Comprehensive Mental Health Action Plan 2013-2030

Comprehensive mental health action plan 2013-2030
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Index
Preface v
Context 1
Overview of the world situation 2
Structure of the Comprehensive Action Plan on Mental Health 2013-2030 5
Proposed actions for Member States and national and international

partners, and actions for the Secretariat 6
Annex 1: Indicators to measure progress towards the defined goals of the

Comprehensive Action Plan on Mental Health 2013-2020 17
Annex 2: Options for the application of the Comprehensive Action Plan

on Mental Health 2013-2030 22
iii
Preface
Mental health and well-being are essential for all of us to lead fulfilling lives,
reach our full potential, participate constructively in our communities, and
overcome stress and adversity.
In addition, mental health services are an essential component of the health

system and of universal health coverage. Although the need to intensify mental
health promotion activities is highlighted in the WHO's 13th General Program of
Work, much remains to be done to ensure that all people enjoy the highest
possible level of mental health and well-being. Measures need to be taken
to solve decades of neglect and insufficient development of mental health services and systems, violation of
human rights and discrimination against people with mental disorders and psychosocial disabilities.
This updated Comprehensive Action Plan on Mental Health, which was endorsed by the 74th World Health
Assembly in its decision WHA74(14), builds on the previous Comprehensive Action Plan on Mental Health
2013-2020, but Some indicators and application options have been reviewed and its global targets have been
updated. The Plan continues to stress the need for a lifelong approach and to implement measures to promote
mental health and well-being for all, prevent mental health problems among people at risk and ensure universal
coverage of care to mental health.
However, its four main objectives remain: to strengthen effective leadership and governance in the field of mental
health; provide comprehensive, integrated, and adaptable mental health and social care services in community
settings; implement promotion and prevention strategies in the field of mental health; and strengthen information
systems, scientific data, and research on mental health.
Although the goals of this Action Plan are ambitious, the WHO Secretariat and Member States remain committed
to their achievement. To that end, we must act together to meet mental health needs now and in the future, for
there is no health without mental health.
Dr Tedros Adhanom Ghebreyesus

Managing Director
World Health Organization
v
Context
01In May 2012, the 65th World Health Assembly adopted resolution WHA65.4 on the global burden of mental disorders and the
need for a comprehensive and coordinated response from countries' health and social sectors. In it, the Director General was
asked, among other things, to prepare a Comprehensive Action Plan on Mental Health in consultation with the Member States
that encompasses services, policies, laws, plans, strategies, and programs.
02This Action Plan has been developed through consultations with Member States, civil society and international
partners. It has a comprehensive and multisectoral approach, with coordination of services in the health and social
sectors, and pays special attention to promotion, prevention, treatment, rehabilitation, care and recovery. It also sets out
clear actions for Member States, the Secretariat and partners at the international, regional and national levels, and
proposes key indicators and targets that can be used to assess implementation, progress and impact. At the core of the
Action Plan is the globally accepted principle that "there is no health without mental health".
03The Action Plan has close conceptual and strategic links with other global action plans and strategies endorsed
by the Health Assembly, such as the Global Strategy to Reduce the Harmful Use of Alcohol, the global action plan
on workers' health 2008-2017, the action plan of the global strategy for the prevention and control of
noncommunicable diseases 2008-2013, and the Global Action Plan for the Prevention and Control of
Noncommunicable Diseases 2013-2030. It is also based on WHO regional action plans and strategies for mental
health and substance abuse that have already been adopted or are under development.
04The Action Plan builds on, but does not duplicate, the work of WHO's Mental Health Gap Action Program
(mhGAP), which focused on expanding mental health services in resource-poor settings. Furthermore, it is global
in scope and aims to provide guidance for national action plans. It addresses the response of the social sector and
other relevant sectors, as well as promotion and prevention strategies, regardless of the magnitude of the
resources.
05In this Action Plan, the term "mental disorders" is used to refer to a series of mental and behavioral disorders
listed in the tenth revision of the International Statistical Classification of Diseases and Related Health Problems
(ICD-10). These include disorders with a high burden of disease such as depression, bipolar affective disorder,
schizophrenia, anxiety disorders, dementia, substance use disorders, intellectual disabilities, and developmental
and behavioral disorders that usually start in childhood and adolescence, including autism. With respect to
dementia and substance use disorders, other preventive strategies may also be necessary (for example,1or in the
global strategy to reduce the harmful use of alcohol). In addition, the Plan covers suicide prevention, and many of
the actions are also relevant to conditions such as epilepsy. The term "vulnerable groups" is used in the Action Plan
to refer to individuals or groups of individuals who are vulnerable to the situations and environments to which
they are exposed (as opposed to any inherent problems of weakness or lack of capacity). The expression should be
applied in countries depending on the national situation.
06The Action Plan also covers mental health, conceived as a state of well-being in which the individual fulfills his abilities,
overcomes the normal stress of life, works productively and fruitfully, and contributes something to his community.
1
Dementia: a public health priority. Geneva, World Health Organization, 2012 (https://apps.who.int/iris/handle/10665/98377 ).
1
Comprehensive Action Plan on Mental Health 2013-2030
With regard to children, emphasis is placed on aspects of development, such as a positive sense of identity, the
ability to manage thoughts and emotions, as well as to create social relationships, or the ability to learn and
acquire an education that in Ultimately it will enable them to participate actively in society.
07Given the widespread cases of human rights violations and discrimination suffered by people with mental
disorders, adopting a human rights perspective is critical to responding to the global burden of mental illness. The
Action Plan emphasizes the need for services, policies, laws, plans, strategies and programs that protect, promote
and respect the rights of people with mental disorders in line with the provisions of the International Covenant on
Civil and Political Rights, the International Covenant on Economic, Social and Cultural Rights, the Convention on
the Rights of Persons with Disabilities, the Convention on the Rights of the Child and other relevant international
and regional human rights instruments.
Overview of the world situation
08Mental health is an integral part of health and well-being, as reflected in the definition of health in the
Constitution of the World Health Organization: "Health is a state of complete physical, mental and social well-
being, and not only the absence of affections or diseases”. Mental health, like other aspects of health, can be
affected by a number of socioeconomic factors (described below) that need to be addressed through
comprehensive, whole-of-government promotion, prevention, treatment and recovery strategies.
Mental health and mental disorders: determinants and consequences
09The determinants of mental health and mental disorders include not only individual characteristics such as the
ability to manage our thoughts, emotions, behaviors, and interactions with others, but also social, cultural,
economic, political, and environmental factors such as policies national standards, social protection, standard of
living, working conditions or social support from the community. Exposure to adversity at an early age is a well-
established preventable risk factor for mental disorders.
10Depending on the local context, some individuals and social groups may be at significantly higher risk of mental
health problems. These vulnerable groups include (but not always) members of families living in poverty, people
with chronic health problems, children exposed to abuse or neglect, adolescents exposed to substance abuse for
the first time, minority groups, indigenous populations, the elderly, people subjected to discrimination and human
rights violations, homosexuals, bisexuals and transgender people, prisoners or people exposed to conflicts,
natural disasters or other humanitarian emergencies. The current global financial crisis is an excellent example of
a macroeconomic factor leading to funding cuts, despite the simultaneous need for more mental health and social
services due to rising rates of mental disorders and suicide, as well as the emergence of new vulnerable groups,
such as unemployed youth. In many societies, mental disorders related to marginalization and impoverishment,
domestic violence and abuse, overwork and stress are a growing concern, especially for women's health.
elevenPeople with mental disorders have disproportionately high rates of disability and mortality. Thus, for
example, people with major depression or schizophrenia have a 40% to 60% higher probability of premature death
than the general population, due to physical health problems, which often go untreated (for example, cancers,
cardiovascular disease, diabetes and HIV infection), and suicide. Globally, suicide is the second most frequent
cause of death in young people.
2
Overview of the world situation
12Mental disorders often influence and are influenced by other diseases such as cancer, cardiovascular disease or
HIV/AIDS, requiring common services and resource mobilization measures. For example, there is evidence that
depression predisposes to heart attack and diabetes, which in turn increase the likelihood of depression. Many risk
factors, such as low socioeconomic status, alcohol use, or stress, are common to mental disorders and other
noncommunicable diseases. There is also considerable overlap between mental disorders and substance use
disorders. Taken together, mental, neurological, and substance use disorders exact a heavy toll, and accounted for
13% of the global burden of disease in 2014. Depression alone accounts for 4.3% of the global burden of disease,
and is among the leading global causes of disability (11% of the global total). of years lived with disability),
especially among women. The economic consequences of these health losses are equally vast: a recent study
estimated that the cumulative global impact of mental disorders in terms of economic losses will be US$16.3
trillion between 2011 and 2030.1
13Mental disorders often plunge individuals and families into poverty.2Homelessness and improper incarceration
are much more common among people with mental disorders than in the general population, exacerbating their
marginalization and vulnerability. Due to stigma and discrimination, people with mental disorders experience
frequent human rights violations, with many denied economic, social and cultural rights and restrictions on work
and education, as well as reproductive and the right to enjoy the highest attainable standard of health. They may
also suffer inhumane and unhygienic living conditions, physical mistreatment and sexual abuse, lack of care, and
harmful and degrading therapeutic practices in health facilities. They are often denied civil and political rights,
such as the right to marry and found a family, personal freedom, the right to vote and full and effective
participation in public life, and the right to exercise their legal capacity in other aspects that affect them,
particularly the treatment and attention. Thus, people with mental disorders often live in situations of vulnerability
and may find themselves excluded and marginalized from society, which represents a major impediment to the
achievement of national and international development goals. The Convention on the Rights of Persons with
Disabilities, binding on States Parties that have ratified or acceded to it, protects and promotes the rights of all
persons with disabilities, including those with mental and intellectual disorders,
Resources and responses from the health system
14Health systems have not yet adequately responded to the burden of mental disorders; consequently, the gap between
the need for treatment and its provision is large throughout the world. In low- and middle-income countries, between
76% and 85% of people with severe mental disorders do not receive treatment; the figure is high also in high-income
countries: between 35% and 50%. The problem is further complicated by the poor quality of care received by treated
cases. The WHO Mental Health Atlas 2011 provides data that demonstrates the scarcity of resources in countries to meet
mental health needs and points to the inequitable distribution and inefficient use of these resources. For example, the
annual global spending on mental health is less than US$2 per person, and less than US$0.25 per person in low-income
countries; 67% of these economic resources are assigned to exclusively psychiatric hospitals, despite the fact that they
are associated with poor health outcomes and human rights violations. Redirecting this funding towards community-
based services, with integration of mental health into care
1
World Economic Forum, Harvard School of Public Health. The global economic burden of non-communicable diseases. Geneva, World
Economic Forum, 2011 (https://www.weforum.org/reports/global-economic-burden-non-communicable-diseases ).
2
Mental health and development: Targeting people with mental health problems as a vulnerable group. Geneva, World Health
Organization, 2010 (https://cdn.who.int/media/docs/default-source/mental-health/9789962642657-spa.pdf?sfvrsn=4ab1514d_2 ).
3
general health care and in programs for maternal, sexual, reproductive and child health, HIV/AIDS and chronic non-
communicable diseases, would allow many more people to have access to better and more cost-effective interventions.
fifteenThe number of specialized and general health professionals dealing with mental health is grossly
insufficient in low- and middle-income countries. Nearly half the world's population lives in countries where, on
average, there is one psychiatrist to care for 200,000 or more people; other mental health care providers trained to
use psychosocial interventions are even more scarce. Similarly, the proportion of countries with mental health
policies, plans and legislation is much higher among high-income countries than among low-income countries; for
example, only 36% of people living in low-income countries are covered by mental health legislation, compared to
92% in high-income countries.
16Civil society movements for mental health are not well developed in low- and middle-income countries. There
are only organizations for people with mental disorders and psychosocial disabilities in 49% of low-income
countries, compared to 83% of high-income ones; with respect to family associations, the corresponding figures
are 39% and 80%.
17Finally, the availability of basic medicines for mental disorders in primary care is considerably low (compared to
medicines available for infectious diseases or even for other non-communicable diseases), and their use is limited
by the lack of professionals qualified health workers with the necessary powers to prescribe medicines. In addition,
there is also no availability of non-pharmacological treatments or qualified personnel to offer these interventions.
These factors are major obstacles to adequate care for many people with mental disorders.
18To improve this situation, in addition to the data on mental health resources in the countries (both those
contained in the WHO Atlas of Mental Health 2011 and the more detailed profiles obtained with the WHO tool for
the evaluation of the mental health systems)1information exists on feasible and cost-effective mental health
interventions that can be scaled up to strengthen mental health care systems in countries. The WHO Mental Health
Gap Action Agenda, launched in 2008, uses evidence-based technical guidance, tools and training modules to scale
up service delivery in countries, especially in resource-poor settings. This program focuses on a series of priority
conditions and, importantly, directs training towards non-specialized health professionals with an integrated
approach that promotes mental health at all levels of care.
19The Secretariat has developed other tools and technical guidance to assist countries in the formulation of comprehensive
mental health policies, plans and laws that encourage improvements in the quality and availability of mental health care (such
as theWHO mental health policy and service guidance package);2in improving the quality and respect for the rights of people
with mental disorders in health services (theWHO Quality Rights toolkit);3and in the relief and reconstruction of the mental
health system after disasters (Inter-Agency Standing Committee Guidelines on mental health and psychosocial support in
emergency settings).4Knowledge, information and technical instruments are necessary,
1
IESM-OMS version 2.2: Assessment instrument for mental health systems, World Health Organization. Geneva, World Health Organization,
2005 (WHO/CDS/2005.32; https://apps.who.int/iris/handle/10665/70771 ).
2
WHO mental health policy and service guidance package. Geneva, World Health Organization, 2004 (https://www.who.int/publications/i/item/
9241546468 ).
3
WHO Quality Rights tool kit: assessing and improving quality and human rights in mental health and social care facilities. Geneva, World Health
Organization, 2012 (https://apps.who.int/iris/handle/10665/70927 ).
4
IASC Guide on Mental Health and Psychosocial Support in Humanitarian Emergencies and Catastrophes. Geneva, Inter-Agency Standing Committee, 2007 (
https://www.unhcr.org/5b50c7b82cd.pdf ).
4
Structure of the Comprehensive Action Plan on Mental Health 2013-2030
But not enough to move decisively from evidence to action and evaluation also requires strong leadership, better
partnerships and a commitment to resource implementation.
Structure of the Comprehensive Action Plan on Mental Health 2013-2030
twentyThe vision of the Action Plan is a world in which mental health is valued, promoted and protected, mental
disorders are prevented, and people affected by them can exercise the full range of their human rights and access
timely care. high quality and culturally adapted health and social care that stimulates recovery, in order to achieve
the highest possible level of health and full participation in society and in the workplace, without stigmatization or
discrimination.
twenty-oneIts overall purpose is to promote mental well-being, prevent mental disorders, provide care,
improve recovery, promote human rights, and reduce mortality, morbidity, and disability of people with mental
disorders.
22The Action Plan has the following objectives:

