Movement for Global Mental Health: The crusade and its critique.

ABSTRACT

The Movement for Global Mental Health (MGMH)1 aims to improve services for people with mental health problems worldwide, with a focus on low- and middle-income countries (LMIC). The core principles of this movement include scientific evidence and human rights. It is a broad coalition led by psychiatry and its membership now includes over 200 institutions and 10 000 individuals. The movement is a product of the call for action of the Lancet Global Mental Health Series.2 The components of the movement include advocacy, human rights, universal healthcare, policy, research and programmes relevant to LMIC.1 Its main aim is to focus on the post 2015 Millennium Development Goals (MDGs) including mental health. The movement has inspired many field studies and has developed resources.1 Support for the movement also comes from the WHO and its recent plans and programmes, which include Mental Health Gap Action Programme (mhGAP),3 Mental Health Evidence and Research (MER) and the Comprehensive Mental Health Action Plan 2013–2020. The mhGAP3 recognizes the burden of mental illness, identifies limitations in service delivery, highlights gaps in treatment and services and attempts to bridge the void. Its resources include an intervention guide for common disorders, resources, projects and publications. The core projects of the WHOs Mental Health Evidence and Research programme are the Mental Health Atlas 2011,4 which maps mental health resources across countries,4 the Assessment Instruments for Mental Health Systems (AIMS), which allows for uniformity of assessment of services,5 and Mental Health in Emergencies.6 The major objectives of the WHO’s Comprehensive Mental Health Action Plan 2013–207 include strengthening effective leadership and governance for mental health, providing comprehensive, integrated and responsive mental health and social care services in community-based settings, implementing strategies for promotion and prevention in mental health and strengthening information system, evidence and research in mental health. Its cross-cutting principles include universal health coverage, human rights, evidence-based practice, life-course and multisectoral approaches and the empowerment of people with mental disorders and psychosocial disabilities. The plan aims to restructure, reinvigorate and invest in mental health services.7 It provides a framework for national governments, development agencies, academia and civil society. It provides broad and objective measurable indicators and targets for key priorities including service coverage, updating mental health policies and laws, reducing rates of suicide, improving data collection to evaluate implementation, progress and impact. The case to scale up services has the following rationale (i) to