GMHAN Taskforce response to the UN Secretary General’s report to the 69th UNGA

“Progress on the prevention and control of non-communicable diseases and the promotion of mental health and well-being”

Learn more about our convening and advocacy work for the High-Level Meeting.

The Global Mental Health Action Network’s (GMHAN) Taskforce on Non-Communicable Diseases (NCDs) and Mental Health welcomes the Secretary General’s report. The report rightly identifies the complementarity and uniqueness of mental health to NCDs. This approach is echoed in the modalities resolution for the 4th High-Level Meeting (Resolution A/79/L.58), and in Member States’ comments to the World Health Assembly and Executive Board. The Secretary General’s report covers many areas, the GMHAN is focusing comments here on the four areas for mental health we consider essential to address at the UN High-Level Meeting: suicide prevention, child and adolescent mental health, service reform, and the social and commercial determinants of mental health. These are covered in more detail in the GMHAN Briefing “UN High-Level Meeting on NCDs and Mental Health: Priorities for Mental Health.” 

Suicide prevention

The GMHAN Taskforce welcomes the acknowledgement in the Secretary General’s report that suicide is a major contributor to global mortality and is an example of inefficient mental health services and inadequate social protection policies. As well as acknowledging the current situation, in upcoming discussions and consultations that inform the political declaration we would like to see more in depth discussion of suicide prevention as well, specifically:

  • Recognising there are still 25 countries worldwide where suicide attempts are criminalised, increasing stigma and preventing people from accessing the help and support they need. States parties are urged to decriminalise suicide and suicidal behaviours.

  • Acknowledging progress on suicide prevention through evidence-based interventions such as WHO’s LIVE LIFE approach which recommends four effective, evidence-based key interventions which should be included in every national response to suicide: limit access to the means of suicide; interact with the media for responsible reporting of suicide; foster socio-emotional life skills in adolescents; early identify, assess, manage and follow up anyone who is affected by suicidal behaviours.

  • Recommending that Member States adopt prevention strategies to address depression and suicide - in particular among adolescents, for whom suicide is a leading cause of death - including through public health policies that respect human rights. Such approaches include: mental health promotion and mental illness prevention, equitable access to early identification, assessment, management and follow-up of people affected, including training of first responders within the health system and all persons who come in contact with them within employment and educational settings, repealing discriminatory legislation such as the criminalisation of suicide, and restricting access to lethal means of suicide, ensuring that a helpline is available as a key means of crisis support in every country, focusing on tackling the social, economic and environmental determinants of mental health, including by enhancing life skills and resilience, addressing responsible reporting of suicide by the media, including online, digital and social, and promoting social inclusion and healthy relationships (A/77/300, paragraph 17).

Child and adolescent mental health

The report shows insufficient attention to the impact of, and solutions to, mental ill health in young people. This is a critical issue that requires urgent attention from Member States, and UN and multilateral agencies. Upcoming discussions and consultations that inform the political declaration should be:

  • Acknowledging anxiety and depression alone in adolescents (young people aged 10 to 19) make up 40% of the global burden of disease. More than 1 in 7 adolescents are living with a diagnosed mental health condition, such as depression, anxiety, or behavioural disorders, and it is estimated that 50% of these begin before the age of 18 (and almost two-thirds by the age of 25). 

  • Acknowledging that each year, an estimated 45,800 adolescents tragically lose their lives to suicide, leading to suicide being the third leading cause of death among people aged 15 to 29, with youth suicides increasing in most parts of the world for years.

  • Acknowledging that there are several key drivers of poor mental health among children and young people, such as poverty, domestic and community violence, bullying, family dysfunction, substance use, and the abuse of technology and social media. Failing to address these issues through prevention and support measures prevents children and youth from growing up to realise their full potential. 

  • Acknowledging that investment in the prevention and treatment of mental health conditions among children and young people, and the promotion of their mental wellbeing, remains extremely low. The adoption of national child and adolescent mental health (CAMH) policies remains slow: in the WHO Mental Health Atlas 2020, only 53% of 168 responding countries had a plan or strategy for CAMH. In 2020, approx. 60% of countries reported that they had updated their policies/plans for children and adolescents since 2017 and others should follow suit. 