1. strengthen effective leadership and governance in the field of mental health;
2. provide comprehensive, integrated, and adaptable mental health and social care services in community
settings;
3. implement promotion and prevention strategies in the field of mental health;
4. strengthen information systems, scientific data and research on mental health.
The global targets set for each goal provide the basis for measuring the collective actions and achievements of
Member States towards the global goals, but should not preclude the setting of more ambitious national targets,
especially for countries that have already achieved the global targets. Indicators for measuring progress towards
the defined global targets are listed in Annex 1.
23The Action Plan is based on six transversal principles and approaches.

1. Universal health coverage.Regardless of age, sex, socioeconomic status, race, ethnicity or sexual orientation,
and in accordance with the principle of equity, people with mental disorders should be able to access, without
risk of impoverishment, essential health and social services that allow them to recover and enjoy the highest
degree of health that can be achieved.
2. Human rights.Therapeutic, prophylactic, and promotional strategies, actions, and interventions in the field
of mental health must conform to the Convention on the Rights of Persons with Disabilities and other
international and regional human rights instruments.
3. Practices based on scientific evidence.Therapeutic, prophylactic and promotional strategies and

interventions in mental health have to be based on scientific evidence and/or best practices, taking into
account cultural considerations.
4. Life course approach.Mental health policies, plans and services must take into account health and social
needs at all stages of the life cycle: infancy, childhood, adolescence, adulthood and old age.
5. Multisectoral approach.A comprehensive and coordinated response to mental health requires partnerships with
5
multiple public sectors, such as health, education, employment, criminal justice, housing, social and others, as well as
with the private sector, as appropriate based on the situation in the country.
6. Emancipation of people with mental disorders and psychosocial disabilities.People with mental
disorders and psychosocial disabilities must empower themselves and participate in mental health
advocacy, policy, planning, legislation, service delivery, monitoring, research and evaluation.
24The framework established in this Action Plan should be adapted at the regional level in order to take into account the
specific situation of each region. Proposed actions for Member States need to be reviewed and adapted as appropriate to
specific national priorities and circumstances in order to achieve the objectives. There is no action plan model valid for all
countries, since they are in different phases of the process of articulation and application of a comprehensive response
in the field of mental health.
Proposed actions for Member States and national and international

