World Federation for Mental Health: 2009 World Mental Health Day campaign highlights need for more attention to mental health services in primary health care

The 2009 World Mental Health Day global awareness campaign will focus on ‘Mental Health in Primary Care: enhancing treatment and promoting mental health’. This year's theme will address the continuing need to ‘make mental health issues a global priority’, and will stress the all too-often neglected fact that mental health is an integral element of every individual's overall health and well-being. Mental illnesses do not choose their victims; they occur in all cultures and at all stages of the life span. Mental illnesses have a major impact on the physical health of people living with them. The campaign theme is intended to draw worldwide attention to the growing body of information and knowledge focusing on the integration of mental health in primary health care, and to provide this information to grassroots patient/consumer, family member/caregiver, and advocacy and educational mental health associations around the world. This is a significant trend in shifting mental health diagnosis, treatment and care from the traditional separate but unequal mental health services delivery system into mainstream health care.

The engagement of the ‘end users’ of mental health services, their families who often carry much of the responsibility for helping people living with mental illnesses to manage in the community, and the advocates who attempt to influence mental health policies, is critical during this time of change, reform and limited resources. Informing and equipping the grassroots mental health community to make certain that mental health and mental illnesses are considered integral to overall good health and that there are appropriate services for those who require them are the principal goals for the 2009 World Mental Health Day campaign. One of the primary advocacy concerns that must be addressed is the danger that adequate and effective diagnosis, treatment and recovery of people living with mental illnesses will not receive a parity-level priority within the general and primary healthcare system. It is the job of the global mental health advocacy movement to assure that this is not an unintended result of healthcare reform.

The release, in September 2008, of Integrating Mental Health into Primary Care: a global perspective by the World Health Organization (WHO) and the World Organization of Family Doctors (Wonca) signalled a major step in fostering a global effort to integrate mental health into primary care. In the publication's introductory message, WHO Director General Dr Margaret Chan, and Wonca President Professor Chris van Weel, state the case for such an effort:

Primary care starts with people. And, integrating mental health services into primary care is the most viable way of ensuring that people have access to the mental health care they need. People can access mental health services closer to their homes, thus keeping families together and maintaining their daily activities. In addition, they avoid indirect costs associated with seeking specialist care in distant locations. Mental health care delivered in primary care minimize stigma and discrimination, and remove the risk of human rights violations that occur in psychiatric hospitals. And, as this report will show, integrating mental health services into primary care generates good health outcomes at reasonable costs. Nonetheless, general primary care systems must be strengthened before mental health integration can be reasonably expected to flourish.¹

World Mental Health Day 2009 will highlight the opportunities and the challenges that integrating mental health services into the primary healthcare delivery system will present to people living with mental disorders and poor mental health, to their families and caregivers – and to healthcare professionals. As always, the campaign will focus on the critical role that mental health advocacy, patient/service user, and family/caregiver organisations need to play in shaping this major general health and mental health reform movement. Such informed proactive and sustained advocacy will be necessary if the movement towards integration is to result in improved access to quality, and adequate and affordable services for people experiencing mental illnesses and emotional health problems the world over.

Advocates, families, professionals and policymakers across the global mental health sector must remember that this current movement to improve the way in which mental health services are delivered is not the first such reform effort. Lessons learned from the past tell us that achieving parity in how mental health services are addressed in countries around the world is not an easy struggle. The effective integration of mental health into primary care at a level of priority appropriate to the documented burden of care of mental illnesses will be a major undertaking in a time of global economic and social difficulty. Certainly, it is well past time for the world to listen and to act to improve mental health services and ready access to services by those experiencing serious mental health problems and disorders such as schizophrenia, anxiety disorders, bipolar disorder and depression! That will be the central message of World Mental Health Day 2009!

The World Federation for Mental Health (WFMH) established World Mental Health Day in 1992, and co-ordinates and promotes its annual commemoration on 10 October. It is the only annual global awareness campaign to focus attention on specific aspects of mental health and mental disorders, and is now celebrated in over 100 countries through public awareness and education events, proclamation signings, advocacy campaigns, and other public events organised by governmental agencies and nongovernmental mental health organisations.