  • Acknowledging the contribution of children and young people to society is limited by mental health conditions. Anxiety and depression, for example, influence a child’s ability to learn, develop, form relationships, reach their full social and economic potential, and contribute to the world. 

  • Acknowledging the fact that not addressing the mental health of children and youth, as well as their psychosocial development, can limit opportunities and may have potential long-term consequences, and that ensuring mental health across the life course requires holistic strategies for early intervention promotion, prevention and care that involves multi-sectoral approaches, including the education, health and social care sectors, among others (A/77/300, preamble). 

  • Recommending that Member States coordinate a multisectoral strategy that aims at promoting mental health for new parents, and caregivers, through home- and health facility-based antenatal and postnatal care for new parents, the provision of early childhood mental health screening, mental health programmes that address the cognitive, sensory-motor and psychosocial development of children and the promotion of non-violent and healthy child-caregiver relationships, and by introducing or strengthening community protection networks and systems (A/77/300, paragraph 20). 

  • Recommending that Member States develop universal and targeted school-based programmes to promote mental health and well-being and by integrating mental health services and psychosocial support in schools (and in associated community settings for out-of-school children), including through socioemotional life skills and peer support programmes to counter bullying, violence and improve social connection, both online and offline, and counter stigmatisation and discrimination against young persons living with mental health conditions and psychosocial disabilities (A/77/300, paragraph 21). 

  • Recommending that Member States accelerate efforts to achieve universal health coverage to ensure that all young people enjoy the highest attainable standard of physical and mental health, including immunisations and vaccinations and sexual and reproductive health, and address all the challenges faced by developing countries in achieving these goals (Pact for the Future, paragraph 60(b). 

  • Recognising that young people are more than beneficiaries of interventions; they are experts in the programmes and circumstances that affect their own mental health and should be fully included and facilitated to lead in discussions and decisions about their wellbeing.

Service reform

The GMHAN Taskforce welcomes the recommendation to Member States to invest in primary healthcare services. For mental health, this is an urgent area of system reform given that in most countries, mental health care is mainly provided in institutions (i.e. mental hospitals, traditional institutions such as prayer camps and other NGO- or government-run custodial care that operates as long-term stay for people with severe mental health conditions). Institutionalising people living with mental health conditions, and the circumstances in which they are held, breach several articles of the UN Convention on the Rights of Persons with Disabilities and does not promote good outcomes in terms of recovery and autonomy. 

The GMHAN Taskforce welcomes the UN SG’s recommendation to tackle underlying health determinants and inequities, specifically, the recommendation to tackle socioeconomic disadvantage, social inequalities, and adverse living or working conditions and address harmful commercial practices. For many social and commercial determinants of health, there is significant overlap for mental health with NCDs however there are unique determinants for mental health that require immediate action. Mental health and psychosocial disability is not solely a health issue and requires a whole of society, cross-sectoral approach. Upcoming discussions and consultations that inform the political declaration should be:

  • Recommending that Member States go further to address the social, economic, environmental, and commercial determinants by recognising that the approach to quality of life should be widened beyond the biomedical model to include a holistic approach that considers all aspects of a person’s life and the risks to health and wellbeing (A/77/300, paragraph 16). 

  • Recognizing the ever-present mental health stigma and discrimination, and urging to raise awareness about early signs and symptoms, and combat discrimination and stigma surrounding mental ill health, including a shift from biomedical language (“mental disorders”) to rights-based terminology (“persons with psychosocial disabilities”).

  • Recommending Member states to continue to commit to creating a safe and secure online space for all users that ensures their mental health and well-being by defining and adopting common standards, guidelines and industry actions that are in compliance with international law, promote safe civic spaces and address content on digital platforms that causes harm to individuals, taking into account work underway by United Nations entities, regional organizations and multi-stakeholder initiatives (SDGs 3, 5, 9, 10, 16 and 17)” (Pact for the Future, paragraph 31(a)). 

  • Recommending Member States to prioritise improving compliance, coherence, wider implementation and enforcement of fiscal, revenue-generating and regulatory measures targeting major commercial risk factors for NCDs and mental health, including those arising not only from the activities of alcohol, tobacco, and unhealthy foods industries but also gambling and social media.