partners, and actions for the Secretariat
25To achieve the vision, goals and objectives of the plan, specific actions are proposed for Member States and
international and national partners. In addition, actions have been defined for the Secretariat. Although these actions
have been specified separately for each objective, many of them will also contribute to the achievement of the other
objectives of the Action Plan. Some possible options for putting these actions into practice are proposed in Annex 2.
26Effective implementation of the Global Mental Health Action Plan will require action by international, regional
and national partners, including but not limited to:
• development agencies, such as international multilateral agencies (for example, the World Bank or United
Nations development agencies), regional agencies (for example, regional development banks),
subregional intergovernmental agencies, and development agencies bilateral development aid;
• academic and research institutions, such as the network of WHO collaborating centers for mental health,
human rights and social determinants of health or other networks, in both developing and developed
countries;
• civil society, in particular organizations of people with mental disorders and psychosocial disabilities,
service users and other similar associations and organizations, family and carer associations, mental
health organizations and other non-governmental, community, human rights and faith-based,
developmental and mental health networks, and associations of health professionals and service
providers.
27The roles of these three groups often overlap, and can include multiple actions in the areas of governance,
health and social services, mental health promotion and prevention, information, evidence, and research (see
actions listed below). National assessments of the needs and capacities of the different partners will be essential to
clarify the roles and actions of the main stakeholder groups.
6
Proposed actions for Member States and national and international partners, and actions for the Secretariat
Goal 1. Strengthen effective leadership and governance in the field of mental health
28The planning, organization and financing of health systems is a complex task that requires the participation of
multiple stakeholders and different administrative levels. As the ultimate protectors of the mental health of the
population, governments bear the primary responsibility for putting in place appropriate institutional, legal, financial and
service arrangements to ensure that all needs are met and the mental health of the entire population is promoted.
population.
29Governance is not just about government, but extends to its relationships with non-governmental organizations
and civil society. The existence of a strong civil society, and in particular organizations of people with mental
disorders and psychosocial disabilities and of family members and carers, can help to formulate policies and laws
and to create more effective, accountable and inclusive mental health services. consistent with international and
regional human rights instruments.
30Among the essential factors in formulating effective mental health policies and plans are strong leadership and
commitment from governments; the formulation of actions based on evidence and substantiated from the
financial point of view; explicit attention to equity; respect for the dignity and human rights of people with mental
disorders and psychosocial disabilities, and the protection of vulnerable and marginalized groups.
31Responses will be stronger and more effective if mental health interventions are firmly integrated into national
health policies and plans. In addition, it is often necessary to develop specific mental health policies and plans that
provide more detailed guidance.
32Mental health legislation, whether addressed in a stand-alone legislative document or integrated into other health
and capacity laws, should codify the fundamental principles, values and objectives of mental health policy, for example
by establishing legal and enforcement mechanisms. monitoring to promote human rights and develop accessible health
and social services in the community.
33Mental health policies, plans and laws must comply with obligations under the Convention on the Rights of
Persons with Disabilities and other international and regional human rights conventions.
3. 4More explicit incorporation of mental health issues into other priority health programs and alliances (for
example, HIV/AIDS, women's and children's health, noncommunicable diseases, Global Health Workforce Alliance)
as well as policies and legislation of other relevant sectors (for example, those dealing with education,
employment, disability, justice, social protection and human rights or poverty reduction and development), is an
important means of addressing multidimensional requirements of mental health systems and should remain at
the heart of government leadership efforts to improve treatment services, prevent mental disorders and promote
mental health.
Global Target 1.1:80% of countries will have developed or updated their mental health policies or plans, in line
with international and regional human rights instruments, by the year 2030.1
Global Target 1.2:80% of countries will have developed or updated their laws on mental health, in line with
international and regional human rights instruments, by the year 2030.
1
All global targets have been updated in accordance with updates to Annexes 1 and 2 to this document, in response to decision WHA72(11)
(2019), paragraph 3(a).
7
Proposed actions for Member States
35Politics and legislation.Formulate, strengthen, update and implement national mental health-related policies,
strategies, programmes, laws and regulations in all relevant sectors, including codes of practice and mechanisms
to monitor human rights protection and law enforcement , in line with evidence, best practice, the Convention on
the Rights of Persons with Disabilities and other international and regional human rights instruments.
36Resource planning.Plan according to quantified needs, and allocate in all relevant sectors a budget
commensurate with the human and other resources needed to implement agreed evidence-based mental health
plans and actions.
37Coordination with interested parties.Engage stakeholders from all relevant sectors, in particular people with
mental disorders, their caregivers and their families, in the formulation and implementation of mental health-
related policies, laws and services, using official structures and/or mechanisms for this purpose.
38Strengthening and emancipation of people with mental disorders and psychosocial disabilities, and their
organizations.Ensure that people with mental disorders and psychosocial disabilities have official roles and
powers to influence the process of making, planning and implementing policies, laws and services.
Actions for the Secretariat
39Politics and legislation.Compile knowledge and best practices on the development, multisectoral
implementation, and evaluation of mental health-related policies, plans, and laws, including codes of practice and
mechanisms to monitor human rights protection and law enforcement in line with the Convention on the Rights of
Persons with Disabilities and other international and regional conventions on human rights, and build the
necessary capacity to do so.
40Resource planning.Provide countries with technical support in multisectoral resource planning, budgeting,
and monitoring of mental health-related expenditures.
41Collaboration with stakeholders.Provide best practices and tools to strengthen collaboration and interaction
at the international, regional, and national levels among stakeholders in the formulation, implementation, and
evaluation of mental health policies, strategies, programs, and laws, with inclusion of the social, health and justice
sectors, civil society groups, people with mental disorders and psychosocial disabilities, their carers and family
members, and United Nations system organizations and human rights bodies .
42Strengthening and emancipation of people with mental disorders and psychosocial disabilities, and their
organizations.Involve organizations of people with mental disorders and psychosocial disabilities in policy-making
at the international, regional and national levels within the structures of WHO itself, and offer these organizations
support to design technical tools for capacity building based on in international and regional human rights
instruments and in the WHO's own human rights and mental health instruments.
8
Proposed actions for national and international partners
43Incorporate mental health interventions into health, development and poverty reduction policies, strategies
and interventions.
44Consider people with mental disorders as a vulnerable and marginalized group that requires priority attention
and must be involved in development and poverty reduction strategies, for example in education, employment
and subsistence programs, as well as in the rights program humans.
Four. FiveExplicitly include mental health in general and priority research policies, plans, and programs, such as those for
noncommunicable diseases, HIV/AIDS, or women's, children, and adolescents' health, as well as in horizontal programs and
alliances, such as such as the Global Alliance for the Health Workforce and other international and regional alliances.
46Support opportunities for exchange among countries on effective policy, legislative, and intervention strategies,
based on the international and regional human rights framework, to promote mental health, prevent mental
disorders, and foster recovery.
47Support the creation and strengthening of associations and organizations of people with mental disorders and
psychosocial disabilities, as well as their families and caregivers, and their integration into existing organizations
related to disabilities, and facilitate dialogue between them, professionals and public authorities from the social
and health, human rights, disability, education, employment and justice sectors.
Goal 2. Provide comprehensive, integrated, and adaptable mental health and social
care services in community settings
48In the context of improving access to care and the quality of services, WHO recommends the development of
comprehensive community-based mental health and social care services; integration of mental health care and
treatment in general hospitals and primary care; the continuity of care between different providers and levels of
the health system; effective collaboration between formal and informal care providers; and the promotion of self-
care, for example through the use of electronic and mobile health technologies.
49The development of good quality mental health services requires protocols and practices based on evidence,
which include early intervention, the incorporation of human rights principles, respect for individual autonomy and
protection of the dignity of people. In addition, health personnel should not limit their intervention to improving
mental health, but should also attend to the needs of children, adolescents and adults with mental disorders
related to their physical health, and vice versa, taking into account the high rates of comorbid mental and physical
health problems, and associated risk factors, such as high rates of tobacco use, which are often overlooked.
fiftyThe provision of community mental health services must have a recovery-based approach that emphasizes
support to enable people with mental disorders and psychosocial disabilities to achieve their own aspirations and
goals. Among the basic requirements of these services are the following: listen to and respond to the opinions of
those affected about their disorders and what helps them to recover; work with them on an equal footing when it
comes to their care; offer alternatives to treatment and care providers, and draw on the work and support of
people in a similar situation, who provide mutual encouragement and a sense of belonging, as well as technical
knowledge. In addition, a multisectoral approach is needed in which
9
services support people at different stages of the life cycle and, as appropriate, facilitate their access to basic
human rights such as employment (including return-to-work programmes), housing or educational opportunities,
and their participation in community activities, programs and other significant activities.
51A more active participation and support of users is needed in the reorganisation, delivery and evaluation and
monitoring of services, so that treatment and care are more responsive to their needs. There is also a need for
greater collaboration with 'informal' mental health care providers, such as family members or religious leaders,
spiritual and traditional healers, teachers, police officers and local non-governmental organisations.
52Another essential requirement is that services respond to the needs of vulnerable and marginalized groups in
society, such as the most socioeconomically disadvantaged families, those affected by HIV/AIDS, women and
children victims of domestic violence, survivors of acts violent, homosexuals, bisexuals and transsexuals,
indigenous peoples, migrants, asylum seekers, persons deprived of liberty or minority groups in the national
context.
53When planning humanitarian emergency response and recovery, it is essential to ensure the wide availability of
mental health services and community psychosocial supports.
54Exposure to adverse life events or extreme stress conditions, such as natural disasters, isolated, repeated or
ongoing conflicts, and ongoing family and domestic violence or riots, can have serious general and mental health
consequences that require careful consideration, especially with regard to to the diagnostic characterization
(especially to avoid overdiagnosis and excessive medicalization) and to the support, care and rehabilitation
approach.
55The availability of adequate numbers of competent, dedicated and well-trained health professionals and their equitable distribution are essential for the expansion of mental health services and the achievement of better results. The integration of mental health into
general and disease-specific health and social services and programs (such as women's health or HIV/AIDS) is a good opportunity to better manage mental health problems, promote healthy mental health and prevent mental disorders. For example, health professionals
with training in mental health must be prepared to treat mental disorders in the people they care for and, in addition, to provide information on general well-being and detect related conditions, such as non-communicable diseases or drug use. The integration of services
requires not only the acquisition of new knowledge and skills to identify, treat and refer people with mental disorders as appropriate, but also a redefinition of the roles of health personnel and changes in the current service culture and attitude from general health
professionals, social workers, occupational therapists and other professional groups. Furthermore, in this context, there is a need to expand the roles of specialist mental health professionals to include supervision and support to general health professionals in the delivery
of mental health interventions. The integration of services requires not only the acquisition of new knowledge and skills to identify, treat and refer people with mental disorders as appropriate, but also a redefinition of the roles of health personnel and changes in the
current service culture and attitude from general health professionals, social workers, occupational therapists and other professional groups. Furthermore, in this context, there is a need to broaden the roles of specialist mental health professionals to include supervision
and support to general health professionals in the delivery of mental health interventions. The integration of services requires not only the acquisition of new knowledge and skills to identify, treat and refer people with mental disorders as appropriate, but also a
redefinition of the roles of health personnel and changes in the current service culture and attitude from general health professionals, social workers, occupational therapists and other professional groups. Furthermore, in this context, there is a need to broaden the roles
of specialist mental health professionals to include supervision and support to general health professionals in the delivery of mental health interventions. but also a redefinition of the roles of health personnel and changes in the current service culture and attitude of
general health professionals, social workers, occupational therapists and other professional groups. Furthermore, in this context, there is a need to broaden the roles of specialist mental health professionals to include supervision and support to general health
professionals in the delivery of mental health interventions. but also a redefinition of the roles of health personnel and changes in the current service culture and attitude of general health professionals, social workers, occupational therapists and other professional
groups. Furthermore, in this context, there is a need to broaden the roles of specialist mental health professionals to include supervision and support to general health professionals in the delivery of mental health interventions.
Global Target 2.1:coverage of services for mental health problems will have increased by at least 50% by 2030.
Global Target 2.2:80% of countries will have doubled the number of community-based mental health centers by
2030.
Global Target 2.3:80% of countries will have integrated mental health into primary health care by 2030.
10
56Reorganization of services and expansion of coverage.Instead of caring for the patient in long-stay
psychiatric hospitals, systematically privilege care in non-specialized health centers, with increasing coverage of
scientifically proven interventions (including the principles of stepped care when appropriate) for priority ailments
and resorting to a network of interlinked community mental health services, including, in addition to short hospital
admissions, outpatient care in general hospitals, primary care, comprehensive mental health centres, day care
centres, support for people with mental disorders living with their family and subsidized housing.
57Integrated and adaptable care.Integrate and coordinate a holistic effort of prevention, promotion,
rehabilitation, care and support that aims to meet the needs of both mental and physical health care and
facilitates the recovery of people of any age with mental disorders together with the set of general services of
health and social care (recovery that includes the promotion of the right to employment, housing and education)
through the application of treatment and recovery plans centered on the service user and, where appropriate,
with the contributions of family members and carers.
58Mental health in humanitarian emergencies (including isolated, repeated or ongoing conflicts, violence
and disasters).Work with national emergency committees and mental health care providers to include mental
health and psychosocial support needs in emergency preparedness and access for people with mental disorders
(whether pre-existing or caused by the emergency) or psychosocial problems to safe support services, including
services that address psychological trauma and promote recovery and resilience, including those for health and
humanitarian personnel, during and after the emergency, with due regard to funding long-term that is required to
build or rebuild a community-based mental health system after an emergency.
59Resource planning.Strengthen the knowledge and skills of generalist or specialized health personnel so that
they can provide mental health and social care services that are scientifically proven, culturally appropriate and
governed by human rights, particularly to children and adolescents, introducing mental health into the study
programs undergraduate and university, and by training and mentoring health workers in the field, especially in
non-specialist care settings, so that they are able to recognize people with mental disorders and offer appropriate
treatment and support or refer them. where appropriate, to other levels of care.
60Correction of inequalities.Take active measures to identify and provide adequate support to groups that
present a special risk of mental illness and have difficulties in accessing services.
61Reorganization of services and expansion of coverage.Provide advice and propose scientifically proven
practices for the deinstitutionalization and reorganization of services. Likewise, provide technical support to
extend the work of treatment, support, prevention and promotion in the matter through community services of
mental health and social protection whose objective is the recovery of the patient.
62Integrated and adaptable care.Gather and disseminate scientific data and best practices for multisectoral
integration and coordination of holistic care, with an emphasis on recovery and the support needed by
eleven
people with mental disorders, which means, among other things, establishing alternative methods to coercive practices
and defining strategies to involve users, family members and caregivers in the planning of services and therapeutic
decisions. Also, offer examples of financing mechanisms to facilitate multisectoral collaboration.
63Mental health in humanitarian emergencies (including isolated, repeated or ongoing conflicts, violence
and disasters).Provide technical advice and guidance on mental health-related policies and activities on the
ground by governmental, non-governmental and intergovernmental entities, including the construction or
reconstruction, after an emergency, of a community-based mental health system take into account everything
related to post-traumatic sequelae.
64Resource planning.Assist countries in formulating a mental health human resources strategy that, among
other things, identifies gaps and specifies needs, training requirements and core competencies for field health
workers, and study programs are defined for undergraduate and university education.
65Correction of inequalities.Gather and disseminate scientific data and best practices to fill gaps in mental
health and social services for marginalized groups.
66Allocate the funds received to the direct provision of services to provide mental health care from the
community level instead of institutional assistance.
67Contribute to the training of health personnel so that they learn to recognize mental disorders. In addition,
propose scientifically proven and culturally appropriate interventions to promote the recovery of people with
mental disorders.
68Support coordinated initiatives to implement mental health programs in and after humanitarian emergencies,
including education and training for health and social care personnel.
Objective 3. Put into practice promotion and prevention strategies in the field of
mental health
69As part of the work of countries to develop and implement health policies and programs, it is essential not only
to meet the needs of people with a particular mental disorder, but also to protect and promote the mental well-
being of all citizens. Mental health evolves throughout life. Governments therefore have an important role in using
data on risk and protective factors to take action to prevent mental disorders and to protect and promote mental
health at all stages of life, including The former are especially conducive to pursuing these objectives, since up to
50% of the mental disorders that affect adults begin before the age of 14. Children and adolescents with mental
disorders should be subject to scientifically proven early interventions of a non-pharmacological nature, whether
psychosocial or of another nature, dispensed from the community level, avoiding institutionalization and
medicalization. Such interventions must also comply with the rights of children under the United Nations
Convention on the Rights of the Child and other international and regional human rights instruments.
12
70The responsibility to promote mental health and prevent mental disorders extends to all sectors and all
government administrations, since mental health problems are strongly influenced by a whole range of social and
economic determinants, such as income level. , employment situation, educational level, material living conditions,
physical health status, family cohesion, discrimination, human rights violations or exposure to difficult life events
such as sexual violence or child abuse and neglect . Children and adolescents exposed to natural disasters or
conflicts or civil disturbances, especially those who have participated in armed forces or groups, have enormous
mental health needs and require special attention.
71 Global strategies to promote mental health and prevent lifelong mental disorders can focus on: anti-discrimination laws and information campaigns that tackle the
stigma and human rights violations that all too often accompany the disorders mental; promoting the rights, opportunities and care of people with mental disorders;
cultivation of the main psychological resources of the individual in the formative stages of life (for example, with programs for early childhood, preparation for active
life and sexual education, or programs to promote a safe, stable and enriching relationship between children and their parents and caregivers); early intervention
through early detection, prevention and treatment of affective or behavioral problems, especially in childhood and adolescence; establishment of healthy living and
working conditions (for example, introducing work organization improvements or scientifically proven stress treatment plans in the public and private sectors);
community protection programs or networks that combat child abuse and other forms of violence in the home or community; and social protection of poor
populations. introducing work organization improvements or scientifically proven stress treatment plans in the public and private sectors); community protection
programs or networks that combat child abuse and other forms of violence in the home or community; and social protection of poor populations. introducing work
organization improvements or scientifically proven stress treatment plans in the public and private sectors); community protection programs or networks that combat
child abuse and other forms of violence in the home or community; and social protection of poor populations.1
72Suicide prevention is one of the important priorities. Many people who try to end their lives come from
vulnerable and marginalized groups. In addition, the young and the elderly are among the age groups most likely
to entertain suicidal thoughts or self-harm. In general, suicide rates are underestimated, due to deficiencies in
surveillance systems and the erroneous attribution of certain suicides to accidental causes, as well as the
criminalization of suicide in some countries. However, in most countries rates tend to remain stable or increase,
while in others there is a long-term downward trend. Since in addition to mental disorders there are many other
risk factors associated with suicide, For example, chronic pain or acute emotional disturbance, preventive
measures should not only come from the health sector, but other sectors should also act simultaneously.
Measures such as reducing access to means of self-harm or suicide (particularly firearms, pesticides, and access to
toxic drugs that can be taken in overdose), a responsible informative praxis on the part of the media, the
protection of people at high risk of suicide and early recognition and treatment of mental disorders and suicidal
behaviour.
Global Target 3.1:80% of countries will have at least two national multisectoral promotion and prevention
programs in operation in mental health by 2030.
Global Target 3.2:the suicide rate will have been reduced by a third by the year 2030.
Global Target 3.3:80% of the countries will have a mental health preparation system and psychosocial support to face
emergencies and/or disasters by the year 2030.
1
See: Risks to mental health: an overview of vulnerabilities and risk factors. Background paper by WHO Secretariat for the development of a
comprehensive mental health action plan. Geneva, World Health Organization, 2019 (https://www.who.int/mental_health/mhgap/
risks_to_mental_health_EN_27_08_12.pdf ).
13
73Promotion of mental health and prevention.Lead and coordinate a multisectoral strategy that: combines
universal and other targeted interventions to promote mental health, prevent mental disorders, and reduce
stigma, discrimination, and human rights violations; respond to the needs of specific vulnerable groups
throughout the life cycle; and is integrated into national mental health and health promotion strategies.
74Suicide prevention.Develop and put into practice comprehensive national suicide prevention strategies, paying
special attention to groups in which a higher risk of suicide has been detected, such as gays, lesbians, bisexuals and
transsexuals, young people or other vulnerable groups of any age in depending on the local context.
75Promotion of mental health and prevention.Provide technical support to countries for the selection,
formulation and application of scientifically proven and cost-effective best practices to promote mental health,
prevent mental disorders, reduce levels of stigma and discrimination and promote human rights at all stages of
life.
76Suicide prevention.Provide technical support to countries to strengthen their suicide prevention programs,
paying special attention to groups in which a higher risk of suicide has been detected.
77Engage all stakeholders in advocacy efforts to raise awareness of the magnitude of the burden of disease
associated with mental disorders and the existence of effective intervention strategies to promote mental health,
prevent mental disorders, treat and care for those affected and make their recovery possible.
78Advocate for the right of people with mental disorders or psychosocial disabilities to receive disability benefit
from the government and to have access to housing and livelihood programmes, and more generally to take part
in work and community life and affairs citizens.
79Ensure that people with mental disorders or psychosocial disabilities participate in the activities of disabled
groups in general, for example in the defense of human rights and in the reporting processes on the application of
the Convention on the Rights of persons with disabilities and other international and regional human rights
treaties.
80Institute measures to combat stigma, discrimination and other violations of human rights that affect people
with mental disorders or psychosocial disabilities.
81Associate with the development and implementation of all relevant mental health promotion and mental disorder
prevention programs.
14
Objective 4. Strengthen information systems, scientific data and research on

