The case for mental health on the post-2015 SDG agenda
January is not typically a busy month in the world of development. Few high level meetings are scheduled, and the major international days marked by the United Nations (UN) to raise awareness of health and development issues are clustered later in the annual calendar. But this year there are some very important discussions taking place within the UN, namely defining the post-2015 development agenda, which will shape global prioritisation for the next fifteen years.
The Sustainable Development Goals (SDGs), are a new set of universal goals, indicators and targets that UN member states will be expected to prioritise in national and international development agendas until 2030. Although they are the successors to the Millennium Development Goals (MDGs), the formation process used for the SDGs is quite different than the MDGs. This time, the UN has conducted its largest consultation ever to gauge opinion on what the new goals should include.
This began with a mandate from the Rio+20 summit in 2012 to create an open working group, involving representatives from 70 countries. These representatives incorporated the insights of a series of 'global conversations' and developed a draft which was presented to the UN general assembly in September 2014. Two co-facilitators, Ireland’s ambassador to the UN, David Donoghue, and Kenya’s ambassador to the UN, Macharia Kamau, were appointed to lead the process of gaining agreement from member states, using inputs from a wide selection of groups and civil society stakeholders.
The current draft includes 17 sustainable development goals and 169 indicators, a huge increase on the neat MDGs, but a necessary increase to ensure they are an extensive and ambitious springboard for change. The Guardian has created an infographic that helps to group the SDGs into six themes and links them to the expiring MDGs, which shows a move from their strong focus on people and dignity into the areas of justice, partnership, prosperity and protecting the planet.
Getting Mental Health on the Agenda
Mental health and non-communicable diseases were noticeably absent in the MDGs, usurped by the pandemics of communicable diseases like HIV and the need for immediate action to reduce preventable maternal and child deaths. Their omission has contributed to a lack of global discussion or prioritization for the last 15 years, which many want to see reversed by the upcoming goals.
Mental illness was explicitly included in the UN report on the Post-2015 development agenda “A life of dignity for all: accelerating progress towards the Millennium Development Goals and advancing the United Nations development agenda beyond 2015”, released in August 2014. In November, during a keynote speech to the Global Crisis of Depression Conference, Kofi Annan stated:
"We need to place mental health in general and depression in particular within the post-2015 agenda. (...) There is no doubt that depression must become a global priority because it not only affects health and well-being but also diminishes labour productivity and economic growth. (...)."
In December 2014, the UN Secretary-General’s synthesis report on the SDGs was released. "The Road to Dignity by 2030: Ending Poverty, Transforming All Loves and Protecting the Planet" will be the foundation for all negotiations on the post-2015 agenda. It includes a clear stance on mental health being included in the SDGs stating:
"Member States have emphasized that sustainable development must be inclusive and people-centred. They underscored the importance of ecosystems to people’s livelihoods, their economic, social, physical and mental well-being, as well as their cultural heritage – “Mother Earth” as it is known in many traditions.1 (...) The agenda must address universal health-care coverage, access and affordability…. reduce the burden of non-communicable diseases, including mental illness, nervous system injuries and road accidents; and promote healthy behaviours, including those related to water, sanitation and hygiene.2"
There are currently two mental health related indicators which fall under target three - Ensure healthy lives and promote wellbeing for all at all ages:
- 3.4 by 2030 reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing
- 3.5 strengthen prevention and treatment of substance abuse, including narcotic drug abuse and harmful use of alcohol
Although these are recognised as a definite step in the right direction, the FundaMentalSDG initiative, comprised of policy makers, academics, researchers and service user organisations from the mental health world, are advocating for the United Nations to strengthen mental health’s inclusion in the goals by making three edits to the current draft:
- Edit the title to ‘Ensure healthy lives and promote physical and mental health and well-being for all at all ages’
- Edit target 3.4 to ‘By 2030, reduce by one third preventable mortality from non-communicable diseases through prevention and treatment in full accordance with the WHO Global Action Plan for the Prevention and Control of Non-Communicable Diseases, and promote mental health and well-being in full accordance with the WHO Mental Health Action Plan 2013-2020.’
- Edit target 3.8 to ‘Achieve universal health coverage for physical and mental disorders, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.’
The next steps
Formal discussions on the content of the SDGs began this week, and it’s expected that member states will meet monthly until September to discuss any additions, exclusions or changes.
It is imperative to remember that agreeing on the final set of SDGs is the easy part. Working towards achieving all 17 goals will be a mammoth task for member states, which will begin in earnest in January 2016, when the MDGs formally end.
Want to get involved?
Read our other SDG related blogs advocating for the need to include mental health here.
Take part in the UN myWorld survey by visiting http://getinvolved.myworld2015.org/ and adding mental health as an optional priority.
Write letters to your politicians, representatives and specifically the two UN representatives, David Donoghue and Macharia Kamau using this template.
Make others aware of this process by sharing resources with friends, family and colleagues.
Tweet: We must include mental health in the @UN #post2015 #SDGs. There is no #health without #mentalhealth #FundaMentalSDG.
Find more information on www.fundamentalsdg.org, www.facebook.com/FundaMentalSDG and twitter.com/FundaMentalSDG, or follow #FundaMentalSDG on Twitter.
- UN Synthesis Report, page 10
- UN Synthesis Report, page 21