Mental Health in an Unequal World

Four people from Malawi standing and smiling

Dr. Julian Eaton, Mental Health Director of CBM Global, reflects on this year’s theme for World Mental Health Day. 

The World Mental Health Day theme this year, ‘Mental Health in an Unequal World’, is about making mental health care a reality for all. This theme emphasizes the urgent need to close the huge gap in access to care for people with mental health problems and psychosocial disabilities around the world.

In most of the countries where CBM Global works, over 80% of people do not have access to good quality and dignified mental health services or psychosocial support structures. We recently launched a Good Practice Guide to share the work we have done with governments and other partners around the world to close this gap through reform of mental health services, making them more inclusive, decentralised and locally accessible, affordable, and based on the best evidence of effectiveness and dignity.

But equal access to mental health is far more than just access to good treatment, as important as this is. CBM Global’s vision of a world where people with psychosocial disabilities are included in their communities also means that we need to think much more broadly about the barriers to equity around mental health. We need to recognize for example the need to address injustices like poverty and barriers to employment, lack of legal rights like freedom to choose treatment, legal systems that discriminate against people with disabilities, and other stresses that we know are risk factors for poor mental health.

One example of such legal and structural injustice is the continuing criminalisation of suicide in over 20 countries around the world. In several countries, notably Nepal, Nigeria, and Kenya, CBM Global partners are working to change this situation and to improve the social environmental factors that contribute to this devastating problem.

One of the most important issues of our time is climate change, which we know will affect people in countries that have not been primarily responsible for creating the problem. CBM Global released a resource outlining the impact on people with disabilities, and there is increasing evidence of the impact of climate change on mental wellbeing. Many CBM Global partners have been working to respond to the impacts of climate change, including in mental health and psychosocial support, and we have gathered examples of this work in a new document which we are launching on this year’s World Mental Health Day, in preparation for our participation with partners in the COP26 meeting in Glasgow in November.

We strongly believe that the only way to see such fundamental changes in our world is to strengthen the voice and power of people with psychosocial disabilities, and this is only possible if the important processes that take place at national and international levels are inclusive of and accessible to them. Over many years, CBM Global has promoted participation in major processes like the development of UN guidelines and in research. For example, we are working with the SUCCEED programme at The London School of Hygiene & Tropical Medicine (LSHTM) to strengthen user voices in research in Zimbabwe, Nigeria, Sierra Leone, and Malawi. We have also worked closely with the World Blind Union in supporting the World Health Organisation and the Inter Agency Standing Committee to ensure their resources are accessible.

World Mental Health Day is a great opportunity every year to bring together the common voice of people with psychosocial disabilities and those working in mental health around the world. We want to add our voice to this call for a better deal for people with psychosocial disabilities, and people living with the stresses of injustice and inequity that have such a negative effect on mental wellbeing.

Main Image: Rose with other family members on the plot of land near their home.

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