mental health
82Information, empirical data and research are basic ingredients for an adequate mental health policy
development, planning and evaluation process. Obtaining new knowledge through research makes it possible for
any policy or measure to be based on verified data and best practices, and the existence of relevant and up-to-date
data or monitoring devices allows to closely monitor the applied measures and determine the services in whose
performance there is room for improvement. But today research almost always takes place in and under the
control of high-income countries,
83Although there are periodic evaluation processes (such as the WHO Atlas project) that provide a synthetic vision
of the mental health situation, periodic information systems on the subject are rudimentary or non-existent in
most low-income countries. or medium, making it difficult to understand the needs of local populations and plan
accordingly.
84The basic data and indicators needed for the mental health system refer to the following: magnitude of the
problem (prevalence of mental disorders and identification of the main risk and protective factors for health and
well-being mental); scope of policies, laws, interventions and services (particularly the gap between the number of
people suffering from a mental disorder and the number receiving treatment and benefiting from an appropriate
package of services, such as social services); data on health outcomes (including rates of suicide and premature
mortality in the population as a whole, as well as improvements, at the individual or group level, related to clinical
symptoms, levels of disability, global functioning and quality of life) and data on social and economic outcomes
(relative levels of education, housing, employment and income in people with mental disorders). These data must
be disaggregated by sex and age and account for the diverse needs of subpopulations, defined according to
geographic criteria (for example, urban versus rural communities) and the vulnerability of certain groups. To
gather these data, periodic surveys specially designed for this purpose will be used, which come to complement
the data usually obtained with the health information system. There are also interesting possibilities to take
advantage of already existing data,
Global Target 4.1:80% of countries will systematically calculate and report every two years at least a core set of
mental health indicators through their national health and social information system by 2030.
Global Target 4.2:Global mental health research output doubles by 2030.
85Information systems.Integrate mental health into the mainstream health information system and
systematically identify, collect, report and use basic mental health data disaggregated by sex and age (including
data on suicides and suicide attempts) to improve service delivery mental health and promotion and prevention
strategies on the matter and to provide information to the Global Mental Health Observatory (as part of the WHO
Global Health Observatory).
fifteen
86Scientific data and research.Improve research capacity and university collaboration around national research
priorities in the field of mental health, particularly operational research that has a direct interest for the
development and implementation of services and for the exercise of human rights of people with mental
disorders, including the creation of centers of excellence that work to clear criteria, with input from all relevant
stakeholders, including people with mental disorders or psychosocial disabilities.
87Information systems.Define a core set of mental health indicators and provide guidance, training and
technical support on designing surveillance/reporting systems to collect data for core mental health indicators.
Facilitate the use of such data for monitoring health outcomes and inequities and increase the volume of
information collected by the WHO Global Observatory for Mental Health (as part of the WHO Global Health
Observatory) by establishing baseline data to closely monitor the world situation in this area (and thus evaluate,
among other things, the progress towards the achievement of the goals set in this Plan of Action).
88Scientific data and research.Engage relevant stakeholders, including people with mental disorders and
psychosocial disabilities and their umbrella organizations, in developing and promoting a global mental health
research agenda; foster global collaborative research networks and conduct culturally validated research on
burden of disease and evaluation of progress in mental health promotion, prevention, treatment, recovery, care,
policy and services.
89Provide support to Member States to establish surveillance/information systems that serve to: define basic
indicators on mental health and on health and social services for people with mental disorders; enable an
assessment of changes that occur over time; and better understand the social determinants of mental health
problems.
90Support research aimed at resolving questions in the field of mental health, including those that have to do
with the provision of health and social services to people with mental disorders and psychosocial disabilities.
16
EXHIBIT1
Indicators to measure progress towards the defined goals of the Comprehensive

