjoy life at the individual and collective levels. That is why the promotion, protection, and restoration of mental health are central concerns for individuals, communities, and societies around the world.
The Determinants of Mental Health
Multiple social, psychological, and biological factors determine a person's degree of mental health at any given time. Thus, persistent socio-economic pressures are recognized risk factors for the mental health of individuals and communities. The evidence that best attests to this is poverty indicators, including low levels of education.
Mental health problems are also associated with the following: rapid social change; harsh working conditions; discrimination against women; social exclusion; unhealthy lifestyle; risks of violence or poor physical health; and human rights violations.
In addition, certain psychological profiles and personality traits predispose to mental disorders. Finally, mental disorders may be due to biological causes, including genetic factors that contribute to chemical imbalances in the brain.
Promotion and protection of mental health
The promotion of mental health involves actions aimed at creating living conditions and an environment that promotes mental health and enables the adoption and maintenance of a healthy lifestyle. For this, there is a wide range of measures to increase the likelihood of more people enjoying good mental health.
An environment that ensures respect for and protection of fundamental civil, political, socio-economic, and cultural rights is essential to promote mental health. Without the security and freedom provided by these rights, it is very difficult to maintain good mental health.
National mental health policies must not limit their scope to mental disorders. They also need to recognize and take into account the broader factors that promote mental health. This includes integrating mental health promotion into public and non-governmental policies and programs. In addition to the health sector, the following sectors should also be involved: education, employment, justice, transport, environment, housing, and social protection.
Mental health promotion relies largely on intersectoral strategies. Concrete ways to promote mental health include:
- early childhood interventions (e.g., home visits for pregnant women, psychosocial activities before schooling, interventions combining nutritional and psychosocial support for disadvantaged populations);
- assistance to children (e.g., skills development programs, child and youth development programs);
- women's access to socio-economic empowerment (e.g., improved access to education and microcredit schemes);
- social support for seniors (e.g., initiatives to foster friendly contacts, community day centres for seniors);
- programs for vulnerable groups, including minorities, indigenous peoples, migrants, and victims of conflict and disaster (e.g., psychosocial responses in the aftermath of disasters);
- school-based mental health promotion activities (e.g., programs that promote environmental behaviour change in schools, and child-friendly schools);
- mental health interventions in the workplace (e.g., stress prevention programs);
- housing policies (e.g., housing improvements);
- violence prevention programs (e.g., reducing the accessibility of alcohol and weapons);
- community development programs (e.g. Communities That Care initiatives).
- poverty alleviation and social protection programmes for the poor;
- anti-discrimination laws and campaigns;
- Promotion of rights, opportunities, and care for people with mental disorders.
Care and treatment
It is essential that national efforts to develop and implement mental health policies aim not only to protect and promote the mental well-being of citizens but also to meet the needs of people with mental disorders.
Knowledge about addressing the growing burden of mental disorders has advanced significantly over the past 10 years. There is growing evidence that some key interventions for priority mental disorders are both effective and cost-effective in countries at different levels of economic development.
Cost-effective, realistic, and affordable interventions include:
- treatment of epilepsy with antiepileptic drugs;
- treatment of depression with a psychological approach and generic antidepressants for severe to moderate cases;
- treatment of psychosis with older antipsychotics and psychosocial support;
- The taxation of alcoholic beverages and restrictions on their availability and marketing.
- There is also a range of effective measures for suicide prevention, prevention and treatment of mental disorders in children, prevention and treatment of dementia, and treatment of substance abuse disorders. The Action Programme "Bridging the Mental Health Gap" (mhGAP) has developed evidence-based guidelines for non-specialists to help them identify and address priority mental health issues.
WHO's work
WHO partners with governments to strengthen and promote mental health. It has assessed evidence on mental health promotion and works with governments to disseminate this information and integrate effective strategies into policies and plans.
In 2013, the World Health Assembly endorsed the Comprehensive Mental Health Action Plan 2013-2020. Through this plan, all WHO Member States commit to taking specific action to improve mental health and contribute to achieving global targets.
Its purpose is to promote mental well-being, prevent mental disorders, provide care, improve the chances of recovery, promote human rights and reduce mortality, morbidity, and disability among people with mental disorders. It has four key objectives:
- Strengthen leadership and governance in the area of mental health.
- Provide comprehensive, integrated, and responsive mental health and social care services within a community setting.
- Implement promotion and prevention strategies in the field of mental health.
- Strengthen information systems, evidence, and research in the field of mental health.
The Plan of Action places particular emphasis on the protection and promotion of human rights, the strengthening and education of civil society, and attaches central importance to community-based care.
To achieve the goals set, the Plan of Action calls for clear action by governments, international partners, and WHO. Ministries of health will need to play a leading role and WHO will work with them and with international and national partners to implement the Plan. No action applies to all countries, and each Government will therefore have to adapt the Plan of Action to its national particularities.
The implementation of the Action Plan will enable people with mental disorders to:
- increased access to mental health and social welfare services;
- to receive treatment from competent health workers in general health care facilities; the Bridging mental health gaps (mhGAP) Action Programme and its evidence-based tools facilitate this process;
- participate in the reorganization, delivery, and evaluation of services so that the care and treatment provided better meets their needs;
- To have better access to State disability allowances, housing, and livelihood programs and to participate more fully in the labour market, community life, and city affairs.
Key facts
- Mental health is more than the absence of mental disorders.
- Mental health is an integral part of health; indeed, there is no health without mental health.
- Mental health is determined by a range of socio-economic, biological, and environmental factors.
- There are cost-effective intersectoral strategies and interventions to promote, protect, and recover mental health.
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