In 2019, nearly a billion people – including 14% of the world’s adolescents – were living with a mental disorder.  Suicide accounted for more than 1 in 100 deaths and 58% of suicides occurred before age 50. Mental disorders are the leading cause of disability, causing one in six years lived with disability. People with severe mental health conditions die on average 10 to 20 years earlier than the general population, mostly due to preventable physical diseases. Childhood sexual abuse and bullying victimization are major causes of depression. Social and economic inequalities, public health emergencies, war, and the climate crisis are among the global, structural threats to mental health. Common mental health problems are estimated to have increased by 3 to 7 times since the advent of the Coronavirus Pandemic. In SA it is estimated that only 10% of people with mental health conditions, who are uninsured, receive any form of care.

 Access to treatment is generally sub-optimal. While 70% of people with psychosis are reported to be treated in high-income countries, only 12% of people with psychosis receive mental health care in low-income countries. For depression, the gaps in service coverage are wide across all countries: even in high-income countries, only one third of people with depression receive formal mental health care and minimally adequate treatment for depression is estimated to range from 23% in high-income countries to 3% in low- and lower-middle-income countries.

 In a press release, dated 17 June 2022, the WHO states that: “ All 194 WHO member states have signed up to the Comprehensive mental health action plan 2013 to 2030,  which commits member states to global targets for transforming mental health. Pockets of progress achieved over the past decade prove that change is possible. But change is not happening fast enough, and the story of mental health remains one of need and neglect”. WHO proposed focussing on the following to accelerate implementation:

Stepping up investments in mental health, not just by securing appropriate funds and human resources across health and other sectors to meet mental health needs, but also through committed leadership, pursuing evidence-based policies and practice, and establishing robust information and monitoring systems. Including people with mental health conditions in all aspects of society and decision-making to overcome stigma and discrimination, reduce disparities and promote social justice.

Intensifying engagement across sectors, including to understand the social and structural determinants of mental health and intervening in ways that reduce risks, build resilience, and dismantle barriers that stop people with mental health conditions participating fully in society.

Implementing concrete actions to improve environments for mental health such as stepping up action against intimate partner violence and abuse and neglect of children and older people; enabling nurturing care for early childhood development, making available livelihood support for people with mental health conditions, introducing social and emotional learning programmes while countering bullying in schools, shifting attitudes and strengthen rights in mental health care,  increasing access to green spaces, and banning highly hazardous pesticides that are associated with one fifth of all suicides in the world.

Building community-based networks of interconnected services that move away from custodial care in psychiatric hospitals and cover a spectrum of care and support through a combination of mental health services that are integrated in general health care; community mental health services; and services beyond the health sector.