Action Plan on Mental Health 2013-2020
1. The updated indicators to assess progress towards the global targets of the Comprehensive Action Plan on
Mental Health 2013-2030 respond to part of the information and reporting needs that Member States must
meet in order to adequately monitor their mental health policies and programs . Since the targets are voluntary
and global in scope, each and every Member State is not expected to necessarily achieve all of the specific
targets, although they may contribute to varying degrees towards their joint achievement.
2. The global targets set for each goal provide the basis for measuring the collective actions and achievements of
Member States towards the global goals, but should not preclude the setting of more ambitious national
targets, especially for countries that have already achieved the global targets.
3. As indicated in objective 4 of the Plan, the Secretariat will continue to offer orientation, training, and technical
assistance to the Member States that request it to develop national information systems that allow them to
obtain data on the indicators of inputs, activities, and results of the systems. mental health The goal is to
continue to leverage existing information systems rather than create new or parallel systems.
17
Goal 2. Provide comprehensive, integrated, and adaptable mental health and social care
services in community settings
Numerator:Number of psychosis cases receiving services, obtained from periodic
Numerator:number of depression cases receiving services, obtained from periodic
18
Appendix 1
19
Objective 3. Put into practice promotion and prevention strategies in the field of mental health
Global target 3.3 80% of the countries will have a mental health preparation system and psychosocial
support to face emergencies and/or disasters by the year 2030.
Indicator Existence of a mental health preparation system and psychosocial support to deal with
emergencies/disasters.
means of Description of the countries of the mental health and psychosocial support preparation
check system that they have in operation, based on the following criteria: existence of a defined
implementation plan; allocation of financial and human resources; and documented
evidence of progress and/or impact achieved.
twenty
Appendix 1
Objective 4. Strengthen information systems, scientific data and research on mental

