The Commission
LISTEN: Appearing on The Lancet podcast, Joint Lead Editors Vikram Patel and Shekhar Saxena outline the priorities ahead for improving mental health worldwide.
The Lancet Commission on Global Mental Health and Sustainable Development is a comprehensive synthesis of knowledge on global mental health, designed to catalyse worldwide action. It builds on the 2007 and 2011 The Lancet series on global mental health that helped make mental health care a greater priority worldwide.
However, it remains a grim reality that the vast majority of people affected by mental health problems globally still do not receive adequate care. The burden of these problems in terms of their direct health consequences, is very large and increasing: but their impacts on social and economic well-being, on family functioning, and on diverse sectors of society is colossal and almost incalculable.
The situation is worsened as violations of basic human rights still continue to be perpetrated across the world – most disturbingly, the infliction of torture and incarceration of people with mental health problems existing globally, making them among the most neglected within our societies. Put simply, mental health is not simply a clinical or health system concern; this is truly a global development issue, for when it comes to mental health, all countries are still developing.
In response to this neglect, The Lancet, one of the world’s most prestigious journals, assembled leaders of the field from across the globe to the prepare the Commission – The Lancet Commission on Global Mental Health and Sustainable Development. The Commission report is an outcome of three years of dedicated efforts by a group of 28 Commissioners bringing in considerable expertise in diverse scientific and policy disciplines, as well as lived experience of mental health problems. The Commission was also guided at crucial junctures by The Lancet Editors as well as an Advisory Group of 10 members, representing the diverse communities which the Commission seeks to reach out to, from the service user community to donors.
The Commission was supported by The National Institute of Mental Health, Wellcome Trust, Grand Challenges Canada and MQ-UK. The formal launch of the Commission report took place on 10 October 2018 in London in the United Kingdom, supported by an international group of public engagement team and partners.
With a substantive focus on the formative years of childhood and adolescence, the Commission has inspired an offshoot creative campaign run by an international group of Young Leaders, which uses Facebook and Instagram to engage young people on mental health.
The Youth Campaign was made possible by funding from the Wellcome Trust and is led by the ‘Becoming Good: Early Intervention and Moral Development in Child Psychiatry’ (BeGOOD) Project at the University of Oxford, in collaboration with NCD Child, Sangath and CitiesRise.
The Vision
The ultimate goal of the Commission is to guide action to reduce the global burden of mental health problems. The Commission should give fresh impetus to the prioritisation of mental health, helping ensure physical and mental health are valued equally by the global health and development communities.
Mental ill health is on the rise worldwide, causing early deaths and fuelling cycles of poverty. Most people with mental health problems do not receive care, which prolongs suffering and leads to colossal societal and economic losses. Even worse, they are often subjected to human rights abuses and discrimination. To respond to these challenges and help achieve the Sustainable Development Goals, the Commission outlines a comprehensive blueprint for action.
The Commission has three unique guiding principles:
One, our approach to mental health covers the full spectrum of mental health from day-to-day wellness to long-term, disabling conditions.
The Commission comprehensively explains how to promote mental health, prevent mental disorders and enable recovery. Solutions have come from around the world, as countries with limited resources provide an example to those with far greater wealth at their disposal. It is time to use this knowledge to benefit entire populations. Putting what we know into practice will drive social and economic progress – especially for young people.
Two, mental health is the product of psychosocial, environmental, biological and genetic factors interacting with neurodevelopmental processes.
Because our experiences in childhood and adolescence shape our mental health for life, it is crucial that these years unfold in nurturing environments, which promote mental health and prevent mental disorders. The mental health of young and old alike also depends on addressing societal challenges like poverty, poor education and gender inequality, as good mental health does not exist in a vacuum.
Three, mental health should be respected as a fundamental right
It is important to start getting people living with mental health problems at the center of planning services and challenging stigma. Everyone is entitled to dignity, autonomy, care in the community and freedom from discrimination.
Guided by these principles, the Commission calls for increasing investment to realize these aspirations, improving services as part of universal health coverage and recognising that everyone, everywhere is entitled to good mental health.
These changes rely on a diverse range of groups – from the mental health and development communities to policy makers and civil society – coming together as a Global Partnership to improve mental health worldwide, as part of the Sustainable Development Goals movement.