#NGOs4MentalHealth: What can NGOs contribute?
Around the world, advocates are calling for governments to treat mental health with “parity of esteem”, that is, to treat mental and physical health as equally important.1 We frequently cite the startling statistic that low-income countries spend less than 1% of their already meagre health budgets on mental health.2 Less frequently do we question the attention devoted to global mental health by the third sector.
The resources at stake are tremendous. 1.4 billion people donated to non-governmental organisations (NGOs) in the year 2014.3 If each of these people had donated just $1 USD to mental health, they could have erased the global mental health workforce shortage projected for 2015.4 In 2002 researchers at Johns Hopkins found that if non-profits were a country, they would have the fifth largest economy in the world.3,5
But money is not the only resource at stake. By their sheer number, geographic distribution and infrastructure, NGOs provide access to some of the worlds’ most vulnerable populations, people without the means to travel to urban centres where mental health specialists typically practice.
Consider the case of India, which has one NGO for every 400-600 people,3,6 but fewer than one psychiatrist for every 300,000 and one psychologist for every 1.4 million.7 Imagine what could be achieved if each NGO were to equip even a single person—perhaps by training an existing staff member or a publicly-funded health worker—to support mental health services in their catchment area. This isn’t as far-fetched as it may sound.
More than a decade ago, Vikram Patel and R. Thara identified 17 Indian NGOs doing innovative work in the field of mental health: for example, SCARF, Sangath, Ashagram.8 Since then, the number has grown considerably,9 along with the evidence for cost-effective interventions delivered by lay workers, both for common mental disorders like depression and severe disorders like schizophrenia.10,11
Task-sharing is the name of the game in global mental health, and it would be naïve of us to assume that NGOs cannot—or do not already—play a vital role.
Unfortunately, we don’t know how many NGOs are already working in this field—either explicitly or within broader health and development programmes.12 Most NGOs don’t report against mental health indicators to stakeholders.12 While public-private partnerships and taskforces are common in well-established global health fields such as HIV, governments may not know where to turn for similar support in mental health. Potential donors don't know where to make their investment. Other NGOs interested in tackling mental health issues don't know who can advise them.
"NGOs and others working in international development should… understand the needs and capacities of people with mental health problems, encourage the inclusion of people with mental disorders in their general development programmes, set up new mental health-specific programmes, and measure the impact of their programmes on mental health." 12
Following the ratification of the WHO’s World Mental Health Action Plan and the inclusion of mental health in the Sustainable Development Goals, now is the time for NGOs to launch a coordinated, global response.13,14
MHIN has co-organised a meeting in Parliament on 22 February with the UK’s All-Party Parliamentary Group (APPG) on Global Health, Mental Health for Sustainable Development: the Role of International Non-Governmental Organisations. This will be followed by a technical workshop at the London School of Hygiene and Tropical Medicine on 23 February, where experts from the international NGO community will gather to define a call to action. Ideally, this call will be launched at the landmark World Bank-World Health Organisation’s meeting in April 2016, Out of the Shadows: Making Mental Health a Global Development Priority.15
Don’t forget to have your say in the comment box below. What can NGOs do for global mental health? What can global mental health do for NGOs? What are the barriers, and what are the benefits? We’d love to hear your thoughts.
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- RCPsych Parity of Esteem Working Group. 2013. Whole Person Care: From Rhetoric to Reality: Achieving Parity Between Mental and Physical Health, London: Royal College of Psychiatrists. Occasional Paper 0P88.
- WHO. 2011. Mental Health Atlas, Geneva: World Health Organisation.
- OnGood. 2016. Facts and Stats about NGOs Worldwide, Public Interest Registry.
- Scheffler RM, Bruckner TA, Fulton BD, et al. 2011. Human Resources for Mental Health: Workforce Shortages in Low- and Middle-Income Countries, Geneva: World Health Organisation.
- Foroohar R. 2005. 'Where the Money Is', Newsweek 9 May.
- Mahapatra D. 2014. 'India Witnessing NGO Boom, There is 1 for Every 600 People', Times of India 23 February.
- WHO. 2014. Mental Health Atlas Country Profile: India. Geneva: World Health Organisation.
- Patel V, Thara R, eds. 2003. Meeting Mental Health Needs in Developing Countries: NGO Innovations in India. New Delhi: Sage (India).
- Thara R, Patel V. 2010. Role of Non-Governmental Organisations in Mental Health in India. Indian J Psych, 52(Suppl1):S389-S395.
- Chatterjee S, Naik S, John S, et al. 2014. Effectiveness of a Community-Based Intervention for People with Schizophrenia and their Caregivers in India (COPSI): a Randomised Controlled Trial. Lancet, 383(9926):1385-1394.
- Patel V, Weiss HA, Chowdhary N, et al. 2010. Effectiveness of an Intervention led by Lay Health Counsellors for Depressive and Anxiety Disorders in Primary Care in Goa, India (MANAS): a Cluster Randomised Controlled Trial. Lancet, 376(9758):2086-2095.
- DeSilva MJ, Roland J. 2014. Mental Health for Sustainable Development. London: Joint All-Party Parliamentary Group on Global Health and Mental Health.
- WHO. 2013. World Mental Health Action Plan 2013-2020. Geneva: World Health Organisation.
- UN. 2016. Goal 3: Ensure Healthy Lives and Promote Well-Being for All at All Ages. Sustainable Development Knowledge Platform. Division for Sustainable Development, United Nations.
- World Bank. 2016. Brief: Mental Health, 8 February. The World Bank Group.