health
twenty-one
Appendix 2
Options for the application of the Comprehensive Action Plan on Mental Health
2013-2030
The actions proposed for Member States in this document show what can be done to achieve the objectives of the
action plan, while this annex sets out some options as to how those actions could be carried out taking into
account the various situations of the countries, especially with regard to the level of development of mental health,
health and social care systems and the availability of resources. Without claiming to be exhaustive or prescriptive,
these options propose illustrative or indicative mechanisms for undertaking the actions considered in the
countries.
Policy and legislation
Actions
Formulate, strengthen, update and implement national mental health-related policies, strategies, programmes,
laws and regulations in all relevant sectors, including codes of practice and mechanisms to monitor human rights
protection and law enforcement , in line with evidence, best practice, the Convention on the Rights of Persons with
Disabilities and other international and regional human rights instruments.
Implementation Options
• Preparation and application of a comprehensive mental health policy and plan in accordance with international
instruments on human rights, which provides for the allocation of human and financial resources and is subject to
periodic monitoring based on indicators or goals for implementation.
• Decriminalization of suicide, suicide attempts and other self-injurious behaviors.
• Establishment of an operational coordination unit or mechanism in the Ministry of Health dedicated specifically
to mental health, with its own budget and functions for strategic planning, coordination, needs assessment,
inter-ministerial and multisectoral collaboration, and evaluation of mental health services throughout the life
cycle. .
• Coordination of activities related to mental health and social care at all relevant subnational levels (eg districts,
municipalities and communities).
• Raising awareness of policy makers on mental health and human rights issues through the development of
policy briefs and scientific publications and the organization of mental health leadership courses and other
learning and knowledge sharing opportunities in the field of mental health.
• Strengthening the capacity of interested parties, in particular regulatory instances, in relation to strategies
aimed at promoting respect for the will and preferences of people in matters of mental health and related
services.
• Integration of mental health and the rights of people with mental disorders and psychosocial disabilities in all
policies, laws and sectoral strategies (for example, health, social affairs, education, justice and work/
employment), and in particular in the fields of emergency preparedness and response, poverty reduction and
development.
• Improving accountability by establishing mechanisms based on independent bodies to monitor and prevent,
and respond to, torture or cruel, inhuman and degrading treatment and other forms of ill-treatment and abuse;
collect data on the use of restraint, seclusion and involuntary treatments; and
22
Appendix 2
encourage participation in such mechanisms by relevant stakeholder groups, for example, lawyers and people
with mental disorders and psychosocial disabilities, in line with the provisions of international human rights
instruments.
• Modification or repeal of legislation that perpetuates stigmatization, discrimination and violation of the human
rights of people with mental disorders and psychosocial disabilities.
• Monitoring and evaluation of the application of policies and legislation aimed at guaranteeing compliance with
international human rights conventions, in particular the Convention on the Rights of Persons with Disabilities
and the United Nations Convention on the Rights of the Child, as appropriate , and incorporating that
information into the reporting mechanism of those conventions.
• Establishment of support mechanisms for decision-making; assistance to people in making plans in advance in
which they indicate their will and preference in case they experience a crisis in the future; and ensuring that
people have all the support they need to make a decision and, in particular, that they have access to trusted
advisers and people and receive valid information on all issues that affect their decision.
Resource planning
Measures
Plan according to quantified needs, and allocate in all relevant sectors a budget commensurate with the human
and other resources needed to implement agreed evidence-based mental health plans and actions.
• Inclusion of mental health services, such as psychosocial and psychological interventions and basic medicines
for mental disorders, in universal health coverage and financial protection systems, and offering financial
protection to socioeconomically disadvantaged groups.
• Use—and, where appropriate, collect—data on epidemiological and resource needs to inform the development
and implementation of mental health plans, budgets, and programs.
• Establishment of mechanisms to track expenditures related to different types of mental health services in the
health sector and other relevant sectors such as education, employment, criminal justice and social services.
• Determination of funds available in the planning phase of specific community-based, culturally appropriate and
cost-effective activities, in order to ensure their implementation.
• Collaboration with other stakeholders to effectively advocate for increased resource allocation to mental health,
particularly through the case for investing in mental health.
Collaboration with stakeholders
Measures
Engage stakeholders from all relevant sectors, in particular people with mental disorders, their caregivers and
their families, in the formulation and implementation of mental health-related policies, laws and services, using
official structures and/or mechanisms for this purpose.
23
• Calling, participation, and consensus-seeking of all relevant sectors and stakeholders in the planning,
development, and implementation of health-related policies, laws, and services, including knowledge sharing on
the most effective mechanisms for improving health coordination. attention and policies between the formal
and informal sectors.
• Building local capacity and sensitization of relevant stakeholders on mental health, related legislation and
human rights, and in particular on their responsibilities in implementing policies, laws and regulations.
Strengthening and emancipation of people with mental disorders and psychosocial

disabilities and their organizations
Actions
Ensure that people with mental disorders and psychosocial disabilities have official roles and powers to influence
the process of making, planning and implementing policies, laws and services.
• Provision of logistical, technical and financial support to strengthen the capacity of people with mental disorders and
psychosocial disabilities and their organizations, in particular young people and those responsible for caring for them,
so that they understand the conventions, policies, laws and services related to human rights and encourage their
introduction, based on their needs and preferences.
• Fostering and supporting the creation of independent national and local organizations of people with mental disorders and
psychosocial disabilities, and establishment of formal mechanisms to ensure their full and effective participation in the
formulation and implementation of mental health policies, laws and services, as well as in their monitoring and evaluation.
• Involvement of people with mental disorders and psychosocial disabilities in the evaluation and monitoring of all
mental health services, both public and private, including psychiatric hospitals and care centers.
• Inclusion of people with mental disorders and psychosocial disabilities and their organizations in capacity
building activities of stakeholders, including policy makers and health workers providing mental health care.
24
Appendix 2
Goal 2. Provide comprehensive, integrated, and adaptable mental health and social care
services in community settings
Reorganization of services and expansion of coverage
Actions
Instead of caring for the patient in long-stay psychiatric hospitals, systematically privilege care in non-specialized
health centers, with increasing coverage of scientifically proven interventions (including the principles of stepped
care when appropriate) for priority ailments and resorting to a network of interlinked community mental health
services, including, in addition to short hospital admissions, outpatient care in general hospitals, primary care,
comprehensive mental health centres, day care centres, support for people with mental disorders living with their
family and subsidized housing.
• Formulation of a phased and costed plan to reduce activity and close long-term psychiatric institutions and
replace them with systems to support patients to live in the community.
• Encouragement of a gradual transfer of financial and human resources to community-based care and closure of
long-term care facilities where appropriate community alternatives are available.
• Accompanying the process of reducing the activity of long-term psychiatric institutions through: a) the
protection of human rights and the improvement of the quality of life in the institutions, and b) the guarantee of
continuity of care and well-being of discharged long-term residents (for example, livelihood and housing
support, including offering places in small functional homes).
• Provision of outpatient mental health services and creation of a unit for the admission of people with mental
disorders in general hospitals.
• Creation of interdisciplinary and community-based mental health services to care for people throughout the life
cycle, for example through outreach services, home care and support, primary health care, emergency care,
rehabilitation community-based and subsidized housing.
• Integration of social assistance and mental health care into programs and services targeting specific diseases,
such as HIV/AIDS, tuberculosis, noncommunicable diseases, and neglected tropical diseases, as well as
programs and services targeting specific populations, such as maternal, sexual and reproductive health, child
and adolescent health, gender violence, and family health and welfare programs and services.
• Incorporation of service users and family members and/or caregivers with practical experience in providing peer
support.
• Support the establishment and implementation of community mental health services run by non-governmental
organizations, faith-based organizations and other community groups, including self-help and family support
groups, while respecting human rights and under the supervision of government agencies.
• Possibility of applying innovative evidence-based approaches to provide psychological support on a larger scale
(for example, guided self-help, digital self-help, collaborative and stepped-care approaches).
• Development and application of tools and strategies for self-help and care for people with mental disorders,
including strengthening the use of electronic and mobile technologies, potentially within the framework of
tiered care systems.
• Development of operational capacities, policies and procedures to deliver services remotely (for example,
telehealth) and use digital health solutions to help professionals deliver care where possible.
25
• Provision of home and community support services to caregivers of children and adults with psychosocial disabilities,
including training and other multidisciplinary services (for example, physiotherapy, occupational therapy, nutritional support,
housing access, educational support and early childhood development).
Integrated and adaptable care
Measures
Integrate and coordinate a holistic effort of prevention, promotion, rehabilitation, care and support that aims to meet
the needs of both mental and physical health care and facilitates the recovery of people of any age with mental disorders
together with the set of general services of health and social care (recovery that includes the promotion of the right to
employment, housing and education) through the application of treatment and recovery plans centered on the service
user and, where appropriate, with the contributions of family members and carers.
• Calling on health workers to initiate and support recovery plans, and to refer people to the right services and
resources based on their needs and preferences, e.g. education, work , health care and livelihood opportunities.
• Collaboration with people with mental health problems and psychosocial disabilities in the planning and delivery
of services.
• Application of guidelines for the management of the physical health of people with serious mental health problems.
• In collaboration with other sectors (for example, livelihood support, housing, education, vocational training,
employment, social welfare and legal aid), promoting the inclusion of people with mental disorders and
psychosocial disabilities in support services and programs .
• Promoting recovery-oriented and culturally appropriate care and support through awareness-raising and
training opportunities for health care and social care providers.
• Provision of information to people with mental disorders, their families and carers about the causes and
possible effects of the disorders, existing treatment and recovery options, as well as healthy lifestyle behaviours,
in order to improve your general health and well-being.
• Promoting the empowerment and participation of people with mental disorders and their families and caregivers in
mental health care.
• Acquisition and availability of basic medicines for mental disorders included in the WHO Model List of Essential
Medicines at all levels of the health system, surveillance of their rational use and authorization of their
prescription by non-specialist health professionals who have proper training.
• Strengthening the skills of health professionals to provide accurate and evidence-based information on various
possible psychosocial and pharmacological interventions and to analyze their benefits and risks, including
possible side effects and those derived from their withdrawal.
• Care for the mental well-being of children and their caregivers when a family member visits health services for
treatment of a serious illness (particularly a mental disorder).
• Provision of services and programs that address mental health needs, promote recovery and resilience, and
prevent further distress for children and adults who so request and who have experienced adverse life events,
particularly domestic violence or social unrest .
• Implementation of interventions to manage family crises and provision of care and support to families and
caregivers in primary care and services at other levels.
• Carrying out early interventions in relation to children and adolescents with mental health problems
26
Appendix 2
through family-centered health care that responds to the needs of children and adolescents, both in the primary
health care setting and in the school and community.
• Application of the WHO QualityRights standards to assess and improve the quality of services and respect for
human rights in hospital and outpatient care provided in health and social care centers, including the
application of targeted policies and procedures to prevent the use of coercive practices and services.
Mental health in humanitarian emergencies (including isolated, repeated or ongoing

