Everybody has a right to good mental health
As the world commemorates World Health Day this year (April 7, 2024), it is imperative to reflect not only on the advancements in physical health, but also on the crucial aspect of mental well-being.

This year’s theme “My Health, My Right” resonates deeply, emphasising the fundamental right of every individual to attain the highest possible standard of health, including mental health.

Mental health, often sidelined, is an integral component of overall well-being.

In recent years, there has been a significant shift in global awareness regarding mental health issues, leading to improved recognition, understanding and support.

However, there is still much ground to cover in ensuring equitable access to mental health services and eradicating discrimination against those facing mental health challenges.

The Covid-19 pandemic has underscored the importance of mental health like never before.

Lockdowns, social isolation, economic uncertainties and the fear of the virus have exacerbated stress, anxiety, depression and other mental health disorders worldwide.

As we navigate the lingering repercussions of the pandemic, prioritising mental health support is paramount.

Taking care of mental health

It is necessary to recognise the interconnectedness of mental and physical health.

Mental well-being influences physical health outcomes and vice versa.

Neglecting one aspect can have adverse effects on the other.

Therefore, adopting a holistic approach to healthcare that integrates mental health services into primary healthcare systems is vital.

In Malaysia, this could be addressed through capacity building in mental health for primary care doctors, thereby relieving some of the burden at the tertiary care level.

This approach helps to ensure early detection, treatment and management of mental health disorders at the community level, thereby attaining accessible and affordable mental health care for all.

Addressing the determinants of mental health is crucial for promoting overall well-being.

These determinants include socioeconomic factors, environmental conditions, access to education, employment opportunities and social support networks.

Tackling these factors requires collaborative efforts from governments, health organisations, communities and individuals.

In line with this year’s (2024) theme, advocating for mental health rights is essential.

Every individual has the right to access quality mental health care without facing discrimination or stigma.

Governments and policymakers must prioritise mental health in their health agendas, allocate adequate resources and implement policies that promote mental well-being for all.

WHO efforts

Reducing stigma is one of the main challenges surrounding mental health care.

Since its establishment 76 years ago, the World Health Organization (WHO) has made significant strides in the field of mental health by developing global mental health policies and strategies aimed at promoting mental well-being and addressing mental health disorders.

In 2013, the WHO launched the Mental Health Action Plan, which provides a framework for countries to prioritise mental health within their health agenda.

The plan outlines key objectives, including strengthening mental health governance, providing comprehensive mental health care in community settings, and promoting mental health and well-being through public awareness campaigns.

The WHO has advocated for the development and implementation of mental health legislation that protects the rights of individuals with mental health disorders.

This includes laws that ensure access to mental health care, prohibit discrimination, and promote the autonomy and dignity of persons with psychosocial disabilities.

The WHO has also spearheaded global campaigns and advocacy efforts to raise awareness about mental health issues, reduce stigma and promote mental well-being.

Initiatives such as World Mental Health Day (marked every Oct 10) and the “Depression: Let’s Talk” campaign have helped to mobilise public support and prioritise mental health on the global health agenda, including here in Malaysia.

During humanitarian emergencies and crises, the WHO provides technical support and coordination for mental health interventions.

This includes deploying mental health professionals, providing psychosocial support to affected populations, and strengthening mental health services in emergency settings.

The successful rebuilding and psychosocial recovery of Aceh, Indonesia, after the Asian tsunami of 2004 is a case in point.

Criticisms and challenges

Despite its great strides, the WHO has faced many criticisms, especially in recent years.

One example of this is its handling of the Covid-19 pandemic.

Some argue that the WHO’s response was slow, lacked coordination, or failed to adequately communicate risks to the public.

While there may be valid concerns about specific aspects of the WHO’s response, it is important to recognise the complexities of managing large-scale emergencies and the challenges of coordinating responses across diverse countries and stakeholders.

Critics have raised concerns about the transparency of decision-making processes within the WHO, particularly regarding the publication of data, communication with member states, and potential conflicts of interest.

In response, the WHO has taken concrete steps to address these concerns, such as establishing independent review mechanisms and strengthening governance structures.

Some countries have criticised the WHO for its funding mechanisms, expressing concerns about the equitable distribution of resources and the allocation of funds to specific initiatives.

However, this only underscores the broader issue of global health financing and the need for sustainable funding models that ensure the WHO can fulfil its mandate effectively.

The WHO relies heavily on contributions of member states and some of these states have not been exactly forthcoming in their support of the organisation.

As a global health organisation, the WHO operates in a politically-charged environment where member countries may seek to influence its decisions and priorities.

While political considerations can undoubtedly impact the WHO’s work, it is essential to recognise the organisation’s efforts to uphold its mandate and prioritise evidence-based decision-making, regardless of political pressures.

Mental health advocates argue that mental health has been historically underfunded and overlooked within global health agendas, including those of the WHO.

Despite the significant burden of mental illness worldwide, mental health services often receive a disproportionately small share of health budgets.

This has been a challenge in Malaysia as well.

Critics have proposed that the WHO should advocate for greater investment in mental health through bold suggestions that resources be allocated equitably to address the mental health needs of populations.

Other stakeholders have argued that the WHO’s approach to mental health has been overly focused on biomedical interventions, such as medication, at the expense of psychosocial and community-based approaches.

There is a growing recognition of the importance of holistic and culturally-sensitive approaches to mental health care that address social determinants of health, and promote recovery and well-being.

However, critics also need to acknowledge the diverse needs and preferences of individuals with mental health disorders.

While criticisms of the WHO by member countries and other stakeholders may highlight legitimate concerns and areas for improvement, it is important to assess them within the broader context of the organisation’s mandate, resources and operational challenges.

Constructive engagement and dialogue between member countries and the WHO can help address these criticisms and strengthen the organisation’s ability to promote global health and well-being.

A human right

As we commemorate World Health Day, let us reaffirm our commitment to promoting mental health as a fundamental human right.

It is timely to recognise the WHO as being instrumental in advancing mental health on the global stage, advocating for the rights of individuals with mental illness, and promoting policies and strategies to improve mental health outcomes worldwide.

By recognising the importance of mental well-being, advocating for equitable access to mental health services, and challenging stigma, we can build a healthier, more inclusive world for all.

Prof Datuk Dr Andrew Mohanraj is a consultant psychiatrist, the Malaysian Mental Health Association president and former WHO Western Pacific Regional Office consultant on mental health and substance abuse. For more information, email starhealth@thestar.com.my. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.
Matters of the Mind,World Health Day,World Health Organization,WHO,mental health
Our columnist takes a look at how the World Health Organization (WHO) has championed this aspect of our well-being.