We open the year by addressing a fundamental theme for our profession of psychologists and psychotherapists , namely the situation regarding mental health and the intervention programs planned in the coming years.
Even before the pandemic, the data on mental health were not reassuring and the difficulties resulting from the pandemic wave have accentuated an already precarious picture both in terms of the increase in mental distress and with respect to the responses provided by the health systems .
And it was precisely this last aspect that aroused particular interest on a global level, becoming the central topic of World Mental Health Day held on 10 October 2021 on the theme “Mental health in an unequal world: together we can make a difference” (WFMH, 2021).
What data has emerged on mental health and access to services?
According to data reported by the World Health Organization ( WHO ), the number of people with depression and/or anxiety problems after the pandemic has increased by almost 50% and the gap in access to therapeutic care between high- risk countries , low and medium income still remains a sore point.
During the day, the ATLAS 2020 Mental Health Report edited by the WHO was shared, which included a collection of data provided by countries around the world on the mental health policies implemented and the monitoring of the achievement of the goals of the WHO Global Mental Health Action Plan 2020 .
What was found in the ATLAS 2020 Report?
The new Mental Health Atlas has highlighted the global failure to provide people with the mental health services they need, particularly in the late COVID-19 pandemic, where demand for help has been growing. Furthermore, data from 171 countries highlighted the failure to achieve those objectives that would have led to an increase in the quality of services provided (Mental Health ATLAS, 2020).
Let’s see what the missed objectives are:
- Lack of progress in leadership, governance and funding: In 2020, only 51% of WHO’s 194 member states reported that their mental health policy or plan was aligned with international and regional human rights instruments , a figure below the expected target of 80%. And only 52% of countries reached the target for mental health promotion and prevention programmes, also below the 80% target.
The only goal achieved for 2020 was to reduce the suicide rate by 10% , but even in this area, only 35 countries claimed to have an independent strategy, policy or prevention plan.
The only progress highlighted was in the adoption of mental health policies, plans and laws, as well as in improving the capacity to report a number of key mental health indicators. Furthermore, even when policies and plans included estimates of the required human and financial resources, only 39% of countries surveyed indicated that the required human resources had been allocated and 34% that the required financial resources had been provided.
- The transfer of care to the community is slow: although the WHO has recommended the decentralization of mental health care to community settings , only 25% of countries have met all criteria for integrating mental health into primary care. Although progress has been made in training and supervision in most countries, the provision of medications for mental health conditions and psychosocial care in primary health care services remains limited. Once again more than 70% of total public spending on mental health was allocated to psychiatric hospitals in middle-income countries, compared to 35% in high-income countries. There has, however, been an increase in the percentage of countries reporting the inclusion of the treatment of people with specific mental health conditions (psychosis, bipolar disorder and depression) in national health insurance or reimbursement schemes in 2020 .
- Increased mental health promotion, but with little evidence of effectiveness: An encouraging finding was the increase in countries reporting mental health prevention and promotion programmes, from 41% of Member States in 2014 to 52% in 2020 However, 31% of the total programs reported lacked dedicated human and financial resources, 27% did not have a defined plan, and 39% had no documented evidence of progress and/or impact.
- Slight increase in mental health workforce: The global median number of mental health workers per 100,000 population increased slightly from nine workers in 2014 to 13 workers per 100,000 population in 2020. However, there was very high variation between countries with different income levels, with the number of healthcare workers in high-income countries over 40 times higher than those in low-income countries (quotidianosanità.it, 2021).
What are the new goals for 2030 reported in the Mental Health Atlas?
The global goals reported in the Atlas for 2030 represent the extension of those already identified in the WHO Global Action Plan for Mental Health for 2020, with the addition of new goals for the inclusion of mental illnesses, health and psychosocial support in emergency preparedness plans , the integration of mental health into primary healthcare and research on mental health (quotidianosanità.it, 2021).
What actions could lead to the concrete achievement of these objectives and reduce inequality in care?
As the Lancet Commission on Global Mental Health and Sustainable Development (2018) argues, the Sustainable Development Goals are not achievable without making significant improvements in the prevention , treatment and promotion of mental health. Only by identifying mental health as a humanitarian and development priority will it be possible to make investments capable of guaranteeing quality mental services for all.
What are the characteristics of Single Session Therapy that make it an ideal tool for achieving sustainable development goals in the field of mental health?
SST as an intervention method capable of providing effective responses in a short time would represent the ideal tool to promote the integration of mental health into primary healthcare and the introduction of healthcare and psychosocial support in preparedness plans for emergencies as foreseen in the Global Action Plan for Mental Health 2030. As already explained in previous articles, Single Session Therapy has provided effective responses in emergency contexts and when used within Walk – In Services it can represent a valid support for community interventions (Cannistrà & Piccirilli, 2018).
Conclusion
To conclude, we shared the importance of synergistic work aimed at enhancing mental health interventions. Unfortunately, even today there are many economic , social and cultural differences that hinder the creation of quality mental health services capable of reaching all the people who need them. Furthermore, these problems have been accentuated in the last two years by the pandemic and the resulting greater difficulty in accessing care . During World Mental Health Day 2021, all of this was addressed with the aim of setting new sustainable development goals aimed at overcoming inequalities in the field of mental health, particularly impacting community services and emergency measures. Once again, thanks to its characteristics, the SST could represent an instrument of choice to achieve these objectives.
Angelica Giannetti
Psychologist, Psychotherapist
Team of the Italian Center
for Single Session Therapy
Bibliography
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Ivbijaro, MBE JP G., (2021). Mental health in an unequal world, from https://wfmh.global/news/2020.20-09-22_wfmh-presidents-foreword.
WHO, 2021. Mental Health ATLAS, 2020, World Health Organization 2021.
Daniels, I. (2020). WFMH President’s Foreword, from https://wmhd2021.com/index.php.