conflicts, violence and disasters)
Actions
Work with national emergency committees and mental health care providers to include mental health and
psychosocial support needs in emergency preparedness and facilitate access for people with mental disorders
(whether pre-existing or caused by the emergency ) or psychosocial problems to safe support services, including
services that address psychological trauma and promote recovery and resilience, including those for health and
humanitarian personnel, during and after the emergency, paying due attention to funding for long term required
to build or rebuild a community-based mental health system after an emergency.
• Collaboration with national and subnational stakeholders from all sectors with a view to integrating mental health and
psychosocial support into all national and local emergency preparedness and response policies, plans, procedures and
measures, as established in the minimum standard of the Sphere Project and Inter-Agency Standing Committee
guidelines on mental health and psychosocial support in emergencies.
• Preparedness for emergencies through the development of guidelines for health and community workers on
basic psychosocial support measures, such as psychological first aid.
• Coordination with partners from the health, protection, nutrition and education sectors to apply during
emergencies the relevant minimum standards of the Sphere Project and the aforementioned Inter-Agency
Standing Committee guidelines.
• Inclusion of mental health and psychosocial support as integral and cross-cutting components of the response
to public health emergencies (for example, COVID-19 and Ebola virus disease), within a set of pillars or domains
These might include case management, risk communication and community engagement, continuity of services,
response coordination and operations (eg staff support).
• Using emergencies as an opportunity to create or rebuild sustainable community-based mental health and
social care systems, and demonstrate the feasibility and effectiveness of community-based models of care in
addressing the long-term increase in mental disorders in affected populations for emergencies.
27
Resource planning
Actions
Strengthen the knowledge and skills of general or specialized health personnel so that they can provide mental
health and social assistance services that are scientifically proven, culturally appropriate and governed by human
rights, both for children and adolescents and for other recipients, through the introduction of mental health in
undergraduate and graduate university curricula and through training and mentoring activities for health workers
in the field, especially in non-specialist care settings, so that they are able to recognize people with mental
disorders and offer them treatment and support or refer them, where appropriate, to other levels of care.
• Development and implementation of a strategy for building capacity and retention in the field of human
resources that allows the provision of mental health and social care services throughout the life cycle in various
health, social and educational settings, such as in the primary health care, general hospitals and schools.
• Support for pre-service and in-service training of health workers in relation to the intervention guide of the WHO
Program of Action to close the gaps in mental health, with a view to the detection and treatment of disorders
mental, neurological, and substance abuse related settings in specialized settings, the implementation of
evidence-based psychological interventions, and the use of appropriate training and supervision material for
priority expanded care.1
• Take steps to ensure that health care and social care staff have access to a cadre of supervisors with experience
in scientifically proven interventions who can provide ongoing support and mentoring services.
• Collaboration with universities, colleges and other relevant educational institutions to define a mental health
component and incorporate it into undergraduate and graduate university curricula, to offer continuing
education and knowledge sharing activities on mental health and to ensure accreditation and supervision of
mental health professionals.
• Creation of a conducive service context for health, education and social personnel to acquire training focused on the
development, monitoring and evaluation of continuous competencies and that includes clearly defined tasks, referral
structures and supervision and mentoring mechanisms .
• Enhanced capacity of health, educational and social personnel in all dimensions of their work (for example, in
relation to clinical aspects, human rights and public health), using e-learning methods where appropriate.
• Inclusion of approaches based on human rights and the recovery of people in the curricula of undergraduate and
postgraduate university courses, as well as in opportunities for continuous professional development and in
mechanisms for professional accreditation, and offer of internships and service learning practices that promote these
approaches.
• Establishment or strengthening of supervised clinical training for future mental health professionals, including
psychologists, social workers, psychiatric nurses, and psychiatrists.
• Improving working conditions, financial remuneration, and career development opportunities for mental health
professionals and other workers, including lay people, to attract and retain mental health personnel.
1
See: Cost-effective set of policy options and interventions to promote mental health and well-being. In: Follow-up to the high-level
meetings of the United Nations General Assembly on health-related issues Political declaration of the third high-level meeting of the
General Assembly on the prevention and control of noncommunicable diseases. Report of the Director General. Geneva, World Health
Organization, 2019: Annex 1 (EB146/7;https://apps.who.int/gb//ebwha/pdf_files/EB146/B146_7-sp.pdf ).
28
Appendix 2
• Collaboration with educational institutions and workplaces to improve the recruitment and retention of people with
diverse profiles (including people with direct experience in mental disorders and psychosocial disabilities) in order to
make their voices heard and diversify staff and leadership in the field of mental health.
Correction of inequalities
Actions
Take active measures to identify and provide adequate support to groups that present a special risk of mental
illness and have difficulties in accessing services.
• Identification and assessment of the needs of the different sociodemographic groups present in the community,
as well as vulnerable people who do not use the services (such as the homeless, children, the elderly, people
involved in criminal proceedings, prisoners , internally displaced persons, asylum seekers, refugees, migrants,
ethnic minorities, people who identify as LGBTIQ+, indigenous populations, people with physical and intellectual
disabilities, and people in emergencies) , and taking action to remove barriers that prevent them from accessing
treatment, care and support.
• Development of a proactive strategy to reach these individuals and groups and offer them services that meet their
needs.
• Strengthening the skills of health and social workers to better understand the needs of vulnerable people and
the social determinants of mental health, including poverty, inequality, discrimination and violence, and respond
appropriately to these factors when pay attention and support.
29
Objective 3. Put into practice promotion and prevention strategies in the field of mental health
Mental health promotion and prevention
Actions
Lead and coordinate a multisectoral strategy that combines universal and targeted interventions to promote
mental health, prevent mental disorders, and reduce stigma, discrimination, and human rights violations; that
responds to the needs of specific vulnerable groups throughout the life cycle; and that it is integrated into national
mental health and health promotion strategies.
• Development and application of national multisectoral programs for the promotion and prevention of mental health.
• Promoting public knowledge and understanding of mental health, as well as how to end discrimination and
access services, through media awareness campaigns and initiatives involving experienced people directly in
mental disorders and psychosocial disabilities.
• Inclusion of mental health care and support as part of antenatal and postnatal care provided at home and in
health facilities for new parents and/or caregivers, including practical training for the latter.
• Implementation of early childhood programs that address children's cognitive, motor, sensory, and psychosocial
development, and that foster healthy relationships with their caregivers.
• Reduction of exposure to the harmful use of alcohol, through the application of the measures provided for in the WHO Global
Strategy to reduce the harmful use of alcohol.
• Implementation of brief interventions against the consumption of dangerous and harmful substances.
• Implementation of programs for the prevention and control of domestic violence, particularly that related to alcohol
consumption.
• Protection for children and adults against mistreatment by establishing or strengthening community networks
and systems that protect them.
• Adoption of measures to meet the needs of children with parents affected by chronic mental disorders, within the
framework of promotion and prevention programs.
• Development of universal and selective school promotion and prevention activities, including programs for the
preparation of socio-emotional skills for life; programs aimed at countering bullying and violence; programs to
counter stigma and discrimination against people with mental disorders and psychosocial disabilities;
awareness-raising measures on the benefits of a healthy lifestyle and the risks of substance use; and early
detection and intervention measures for children and adolescents with emotional or behavioral problems
(including eating disorders) or neurodevelopmental disorders.
• Fighting discrimination in educational institutions and in the workplace, and promoting full access to
educational opportunities, work participation and re-employment programs for people with mental disorders
and disabilities psychosocial.
• Promotion of safe, conducive and decent working conditions for all (including workers in the informal sector),
paying special attention to aspects such as organizational improvements at work; the implementation of
scientifically proven programs to promote mental well-being and prevent mental health disorders, including the
training of managers to promote the mental well-being of their employees; introduction of stress management
interventions and workplace wellness programmes; and the fight against stigma and discrimination.
30
Appendix 2
• Empowerment of self-help groups, social support, community networks and community engagement
opportunities for people with mental disorders and psychosocial disabilities and other vulnerable people, using
digital media where possible.
• Promotion of scientifically proven traditional and cultural practices for the promotion and prevention of mental
health (for example, yoga and meditation).
• Strengthening the use of social networks in promotion and prevention strategies.
• Implementation of prevention and control strategies for neglected tropical diseases (for example, taeniasis and
cysticercosis) in order to prevent neurological problems and their consequences in the field of mental health.
• Formulation of policies and measures for the protection of vulnerable populations during financial and
economic crises, and implementation of the same by the relevant ministries (eg finance, labor and social
welfare).
suicide prevention
Actions
Develop and put into practice comprehensive national suicide prevention strategies, paying special attention to groups
in which a higher risk of suicide has been detected, such as gays, lesbians, bisexuals and transsexuals, young people or
other vulnerable groups of any age in depending on the local context.
• Developing, updating, implementing, and evaluating national suicide prevention strategies to guide
governments and key stakeholders in implementing effective preventive interventions, raising public awareness,
encouraging help-seeking, and reducing stigmatizing thoughts and behaviors suicidal.
• Public, political and media awareness about the magnitude of the problem and about the availability of effective
and scientifically proven strategies to prevent suicide.
• Prohibition of highly dangerous pesticides and restriction of access to other means of self-harm and suicide (for
example, placing medicines and firearms in high places).
• Promotion of the responsible dissemination of information in the media about suicide cases, providing training
on how to inform about it aimed at professionals in this and other fields that generate content for screens or
stages.
• Implementation of universal and selective school programs for socio-emotional learning and other interventions
aimed at strengthening the ability of adolescents to solve and face problems.
• Promotion of suicide prevention initiatives in the workplace, school and other community settings, designed to
reach risk groups, particularly adolescents and the elderly.
• Improving the response of the health system and other sectors to self-harm and suicide, including training of
personnel (for example, lay health workers, social workers, teachers, police, people working in the criminal
justice system, firefighters and other frontline responders, religious leaders) in the assessment, treatment, and
follow-up of self-harm and suicide.
• Community involvement in suicide prevention and optimization of psychosocial support based on available
community resources, both for people who self-harm or attempt suicide and for the families of people who die
from this cause.
• Formulation of community-level strategies for suicide prevention that include access to formal and informal
services, volunteer social support groups, and other culturally appropriate programs.
31
• Adequate resourcing to ensure funding for suicide prevention.

