How Countdown Global Mental Health 2030 will help achieve SDGs

This has helped spur efforts to collect and report more data – something which has proliferated with the impact of COVID-19, as the stresses of the pandemic have led to increased public attention to, and conversation about, the mental health and wellbeing of populations.

BOX 2: Mental Health Data Drives Unprecedented Focus at World Health Assembly

Since the start of the pandemic, the WHO has been regularly assessing the impact of COVID-19 on health services including mental, neurological and substance use services. The WHO undertook a rapid assessment of mental, neurological and substance use services (published October 2020).5 Among the 87 (67%) of WHO Member States which responded, a high level of disruption to mental health services – particularly at community level and those covering substance use – was reported. This was a disheartening but helpful statistic to help increase political attention: the impact of COVID-19 on mental health was put on the agenda of the WHO’s Executive Board in January 2021 for the first time.

Dr Zsuzsanna Jakab, Deputy Director-General, stated: “This is the first time, ladies and gentlemen, that mental health is being discussed in the Executive Board within the emergency agenda ... therefore this is a historic moment.”

In April 2021, a follow up WHO survey of Member States6 revealed the most frequently disrupted health services were those for mental, neurological, and substance use disorders and neglected tropical diseases (reported in more than 40% of countries). Again, this helped galvanise political attention. Member States developed and proposed a resolution on the topic, and a dedicated discussion on COVID-19 and its impact on mental health was held for the first time at the World Health Assembly (WHA). During discussions at the WHA, more than 50 Member States spoke –the highest ever number on mental health at a WHA – and they called on the WHO to provide more support and guidance to help them address mental health needs in the context of COVID-19 response and recovery. Work has continued in this area at global and regional level. For example, a series of recommendations were made by the WHO Technical Advisory Group on the mental health impacts of COVID-19 in the WHO European Region7 . These included, “monitor changes in mental health at population level through valid, standardized and comparable measures and instruments.”

5 WHO (2020), The impact of COVID-19 on mental, neurological and substance use services https://www.who.int/publications/i/ item/97892401245 6 WHO (2021), Second round of the national pulse survey on continuity of essential health services during the COVID-19 pandemic https://www.who.int/publications/i/item/WHO-2019-nCoV-EHS-continuity-survey-2021.1 7 WHO (2021) Recommendations from the WHO Technical Advisory Group on the mental health impacts of COVID-19 in the WHO European Region https://www.euro.who.int/__data/assets/pdf_file/0009/507753/TAG-mental-health-COVID-19-recommendations-eng.pdf Despite multiple different data gathering efforts, there are a host of data gaps at population level, and a lack of systematic data that can inform action – whether that is action in terms of advocacy and campaigning, or changes to policy and practice. Moreover, the data that exists is not necessarily complete nor independent: for example, the WHO Mental Health Atlas is a crucially important monitoring tool, but it relies on self-reporting by Member States. Without comprehensive, independent data which can capture the full range of issues that impact and are impacted by mental health, it is not possible to drive better monitoring and accountability to ensure that the right to good mental health for all is upheld.

In 2018, the Lancet Commission on global mental health and sustainable development reviewed the implications of the inclusion of mental health and well-being within the United Nations’ SDGs.8 The Commission highlighted the need for robust and systematic mechanisms for monitoring and accountability, to ensure that necessary investments in services and research are made, such investments are utilised efficiently and effectively, and that mid-course corrections are implemented as required. Additionally, the Commission outlined a set of SDG-relevant indicators to monitor progress on mental health, and recommended the use of these indicators to establish a comprehensive, longitudinal monitoring and accountability mechanism for mental health that would address the needs at all stages of life.

In 2019, Countdown Global Mental Health 2030 was announced in the Lancet in February,9 and then launched in September at the Goalkeepers conference in New York, which was organised by the Bill & Melinda Gates Foundation.10 Over the past two years, Dr Shekhar Saxena, the co-editor of the Lancet Commission report, has worked with United for Global Mental Health and a range of other partners to make Countdown 2030 a reality. This project has been made possible through the generous support of the Bernard van Leer Foundation11 and the Vitol Foundation.12

8 The Lancet, Patel et al. (2018) The Lancet Commission on global mental health and sustainable development https://www.thelancet. com/commissions/global-mental-health 9 The Lancet, Saxena et al. (2019) Countdown Global Mental Health 2030 https://www.thelancet.com/journals/lancet/article/PIIS01406736(19)30424-6/fulltext 10 The Bill & Melinda Gates Foundation, Gates Foundation, [accessed 24 August 2021] https://www.gatesfoundation.org/ 11 The Bernard van Leer Foundation, Bernard van Leer Foundation, [accessed 24 August 2021] https://bernardvanleer.org/ 12 Vitol Foundation, Vitol Foundation, [accessed 26 August 2021] https://www.vitol.com/vitol-foundation/