Countries are significantly off track in meeting global targets set to transform mental health systems, according to the latest Director-General report tabled at the World Health Organization’s (WHO) Executive Board meeting.

Around 1.1 billion people were estimated to be living with a mental health disorder, according to the latest WHO data available for 2021.

Financial and human resources available for mental health services have not increased since 2020, with budgets remaining at a median of 2% of government health spending, the report found.

On average, there is only one government mental health worker for every 10,000 people with stark variations between lower- and higher-income countries, the Director General’s (DG) report noted.

Countries discussed a range of responses.

“It is absolutely essential to advance towards true inclusion of mental health and all policies tackling related inequalities to do with housing, the socio-economic level, work and climate change, as well as discrimination and violence,” the representative from Spain said.

“We want to make sure that we focus ourselves on non-pharmaceutical tools, the fewer prescriptions of psychotropic drugs and the prescription of social measures and community action,” the Spanish representative added.

The WHO has a ‘Comprehensive Mental Health Action Plan 2013-2030’ in place, and the DG’s report was meant to highlight the ways in which this action plan can be implemented or enhanced.

New pressures on mental health disorders

Mental health disorders are worsening with the added pressure of the recent COVID-19 pandemic and increasing climate change impacts. The pandemic has worsened all the factors that expose young people to mental health problems – indebtedness, economic insecurity and inequalities, migration and conflict, the report found.

Death by suicide is now the third leading cause of death among 15 to 29-year-olds, with an estimated 727,000 deaths by suicide in 2021, according to WHO data.

Digital pressures are exacerbating poor mental health, and the WHO has already recognized that the time spent online is associated with depression, anxiety, and psychological distress in adolescents.

“We request WHO to urgently address the impact of social media and extensive use of technology among adolescents and young people by ensuring that the recently published guidance on mental health for children and young people is fully implemented by member states,” a representative of Zambia said during the discussion. Belgium echoed similar sentiments.

One of the key components of WHO’s plan is to integrate mental health and social care services in community-based settings. Currently, most countries are at an early stage of this transition to community-based service delivery, despite it being a key priority area for the WHO, according to the DG report.

Millions of alcohol and drug-use deaths 

In 2019, an estimated 2.5 billion people consumed alcohol and 400 million people were living with alcohol use disorders. Alcohol consumption and psychoactive drug use was responsible for 2.6 million and 0.6 million deaths in 2019, according to the WHO.

The world health body estimates that 316 million people used psychoactive drugs in 2023, and 64 million people were living with drug use disorders.

Both alcohol use and drug use disorders are problems that in recent years have been categorized as a mental health issue that require help.

“Little progress has been made in implementing the high-impact policy interventions proven to reduce alcohol-related harm,” the DG’s report read. “…and quality and ethical treatment for substance use disorders is still largely inaccessible for those most in need.”

Members of the European Union raised concern over tobacco products being aggressively marketed to children online.

“Children should be protected from aggressive online marketing of unhealthy food and drinks, alcohol, tobacco and similar products or prohibited substances. We call upon WHO to advance research and develop effective guidance to protect and promote mental health online and offline, while recognizing the responsibility of digital platforms and industries,” said Bulgaria on behalf of the European Union.

Growing recognition of the impact of mental health

While the action on the ground is still limited, it is clear that there is a growing recognition among countries of the kinds of mental health disorders affect health. Discussions on the non-communicable diseases (NCDs) too saw extensive mention of mental health disorders.

Germany drew attention to the impact of climate change on all NCDs, including mental health.

Several non-state actors raised concerns about the mental health impacts on healthcare providers themselves due to a combination of excessive working hours, job insecurity, violence and psychosocial workplace risk.

“Studies show that health workers face mental health crises in several countries, reflected in a suicide risk that is 24% higher than in other sectors. We urge member states to ramp up efforts at strengthening mental health and psychosocial support for the populations of their countries and with dedicated programs for health workers,” said a representative of Public Services International, a global union that represents millions of workers.

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