MEMBER BLOG: Inroads for Mental Health as the G20 Come Together in Italy

By Muhammad Ali Hasnian, United for Global Mental Health.

The G-20, a forum that brings together leaders from the World’s major economies, accounting for 80% of its GDP and 60% of its population, had its presidency in Italy this year. With Health forming a big part of the agenda of the forum’s various events, sessions and high level meetings, there were some encouraging inroads for mental health. 

The G-20 Health Ministers Declaration in Rome, drafted after a two day session on the 5th and 6th of September, was the culmination of a dialogue which began in January, spanning three health working group meetings and a focused G-20 side event on 3rd September titled “Covid-19 and the Need for Action on Mental Health.” 

Set in the context of recovery from the impacts of the pandemic, declaration did well to touch upon the social determinants of mental health such as rising unemployment, food insecurity, gender based violence, isolation, restricted access to healthcare etc. which have been exacerbated by the fallout of the COVID-19 pandemic. 

By committing to respecting the right of all persons to the enjoyment of the highest attainable standards of physical and mental health, the health ministers not only affirmed mental health as a rights based issue but also recognised mental health at par with physical health. 

However, the biggest victory for mental health was the acknowledgement that the pandemic had underscored gaps in mental health systems and that a dedicated effort was needed to increase the capacity of and improve access to mental health services, in particular in times of health emergencies and crises, and raise the access to and quality of care. The ministers promised to work in line with the WHO Comprehensive Mental Health Action Plan 2013-2030, recently endorsed at the 74th World Health Assembly, by integrating mental health into broader health systems and promoting equitable access to mental health services and psychosocial support as part of pandemic response and economic recovery efforts. 

This was made possible in part due to the mental health side event referenced above, organised by the Italian Presidency wherein the Civil Society20’s (C-20) Global Health Working Group made several important recommendations to strengthen mental health as a crucial element of the Covid-19 response and recovery. 

Among these was a whole-of-society approach to mental health, focused on the wellbeing of community health workers, caregivers and increased access to mental health and psychosocial support. The working group also recommended a rights and social justice based approach to mental health, emphasising on inclusivity and addressing human rights violations of people with mental health conditions and disabilities. Stigma reduction, community based mental health care, emphasis on the mental health of children, adolescents and young adults and the ultimate goal of recognition of mental health at par with physical health were all proposed. 

Mental Health also got a fleeting mention as part of the Rome Declaration from the Global Health Summit on 21st May, put together by the G-20 leaders and guest nations, wherein they recognised mental health as a critical health issue. However there was a decided feeling of an opportunity missed to more decisively acknowledge and engage with mental health as a cross cutting issue. 

Mental health was also conspicuous by its absence in the Think20’s (T-20) recommendations especially as they touched upon the preparedness of healthcare systems and global health equity.  Nor was it covered by the Development Working Group in the Development ministers meeting despite discussions on health, financing and the Sustainable Development Goals. 

Whilst both of these are missed opportunities, there is no doubt that mental health advocates have been presented with plenty more opportunities going forward. For starters, universal health coverage (UHC) was prominently discussed throughout the various sessions, and engaging with national policy makers and global influencer organisations to integrate mental health into UHC would be an excellent way to influence health discourse and address health system gaps pertaining to mental health. The Global Health threats fund of US$10billion being set up by the G20 High Level Independent Panel to finance the Covid-19 response may also be an area to influence, as a portion of those funds could make a substantial contribution to mental health efforts across the globe. 

The summit is also far from over, with the 3rd Global Ministerial Mental Health Summit, organised in Paris on 5th and 6th October, with the support of the WHO, likely to present significant updates on the mental health landscape. 

These are all promising signs regarding the growing acknowledgment globally of the fact that there is no health without mental health and it is hoped that with the Presidency of the G-20 being handed over to Indonesia, 2022 will see sustenance and even build upon the progress made in this regard.