GMHAN response to the Zero Draft of the Political Declaration of the UN High-Level Meeting on NCDs and Mental Health

As part of the preparatory activities for the Fourth High-level Meeting of the UN General Assembly on the prevention and control of NCDs and the promotion of mental health and wellbeing (HLM4), the President of the General Assembly and the Co-facilitators of the intergovernmental negotiations process have released the Zero Draft of the Political Declaration – available on the On the Road to 2025 campaign website.

The Global Mental Health Action Network (GMHAN), the world’s leading advocacy network for mental health with more than 6,000 members from 170 countries, welcomes the Zero Draft of the Political Declaration for the High-Level Meeting (HLM) on NCDs and Mental Health.

We are excited to see mental health and psychosocial wellbeing fully integrated into the Political Declaration of a UN High-Level Meeting for the first time and encouraged that so many important commitments on mental health are incorporated, as outlined in: (i) Our joint Briefing on Priorities for Mental Health at the HLM, endorsed by all major international mental health organisations, and (ii) the key positions shared by national mental health advocates at the Multi-Stakeholder Hearing at the UN on May 2nd.

On behalf of our Global Taskforce of international mental health organisations and our Short-Term Action Group of national advocates,

GMHAN Welcomes:

●        The commitment to and full integration of mental health into the High-Level Meeting’s scope and declaration, including the recognition that:

○        The global prevalence, preventable disability, and economic costs caused by mental health conditions are significant; whilst only a minority of people have access to mental health treatment, and there is a huge implementation gap in evidence-based interventions.

○        Mental health is shaped by social determinants and our environments, and marginalized communities are often those most affected.

○        People living with mental health conditions, including youth, have unique experiences and can provide first-hand expertise in designing, implementing, and monitoring person-centred prevention, diagnosis, treatment, and care policies and programmes.

●        The commitment to 150 million more people having access to mental health care by 2030.

In the context of the five areas covered by the Zero Draft:

1. Create health-promoting environments through action across government

GMHAN Welcomes: The full inclusion of mental health into considerations addressing the social and commercial determinants of health, including increased taxation and labelling for harmful products, enhanced measures to reduce harmful use of alcohol and tobacco, improved access to education and healthy life skills in schools, safe working conditions and social protection; as well as the consideration to take steps to decriminalize suicide around the world, self-harm and suicide-related injuries coverage, and reduce access to means of suicide.

We would like to see: An urgent commitment to develop national suicide prevention strategies through evidence-based interventions, such as WHO’s LIVE LIFE approach, including among adolescents, for whom, globally, suicide is a leading cause of death; as well as for different sectors to implement evidence-based interventions to promote mental wellbeing and prevent mental health conditions.

2. Strengthen primary healthcare

GMHAN Welcomes: The call for a decisive shift of the provision of mental health care from institutions to community-based and primary care settings, including prevention, early intervention, and affordable pricing and financial protection; the target on essential medicines and diagnostics; as well as the commitment to increase the number, capacity, retention and competencies of healthcare, community, lay and allied MHPSS workers.

We would like to see: Measures to care for mental health conditions as an essential component of universal health coverage and in armed conflict, displacement and humanitarian crisis settings; as well as steps towards eliminating coercive practices and discrimination against people living with mental health conditions and psychosocial disabilities within healthcare and broader society.

3. Increase sustainable financing

GMHAN Welcomes: The commitment to increasing domestic resources for mental health - and through bilateral and multilateral channels - and the urgent call to scale up the percentage of government national healthcare budgets to at least 5%; as well as the call to reduce out-of-pocket expenditure and the risk of impoverishment for households affected by mental health conditions, through appropriate financial protection policies and limits on the cost of essential services.

We would like to see: Innovative multisectoral financing mechanisms with equitable distribution across regions, transparent public reporting on budgeting and how health-harming product taxes are channelled to prevention, treatment and research; and High-Income Countries commit to allocating at least 10% of their healthcare - and 10% of their public health and prevention - budgets to mental health.

4. Strengthen governance

GMHAN Welcomes: The call for implementable multisectoral national plans that sustainably address population mental health needs, including for people living and working within emergency and humanitarian response settings, and for the engagement of people living with mental health conditions, as well as the regulation of harmful digital environments.

We would like to see: Meaningful and institutionalised participation for experts by experience, incl. young people, in the design, implementation and monitoring of national plans. Consideration of gender- and sexuality- inclusive approaches. Recognition that progress on prevention and management of mental health conditions is being put at risk by climate change and that these impacts - esp. for indigenous peoples and in SIDS - will worsen if this is not mitigated.

5. Strengthen data and surveillance to monitor progress and hold ourselves accountable

GMHAN Welcomes: The commitment to improved data infrastructure and implementation research for mental health and the 80% target for countries having a monitoring system by 2030.

We would like to see: Systematic collection and transparent and equitable access to disaggregated data for participatory research, evidence-informed policy-making and accountability.

Lastly, GMHAN welcomes the emphasis on the leading role of the World Health Organization as the directing and coordinating authority in international health.