Comprehensive Mental Health Action Plan 2013–2030: We must rise to the challenge

In May 2013, WHO's Mental Health Action Plan 2013-2020 was adopted at the 66^th World Health Assembly which was extended until 2030 by the 72^nd World Health Assembly in May 2019 with modifications of some of the objectives and goal targets to ensure its alignment with the 2030 Agenda for Sustainable Development. Further, in September 2021, the 74^th World Health Assembly accepted the updates to the action plan, including updates to the target options for indicators and implementation. This is an opportunity for the psychiatric community to rise to the challenge and work towards the realization of these objectives and in turn to integrate psychiatry with the mainstream of medicine.

The change in objectives and targets is summarized in Table 1.

Table 1.

Comparison between Mental Health Action Plans 2013-20 and 2013-30

Mental health action plan 2013-2020[1]		Comprehensive mental health action plan 2013-2030[2]
Objective 1: To strengthen effective leadership and governance for mental health
Global target 1.1	80% of countries will have developed or updated their policy/plan for mental health in line with international and regional human rights instruments (by the year 2020)	80% of countries will have developed or updated their policy or plan for mental health in line with international and regional human rights instruments, by 2030
	Indicator - Existence of a national policy or plan for mental health that is in line with international human rights instruments Many policies and plans older than 10 years may not reflect recent developments in international human rights standards and evidence based practice For countries with a federated system, the indicator will refer to policies or plans of most states or provinces within the country. Policies or plans for mental health may be stand-alone or integrated into other general health or disability policies or plans	Indicator - Existence of a national policy or plan for mental health that is being implemented and in line with international human rights instruments For countries with a federated system, the indicator will refer to policies or plans of most states or provinces within the country. Policies or plans for mental health may be stand-alone or integrated into other general health or disability policies or plans Human rights standards include provisions for: (i) transition to mental health services based in the community, (ii) respect of human rights, (iii) comprehensive support and services, (iv) promotion of a recovery approach and (v) participation in decision making processes. Implementation status includes: (i) estimation and allocation of human resources, (ii) estimation and allocation of financial resources, and (iii) monitoring and evaluation of specified indicators or targets
Global target 1.2	50% of countries will have developed or updated their law for mental health in line with international and regional human rights instruments (by the year 2020) Indicator - Existence of a national law covering mental health that is being in line with international human rights instruments	80% of countries will have developed or updated their law for mental health in line with international and regional human rights instruments, by 2030 Indicator - Existence of a national law covering mental health that is being implemented and in line with international and regional human rights instruments
Objective 2: To provide comprehensive, integrated and responsive mental health and social care services in community-based settings
Global target 2.1	Service coverage for severe mental disorders will have increased by 20% (by the year 2020) Indicator - proportion of persons with severe mental disorder (psychosis, BPAD, moderate - severe depression) who are using services (%) Estimates of service coverage are needed for all mental disorders, but are restricted here to severe mental disorders to limit measurement effort	Service coverage for mental health conditions will have increased at least by half, by 2030 Indicator - Indicator 2.1.1 - Proportion of persons with psychosis who are using services over the past 12 months (%) Indicator 2.1.2 - Proportion of people with depression who are using services over the past 12 months (%) Estimates of service coverage are needed for all mental disorders, but are restricted here to psychosis and depression as tracer indicators for severe and common mental disorders respectively to limit measurement effort
Global target 2.2		80% of countries will have doubled number of community-based mental health facilities, by 2030 Indicator - Number of community-based mental health facilities In the context of improving access to care and service quality, development of comprehensive community-based mental health and social care services is recommended. Community-based services can be outpatient or inpatient services as well as home help and support services
Global target 2.3		80% of countries will have integrated mental health into primary health care, by 2030 Indicator - Existence of a system in place for integration of mental health into primary health care Integration of mental health into primary health care is essential to ensure universal health coverage. A range of mental health services including promotive, preventive, treatment and care services can be provided when integrated into primary health care
Objective 3: To implement strategies for promotion and prevention in mental health
Global target 3.1	80%of countries will have at least two functioning national, multisectoral mental health promotion and prevention programmes (by the year 2020)	80% of countries will have at least two functioning national, multisectoral mental health promotion and prevention programmes, by 2030
Global target 3.2	The rate of suicide in countries will be reduced by 10%(by the year 2020) Indicator - Number of suicide deaths per year per 100,000 population	The rate of suicide will be reduced by one-third, by 2030 Indicator - Suicide mortality rate (per 100,000 population)
Objective 3: To implement strategies for promotion and prevention in mental health
Global target 3.3		80% of countries will have a system in place for mental health and psychosocial preparedness for emergencies and/or disasters, by 2030 Indicator - Existence of a system in place for mental health and psychosocial preparedness for emergencies/disasters Planning for disaster and/or emergency response is a priority as expressed in the Sendai framework for disaster risk reduction (2015-2030) and in the Inter-Agency Standing Committee Guidelines for Mental Health and Psychosocial Support in Emergency Settings
Objective 4: To strengthen information systems, evidence and research for mental health
Global target 4.1	80% of countries will be routinely collecting and reporting at least a core set of mental health indicators every 2 years through their national health and social information systems (by the year 2020)	80% of countries will be routinely collecting and reporting at least a core set of mental health indicators every 2 years through their national health and social information systems, by 2030
Global target 4.2		The output of global research on mental health doubles, by 2030 Indicator - Number of published articles on mental health research (defined as research articles published in the databases) The indicator measures the output of mental health research as defined by national published research studies. The annual published research output in peer-reviewed and indexed journals is a proxy for the amount (and quality) of mental health research being conducted in a country. It indirectly assesses a country’s commitment to mental health research, which will ultimately have an impact on outcomes for people with mental health conditions
Goal 3 of sustainable development goal 2015-2030
Target 3.4 - Sustainable development goal - by 2030, reduce premature deaths from noncommunicable diseases by one-third through prevention and treatment and promote mental health and well-being Target 3.5 - Strengthen the prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol

BPAD – Bipolar Affective Disorder

As it is obvious that there is an enormous opportunity for the psychiatric community to implement things that we always have been talking about like:

1. Global target 2.2 – Target's doubling of community-based mental health facilities by 2030 in 80% of countries. It would be a substantial achievement for the psychiatric community for its implementation will lead to significant service to psychiatric patients

2. Global target 2.3 – Integration of mental health care into primary healthcare

3. Global target 3.2 – Reduction in suicide rate by one-third by 2030

4. Global target 3.3 – Psychological care for disaster

5. Global target 4.2 – Mental health research to be doubled by 2030.

What has brought about profound change is target 3.4 of Sustainable Development Goal, which is to reduce premature death by NCD by one-third by promoting mental health and wellbeing. It is an opportunity for us to expand psychiatry by being involved in general medical care and reduce stigma. We must also utilize this opportunity to press for the greater representation of psychiatry in MBBS curriculum throughout the country and stop not till it gets a separate subject status in undergraduate medical studies.

Now is the time for us to strive to achieve all the objectives which provide an opportunity to expand mental health care, reduce stigma, and translate all the talk of furthering the growth of mental health into action.[2]