Responses to questions about WHOs Special Initiative for Mental Health
By Lidiia Lukasevych, Consultant supporting WHO Special Initiative for Mental Health
How have countries for WHOs Special Initiative for Mental Health been chosen?
There is no formula to selecting countries under the WHO’s Special Initiative for Mental Health. One non-negotiable requirement is a commitment from a country’s Ministry of Health to work with WHO for at least 5-years, towards transforming mental health systems and systems, to ultimately increase the availability of mental health services across the country (or identified geographical areas). Once this commitment is confirmed, WHO considers the existing capacities in each country (financial, human, governance, civil society, WHO Country Office) so we can further build on strengths. We also try to balance countries from across WHOs six regions to ensure global learnings.
How will WHO select new countries for the WHO Special Initiative for Mental Health?
WHO’s Special Initiative for Mental Health planned to work in 12 countries. It is presently being implemented in nine countries: Argentina, Bangladesh, Ghana, Jordan, Nepal, Paraguay, the Philippines, Ukraine and Zimbabwe. Ideally, the next three countries will be from WHO’s European, Eastern Mediterranean and Western Pacific Regions. However, WHOs ability to extend the Initiative to new countries also depends on funding. An investment of at least USD 5 million over 5-years is necessary to support systems level work that can achieve big-vision targets. Should a country be able to secure government commitment and raise funds, WHO’s Special Initiative for Mental Health could be expanded anywhere!
Has each of the 12 countries identified at least one key outcome it wants to achieve for itself and what are these?
All WHO Special Initiative for Mental Health countries contribute to the Initiative’s overall target: ensuring one hundred million people across nine participating countries have access to affordable, quality mental health services. In addition, each country monitors and evaluates various other country-specific outcomes, which are determined via a consultative and comprehensive design process. Click here to view some of the individual country designs (outcomes): Ghana, Jordan, Nepal, Paraguay, the Philippines, Ukraine, Bangladesh.
Can you describe the Monitoring and Evaluation process and explain the challenges you have faced?
We are looking for each country to monitor coverage of treatment for people living with mental, neurological and substance use disorders, and numbers of people learning about rights-based person-centered approaches to mental health care. The greatest challenge we face with M&E is lack of data on mental health care. Most facilities do not identify or record individuals experiencing mental disorders, or their treatment. Countries that do record minimal data at a health systems level, use different data collection methods and indicators, making it difficult to track data across regions. This has been an enormous challenge for WHO’s Special Initiative for Mental Health to demonstrate collective impact. Nonetheless, we have been working to find ways to address the lack of data by considering mapping approaches for M&E (i.e., to assess increasing availability of services) and smaller geographic areas to be representative of increased coverage.
How can CSOs get involved in the work of WHOs Special Initiative for Mental Health in their country?
CSOs and civil society are key partners for WHO’s Special Initiative for Mental Health countries. We have worked closely with civil society to contribute to the ways mental health systems and services are being transformed. CSOs would be best to contact WHO offices in their country to learn about activities underway through the Special Initiative for Mental Health and enquire about ways to get involved. Engagement with and activities for CSOs differ in each country but could potentially involve attending meetings to discuss minimum services, improving referrals, developing advocacy campaigns, expanding peer support or delivering trainings for health workers.
What is next for the WHO Special Initiative for Mental Health?
The Special Initiative for Mental Health is entering a learning phase. Consultative planning and getting ‘over the line’ from design to implementation took longer than anticipated, but on-the-ground expansion of services is now well underway. Next steps for WHO’s Special Initiative for Mental Health will include a stronger focus on documenting learnings (e.g., developing case studies for different phases of transformation work) and consolidating monitoring indicators to demonstrate impact (e.g., more regular reporting or increased availability of services). Implementation activities will focus on the quality of sustaining new/improved services. To achieve this, we will continue to advocate for financing mental health within national health budgets.
How can stakeholders who are not in WHO Special Initiative for Mental Health countries get involved in and/or learn from the work?
WHO is curating a collection of impact stories, case studies and learnings from the experiences of countries implementing the Special Initiative for Mental Health. These assets will be practical, on-the-ground examples of how mental health reforms were achieved, and challenges addressed. Other stakeholders are welcome to use these assets to explore their own experiences of transforming national mental health services and systems, and thus contribute towards building collective learning and insights. The WHO Special Initiative for Mental Health website is a repository of such assets and we also issue a biannual newsletter highlighting major advances.
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