Mental health, poverty and development
"The biggest enemy of health in the developing world is poverty"
Kofi Annan, former Secretary-General of the United Nations
An overwhelming majority of people with mental and psychosocial disabilities are living in poverty, poor physical health, and are subject to human rights violations.
Mental health issues cannot be considered in isolation from other areas of development, such as education, employment, emergency responses and human rights capacity building.
Development stakeholders - including governments, civil society, bilateral development agencies, research institutions and others - need to ensure that people with mental and psychosocial disabilities benefit from development efforts, just like any other group.
People with mental disabilities as a vulnerable group
People with mental and psychosocial disabilities are a vulnerable group as a result of the way they are treated by society. They are subjected to stigma and discrimination on a daily basis, and they experience extremely high rates of physical and sexual victimization. Frequently, people with mental disabilities encounter restrictions in the exercise of their political and civil rights, and in their ability to participate in public affairs. They also are restricted in their ability to access essential health and social care, including emergency relief services. Most people with mental disabilities face disproportionate barriers in attending school and finding employment. As a result of all these factors, people with mental disability are much more likely to experience disability and die prematurely, compared with the general population.
Vulnerable groups often targeted by development groups also have high rates of mental disabilities. For instance, up to two thirds of people with HIV/AIDS have depression, while rates of mental disability among the homeless can be greater than 50%, but their mental health needs are commonly not addressed.
People with mental disabilities are not only missed by development programmes, but can be actively excluded from these programmes. This is in spite of the fact that an explicit goal of development is to reach the most vulnerable.
Improving development outcomes for people with mental and psychosocial disabilities
A number of principles and actions, consistent with the Convention on the Rights of People with Disabilities, will substantially improve the lives of people with mental and psychosocial disabilities and thus improve development outcomes for these individuals, their families, and their communities.
These evidence-based strategies should be integrated into national development and sectoral strategies and plans. Specific actions include:
- Mental health services should be integrated systematically into all health services including primary level care.
- Mental health issues should be integrated into broader health policies, programmes, and partnerships.
- Mental health should be included in services during and after emergencies.
- Mental health issues should be taken into account within social services and housing development.
- Mental health issues should be mainstreamed into education, and children with mental and psychosocial disabilities should be supported to access schooling.
- Employment and income generating opportunities must be created for people with mental and psychosocial disabilities.
- Human rights should be strengthened by developing policies and laws that protect the rights of people with mental and psychosocial disabilities.
- There should be investment in developing the capacity of people with mental and psychosocial disabilities to participate in public affairs, including the support of service user-led movements.
- Development actors should create mechanisms to involve people with mental and psychosocial disabilities in decision-making processes.
- For more information access the WHO report "Mental health and development: Targeting people with mental disability as a vulnerable group"
Mental health policy and service development
Department of Mental Health and Substance Abuse, WHO Geneva.
- Report launch and panel discussion, New York, USA, 16 September 2010
Report launch, Kathmandu, Nepal, 6 December 2010