• Adoption of measures to ensure that all risk groups in relation to suicide, including indigenous peoples,
participate in the development of prevention strategies in this area.
• Conducting a situation analysis (eg, suicide and self-harm rates, specific populations at risk, most common
methods of suicide, existing activities and gaps) to guide planning of suicide prevention activities.
32
Appendix 2
Objective 4. Strengthen information systems, scientific data and research on mental

health
Information systems
Actions
Integrate mental health into the mainstream health information system and systematically identify, collect, report
and use basic mental health data disaggregated by sex and age (including data on suicides and suicide attempts)
to improve service delivery mental health and promotion and prevention strategies on the matter and to provide
information to the Global Mental Health Observatory (as part of the WHO Global Health Observatory).
• Establishment of a surveillance system for mental health, self-harm and/or suicide, and suicide attempts, breaking
down the records by center, gender, age, disability, method, and other relevant variables.
• Incorporation of information needs and indicators on mental health, self-harm and/or suicide, including risk
factors and disabilities, in population surveys and national health information systems.
• Collection of detailed data from secondary and tertiary services, in addition to those collected systematically
through the national health information system.
• Inclusion of mental health indicators in the information systems of other sectors.
• Analysis and publication of the data collected on the availability, financing and evaluation of mental health and social care
services and programs, in order to improve services and interventions at the population level.
Scientific data and research
Actions
Improve research capacity and university collaboration around national research priorities in the field of mental
health, particularly operational research that has a direct interest for the development and implementation of
services and for the exercise of human rights of people with mental disorders, including the creation of centers of
excellence that work to clear criteria, with input from all relevant stakeholders, including people with mental
disorders or psychosocial disabilities.
• Developing and promoting a funded and prioritized national mental health research agenda, based on
consultation with all stakeholders.
• Enhanced research capacity to assess needs and assess effectiveness, delivery and scale-up of services and
programmes, including human rights and recovery oriented approaches.
• Strengthening of cooperation between universities, institutes and health and social services, as well as in other
relevant settings (such as education), in the field of mental health research.
• Conducting research in different cultural contexts on understanding and expressing psychological distress, as
well as harmful (for example, human rights violations and discrimination) or protective (for example, social
support and traditional customs) practices, ways to seek help (for example,
33
traditional healers), and the efficacy, acceptability and feasibility of treatment and recovery, prevention and promotion
interventions.
• Development of methods to characterize the differences in mental health that exist between subpopulations of
the same country, in particular in relation to factors such as race and/or ethnic origin, sex, socioeconomic status
and geographic area (urban or rural), and assess the capacity of interventions to respond to the needs of specific
groups and address social determinants.
• Strengthening of collaboration between national, subnational and international research centers for the
interdisciplinary exchange of research and resources between countries.
• Promotion of rigorous ethical criteria in research related to mental health, so that these are carried out only with the
free and informed consent of the person concerned; that researchers do not receive any type of privilege, reward or
remuneration for encouraging or recruiting people to participate in research; that research not be carried out if it is
potentially harmful or dangerous; that all research be approved by an independent ethics committee that operates in
accordance with national and international standards and criteria; and that there is a significant participation of local
collaborators and interested parties in the design and implementation of the investigations, as well as in the
dissemination of the results obtained.
• Arranging for people with mental health and psychosocial disabilities and their organizations to contribute to
mental health research, for example by setting the research agenda, advising on research methods and design,
and reporting on research. your personal experience.
• Taking steps to ensure that research results have a practical translation and to transfer knowledge from
academic settings to service settings, through training of stakeholders, including policy makers and
practitioners mental health, so that they can critically evaluate the evidence, as well as by facilitating access to
unbiased and easy-to-understand information.
3. 4
For more information, please contact:
Department of Mental Health and Consumption

of Psychotropic Substances
World Health Organization
Avenue Appia 20
CH-1211 Geneva 27 (Switzerland)
https://www.who.int/teams/mental-health-
andsubstance-use

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Comprehensive mental health action plan 2013-2030

ISBN 978-92-4-005018-1 (electronic version)

© World Health Organization 2022

Cataloging (CIP).It can be consulted inhttp://apps.who.int/iris .

Overview of the world situation 2

Structure of the Comprehensive Action Plan on Mental Health 2013-2030 5

Proposed actions for Member States and national and international

Annex 1: Indicators to measure progress towards the defined goals of the

Annex 2: Options for the application of the Comprehensive Action Plan

In addition, mental health services are an essential component of the health

Dr Tedros Adhanom Ghebreyesus

World Health Organization

Overview of the world situation

Mental health and mental disorders: determinants and consequences

Resources and responses from the health system

Structure of the Comprehensive Action Plan on Mental Health 2013-2030

22The Action Plan has the following objectives:

3. implement promotion and prevention strategies in the field of mental health;

4. strengthen information systems, scientific data and research on mental health.

23The Action Plan is based on six transversal principles and approaches.

3. Practices based on scientific evidence.Therapeutic, prophylactic and promotional strategies and

Proposed actions for Member States and national and international

Proposed actions for Member States

Actions for the Secretariat

Proposed actions for national and international partners

Proposed actions for Member States

Actions for the Secretariat

Proposed actions for national and international partners

Proposed actions for Member States

Actions for the Secretariat

Proposed actions for national and international partners

Objective 4. Strengthen information systems, scientific data and research on

Global Target 4.2:Global mental health research output doubles by 2030.

Proposed actions for Member States

Actions for the Secretariat

Proposed actions for national and international partners

Indicators to measure progress towards the defined goals of the Comprehensive

Numerator:Number of psychosis cases receiving services, obtained from periodic

Numerator:number of depression cases receiving services, obtained from periodic

Objective 4. Strengthen information systems, scientific data and research on mental

Policy and legislation

Collaboration with stakeholders

Strengthening and emancipation of people with mental disorders and psychosocial

Reorganization of services and expansion of coverage

Integrated and adaptable care

Mental health in humanitarian emergencies (including isolated, repeated or ongoing

Mental health promotion and prevention

• Adequate resourcing to ensure funding for suicide prevention.

Objective 4. Strengthen information systems, scientific data and research on mental

Scientific data and research

Department of Mental Health and Consumption

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