Intercountry meeting to scale up action on mental health in the Eastern Mediterranean Region

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WHO event addressing public health priorities

Citation: World Health Organization. Intercountry meeting to scale up action on mental health in the Eastern Mediterranean Region. East Mediterr Health J. 2024;30(7):532–533. https://doi.org/10.26719/2024.30.7.532.

Copyright © Authors 2024; Licensee: World Health Organization. EMHJ is an open access journal. This paper is available under the Creative Commons Attribution Non-Commercial ShareAlike 3.0 IGO licence (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

* Summary report on the intercountry meeting to scale up action on mental health in the Eastern Mediterranean Region. https://applications.emro.who.int/docs/WHOEMMNH238E-eng.pdf?ua=1

Introduction

Mental disorders, including substance use disorders (3.1% of YLDs) and neurological conditions (6.4%), are the leading causes of years lived with disability (YLDs); they account for 1 in every 6 (15.6%) YLDs globally (1). In the WHO Eastern Mediterranean Region (EMR), 13.53 million disability-adjusted life years (DALYs) were lost due to mental disorders in 2019 alone, a 26.4% increase from the 2015 estimates (2). This accounted for 5.49% of all DALYs in a region where depressive disorders are the ninth leading cause of disease burden. The wars and conflicts in the region contribute to the relatively high rates of mental disorders, and the COVID-19 pandemic presented new mental health challenges as well as new opportunities for tackling mental health issues in the region (3,4,5).

In 2013, the 66th World Health Assembly adopted the Comprehensive Mental Health Action Plan 2013–2020, which was extended to 2030 by the 72nd World Health Assembly in 2019 (6). To implement the action plan in the region, the WHO Regional Committee for the Eastern Mediterranean endorsed a framework of action in 2015 (7), which presents the recommendations of the action plan as practical and strategic interventions tailored to the needs and priorities in the region. This framework continues to guide WHO’s work in the EMR.

In November 2023, the WHO Regional Office for the Eastern Mediterranean (WHO/EMRO) convened a meeting of mental health stakeholders in the EMR to identify key challenges and learnings from country experiences in implementing the regional framework and to review and finalize the new regional action plan for mental health and psychosocial support during emergencies (8).

Summary of discussions

Member States highlighted challenges in implementing the regional framework. The most frequently mentioned challenge was the persistent stigma and discrimination against mental health patients even among healthcare workers. The perception of suicide as a taboo in the region presents a barrier to support. Several EMR countries are facing protracted emergencies, conflict, wars, political instability, and economic turmoil, and yet mental health is not seen as a priority health issue by Member States. There is limited or no budget for mental health interventions in the countries. With no mental health plan or legislation at country level, health authorities lack clarity on how to handle mental health issues in their countries. Human resource for mental health is low compared to the need, while substance abuse and domestic violence continue to increase. These challenges present a serious dilemma to mental health professional in the region.

Lessons from Member States that have implemented the regional framework highlight the need to start advocacy and community awareness early to mobilise support for mental health interventions. This should include engagement with parliamentarians, other international and national initiatives, people with experience in service governance and quality improvement, and grassroots non- expert community actors. Collaborative partnerships with multisectoral stakeholders, including those in other ministries, local authorities, education and child protection sectors, the workplace, and religious groups is essential as well as integration with the national primary health care strategy. Efforts should be made to address stigma by rebranding the mental health narrative beyond the biomedical model, including supporting health journalism relating to mental health and co-creating a mental health-friendly culture at the community level.

Recommendations for Member States and WHO

Participants in the meeting recommended the following actions for Member States and WHO:

For Member States

1. Finalize and secure approval for country level mental health profiles and plans.

For WHO

1. Support implementation of the regional framework to scale-up action on mental health.
2. Finalize and submit the regional action plan for mental health and psychosocial support in emergencies 2024–2030 for endorsement at the 71st Session of the WHO Regional Committee for the Eastern Mediterranean in 2024.

References

1. World Health Organization. The global burden of disease, 2024 update. Geneva: World Health Organization, 2024. https://iris.who.int/bitstream/handle/10665/43942/9789241563710_eng.pdf.
2. World Health Organization. Global health estimates: leading causes of DALYs. Geneva: World Health Organization, 2020. https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/global-health-estimates-leading-causes-of-dalys.
3. Al-Mandhari A. Reviewing recent achievements and preparing for accelerated action on health: highlights of 70th Session of the WHO Regional Committee for the Eastern Mediterranean Region. East Mediterr Health J. 2023;29(10):763–764. https://doi.org/10.26719/2023.29.10.763.
4. Al-Mandhari A, Peeperkorn R, Al-Shorbaji F, Akbar B, Kamil AM, Brennan R. Gaza disaster: we need a permanent ceasefire, now! East Mediterr East Mediterr Health J. 2023;29(12):919–920. https://doi.org/10.26719/2023.29.12.919.
5. Balkhy H. Increasing access to healthcare in the Eastern Mediterranean Region. East Mediterr Health J. 2024;30(2):91–92. https://doi.org/10.26719/2024.30.2.91.
6. World Health Organization. Mental health action plan 2013-2020. Geneva: World Health Organization, 2013. https://iris.who.int/bitstream/handle/10665/89966/9789241506021_eng.pdf?sequence=1.
7. Gater R, Saeed K, Rahman A. From plan to framework: the process for developing the regional framework to scale up action on mental health in the Eastern Mediterranean Region. East Mediterr Health J. 2015;21(7):464-6. doi: 10.26719/2015.21.7.464. 
8. World Health Organization. Summary report on the intercountry meeting to scale up action on mental health in the Eastern Mediterranean Region. Cairo: WHO Regional Office for the Eastern Mediterranean, 2024. https://applications.emro.who.int/docs/WHOEMMNH238E-eng.pdf?ua=1.