Mapping out a 'blueprint' for mental health advocacy

The global mental health community needs to make substantial improvements in governance, service delivery, and investment if the large care gap in mental health and ongoing human rights abuses are to be addressed effectively.  

In the 2017 WHO Mental Health Atlas, only just over half of all WHO member states who responded to the WHO survey had a dedicated mental health law in place and in many countries, the public health expenditure on mental health is strikingly low (often less than 1% of health budgets), and inefficiently used1. Lack of human resources and technical expertise are additionally recognised constraints to scaling up care and support to people with mental health conditions.  

Over the last 15 years, there has been substantial development in evidence and experience of what works in mental health service reform, that has shown there to be cost-effective innovations which have a positive impact on clinical, social and economic outcomes for the populations involved. Positive changes in high-level policy frameworks at an international level, for example the Sustainable Development Goals, and the WHO Mental Health Action Plan, have not been matched by country-level policy and investment. Without a collective approach to the problem, the care gap and the current neglect of human rights will remain unaddressed.  

United for Global Mental Health, an advocacy and campaigning organization focussed on raising the profile of mental health globally (UnitedGMH), brought together the BluePrint Group on the principles of participatory action towards common goals. The group initially focused on priority-setting for key policy asks, with an associated plan for communicating and driving home these key messages to target audiences at specific events in the global health and development calendar. Since the group’s inception, they’ve led efforts at the following global events:

• United Nations General Assembly Side Event. On the 26th of September 2018, UnitedGMH organized the first ever United Nations side-event dedicated to mental health by enlisting the support of BPG members including the Government of Canada, Born This Way Foundation and many other supporting organizations. The meeting was instrumental as it brought together key leaders in health from around the world and played a strategic role in situating the messages agreed by the BPG, and the role of United for Global Mental Health, as a strong voice for promoting mental health as a key priority for public health leaders around the world. The event included speeches and a short film about the Friendship Bench project that originated in Zimbabwe (as an example of how inexpensive and simple interventions can improve mental health).

• Global Ministerial Mental Health Summit. Held in London to commemorate World Mental Health Day 2018 at the instigation of the UK government, the Global Ministerial Mental Health Summit was a sign of the UK’s efforts in prioritising mental health and achieving parity between mental and physical health. The event highlighted both the UK government’s prioritization of mental health as well as their commitment to building partnerships with ministries of health around the world to improve action on mental health globally.

• World Innovation Summit on Health (WISH). WISH was held in Qatar in November 2018. Building from the momentum of the UK Summit, WISH also showcased the Friendship Bench to highlight the need for action on mental health. The Bench was an effective tool in engaging policy makers (including the Qatari Royal Family) and health experts in talking about mental health. The BPG joint narrative, ‘Time to Act’, was additionally featured in discussions and supported by Lancet Commission Editor, Dr. Shekhar Saxena, who spoke at WISH on the panel for mental health (alongside BPG member MIND CEO Paul Farmer). The event garnered media attention for mental health in regional media and the materials were translated into Arabic to encourage a larger audience to access the ‘Time to Act’ messaging.

• WHO mhGAP Forum. Aligning well with the BPG’s message, ‘Time To Act’, and echoing repeated recommendations made at the Global Ministerial Mental Health Summit in London, the theme of the World Health Organization’s 2018 mhGAP forum was ‘Accelerating Action on Global Mental Health’.

• World Economic Forum (WEF), Davos. In 2019, the first ever mental health plenary session ‘Mental Health Matters’ was held at the WEF. The event was organised by a BPG and WEF member with input from other BPG members including Wellcome and UnitedGMH and featured the BPG advocacy messaging ‘Time To Act’. During the session, New Zealand’s Prime Minister shared the country’s plans for developing and implementing the world’s first-ever national well-being strategy. This commitment comes at a time when BPG members including UnitedGMH are already taking action to strengthen local capacity for countries to engage their policymakers and governments for prioritising mental health care.

• World Health Assembly, Geneva. At the annual gathering of health ministers, members of the BPG advocated for greater action on mental health: specifically for integration of mental health in Universal Health Coverage (as UHC is the focus of much of the health community this year); and for greater funding for mental health including through the Global Fund which holds its replenishment on World Mental Health Day 2019. The Friendship Bench was once again a highly successful way to engage policy makers on the issue of mental health. Mental health was raised by more member states than ever before and a new WHO Goodwill Ambassador for Mental Health, Cynthia Germanotta was announced. Some members of the BPG from low, medium and high income countries and global partner organisations announced the formation of a new, global mental health campaign, Speak Your Mind, to encourage citizen action to advocate for greater political and financial mental health support.

The BluePrint Group also held their fourth in-person meeting at UNICEF on May 7, 2019, bringing together over 50 people from international organizations, governments, civil society organizations, academics and the private sector. The meeting was instrumental in bringing together experts in targeted workstreams for contributing towards the planned advocacy around high-level events in 2019. These events include the launch of the new WHO Mental Health Special Initiative, the World Health Assembly and events around World Mental Health Day like the Global Fund Replenishment and Global Ministerial Mental Health Summit.

Global Mental Health is a field that has been largely led by researchers, with some NGO collaborators, and despite the growth of the evidence of effective interventions, and a clear moral mandate, it is clear that there needs to be a push to adopt global guidelines and recommendations.  Experience from other areas of global health e.g. HIV, or Non-Communicable Diseases, suggest that in order to accelerate progress in Global Mental Health, better coordination between actors, clearer messages, and more professional advocacy was needed.

It is important not to underestimate the power of harnessing political voices for mental health advocacy and campaigning. The BluePrint Group is the result of a clear consensus on the need and strength of a globally representative group to provide a common voice for the field of global mental health. The significant achievements of the group is a testament to what can be achieved with good coordination and leadership, and involvement of a range of actors in the field, including multilateral and bilateral agencies, several governments, non-governmental organisations, private sector, and service user voices. United for Global Mental Health plays an essential role, funded through a Wellcome grant, in coordinating the activities of the group, maintaining consistent communication between meetings, and providing expertise in effective advocacy and campaigning. This is, however, a long game, and for this very strong start to be sustained there is need for a next phase of coordinated action to be put in place.

More Information:

Access the periodic Blue Print Group newsletters and co-hosted webinars available on this resource page