GMHAN Financing Mental Health Working Group: Statement to the 74th World Health Assembly
Even prior to the COVID-19 pandemic, the world was not equipped to respond to the mental health needs of populations around the world. Poor mental health costs the world economy US$1 trillion a year due to reduced economic productivity and direct cost of care — more than cancer, diabetes, and respiratory diseases combined — and mental health and substance use conditions are the global leading cause of years lived with disability. These are losses of human capital that no country can afford. Now, COVID-19 is exacerbating this situation to an extreme degree.
For every US$1 invested in scaled-up treatment for common mental health issues such as depression and anxiety, there is a return of US$4–5 in improved health and productivity. No other area of health can match investment in mental health in terms of the breadth of the positive potential economic impact across society, and in terms of the numbers of people affected.
The effects of greater investment in mental health are direct to individuals. Research using the WHO One Health Tool shows that if mental health expenditure on five common and severe mental health conditions was to rise steadily to meet the globally recognised target of mental health expenditure - at least 5% to 10% national health budgets - then by 2030:
The number of cases of anxiety, depression and epilepsy alone can be decreased by nearly 60 million leading to an overall reduction in cases across the world.
A sustained increase of 25 million healthy life years gained for those with anxiety, depression, psychosis, bipolar disorder or epilepsy.
Nearly 200,000 deaths could be avoided due to depression, psychosis and epilepsy alone.
In order to make a significant positive impact of mental health systems and improve the lives of all, development partners and governments, with leadership from health ministers, need to ensure:
Public mental health expenditure constitutes 5% of total public health expenditure in low- and middle-income countries and 10% of expenditure in high income countries, in line with global recommendations;
Mental health is at the centre of national and global COVID-19 response plans to end the pandemic and build systems more resilient to future public health emergencies;
Mental health services are adequately financed and integrated throughout government areas of responsibility including, but not limited to, health, education, welfare, and justice systems, as well as the workplace — integration of services must be both cross-governmental and cross-sectoral;
Financing for mental health in health systems is decentralised from the
costly and ineffective tertiary level institutions, to less costly and more effective primary and community health facilities underpinned by good referral systems. This will facilitate low-cost and highly effective psychosocial approaches and address the needs of various marginalised groups.
