Mental health is an integral part of health; So much so that there is no health without mental health. It is determined by multiple biological, socioeconomic and environmental factors. Mental well being is an integral and essential component of health. The World Health Organization (WHO) Constitution says: “Health is a state of complete physical, mental and social well-being, and not just the absence of conditions or diseases.” An important consequence of this definition is that it considers mental health as more than just absence of mental disorders or disabilities.
Mental health is a state of well-being in which the person realizes his/her abilities and is able to cope with the normal stress of life, to work productively and to contribute to his/her community. In this positive sense, mental health is the foundation of individual well-being and effective functioning of the community. In other words, mental health and well-being are fundamental to our collective and individual capacity to think, express feelings, interact with others, earn a living and enjoy life. On this basis it can be considered that the promotion, protection and restoration of mental health are vital concerns of people, communities and societies around the world.
Determinants of Mental Health
Individual mental health is determined by multiple social, psychological and biological factors. For example, persistent socio-economic pressures constitute a well-known risk to the mental health of people and communities. The most obvious evidence is related to poverty indicators, and in particular to the low educational level. Poor mental health is also associated with rapid social changes, stressful working conditions, gender discrimination, social exclusion, unhealthy lifestyles, risks of violence and poor physical health. There are also specific personality and psychological factors that make a person more vulnerable to mental disorders.
Promotion and Protection
The promotion of this cognitive wellbeing is significant for our society. The promotion of mental health consists of actions that create environments and living conditions that promote intellectual wellbeing and allow people to adopt and maintain healthy lifestyles. Among them are a series of actions to increase the chances of more people having better mental health.
- An environment of respect and protection of basic civil, political, socioeconomic and cultural rights is essential for the promotion of mental health. Without the security and freedom that these rights provide, it is very difficult to maintain a good level of mental health.
- National mental health policies should not only deal with mental disorders, but recognize and address broader issues that foster cognitive health such as the incorporation of its promotion into the policies and programs of governmental and non-governmental sectors. In addition to the health sector, the participation of education, work, justice, transport, environment, housing or social assistance sectors is also essential.
The promotion of mental health depends largely on intersectoral strategies. Among other concrete ways to promote mental health, following measures are also important:
- Early childhood interventions (for example, creating a stable environment that addresses the health and nutrition needs of the child, protects them from threats and provides early learning opportunities and interactions that are sensitive, give emotional support and stimulate their development);
- Support for children (for example, capacity building programs and child and youth development programs);
- The socio-economic emancipation of women (for example, improving access to education and granting microcredits)
- Social support for geriatric populations (for example, initiatives to make friendships and community centers and day centers);
- Programs targeting vulnerable groups, and in particular minorities, indigenous people, migrants and people affected by conflicts and disasters (for example, psychosocial interventions after disasters);
- Mental health promotion activities at school (for example, programs to support ecological changes in school and children’s friendly schools);
- Mental health interventions at work (for example, stress prevention programs); housing policies (for example, home improvement);
- Violence prevention programs (for example, reducing the availability of alcohol and access to weapons);
- Community development programs (for example, initiatives for citizen collaboration and integrated rural development);
- Measures for reduction of poverty and social protection for the poor;
- Lawmaking and campaigns against discrimination; promotion of rights, opportunities and care of people with mental disorders.
Care and Treatment of Mental Health Disorders
In the context of national efforts to develop and implement policies related to mental health, it is essential, not only to protect and promote the mental well-being of citizens, but also to meet the needs of people with mental health disorders. Over the last decade, knowledge of what needs to be done in relation to the growing burden of morbidity due to mental disorders has improved considerably. There is a growing body of scientific evidence that demonstrates the efficiency and good cost-effectiveness of crucial interventions to address priority mental disorders in countries with different levels of economic development. Among the cost-effective, viable and affordable interventions can be mentioned:
- Treatment of epilepsy with antiepileptic medication;
- Treatment of depression with psychotherapy and, in moderate and severe cases, antidepressants (generic);
- Treatment of psychosis with older antipsychotic medications and psychosocial support to the patient;
- Application of taxes on alcoholic beverages and restriction of their availability and marketing.
There are also a number of effective measures to prevent suicide, prevent and treat mental disorders in children, prevent and treat dementia and treat disorders related to substance use. The Action Program to bridge the mental health gap (MHGAP) has developed evidence-based guidelines so that non-specialists can better identify and address a number of priority mental disorders.
WHO supports governments in order to promote and strengthen mental health. WHO has evaluated scientific data to promote mental health and is collaborating with governments to disseminate this information and integrate effective strategies into policies and plans.
In 2013, the World Health Assembly approved a comprehensive mental health action plan for the 2013-2020 period. Under this Plan, WHO Member States undertake to take specific measures to improve mental health and contribute to the achievement of global goals.
The Action Plan has the general objective of promoting mental health, preventing mental disorders, providing care, improving recovery, promoting human rights and reducing mortality, morbidity and disability of people with mental disorders. It is focused on four main objectives aimed at: strengthen effective leadership and governance regarding mental health; provide complete, integrated and adequate mental health and social assistance services at the community level; implement promotion and prevention strategies in the field of mental health;
Strengthen information systems, scientific data and research on mental health. In the framework of the Plan, particular emphasis is placed on the protection and promotion of human rights, the strengthening and promotion of civil society and the central role of community care. With a view to achieving its objectives, the Action Plan proposes and calls on