1. Mental Health Policy, Plans and Programmes Presentation prepared by: Dr. Michelle Funk (Coordinator) & Ms. Natalie Drew (Technical Officer), Mental Health Policy and Service Development, Department of Mental Health and Substance Dependence Prof. Crick Lund, Director of the Centre for Public Mental Health & Associate Professor, Department of Psychiatry and Mental Health at UCT © WHO, 2013. All rights reserved. Permission has been granted to University of Pittsburgh to use and disseminate this presentation for non-commercial purposes.

2. Aims of the Presentation Conceptual introduction to mental health policy, plans, programmes Practical guidance for developing and implementing MH policy, plans and programmes WHO Module on Mental Health Policy, Plans and Programmes (WHO Mental Health Policy and Service Guidance Package)

3.  Policy makers  Public health professionals  Service planners and managers  Users, families and carers  Advocacy organizations  Service providers Target Audience

4. What is Mental Health Policy? Mental health policy is an organized set of values, principles and objectives for improving mental health and reducing the burden of mental disorders in a population.

5. Why Do We Need Mental Health Policy? Written mental health policy: – Provides a general blueprint – Gives priority to mental health – Helps to develop mental health services in a coordinated, systematic manner – Identifies key stakeholders – Allows different stakeholders to reach agreement

6. Differences between Policy, Plans and Programmes PlansStrategies Time Frames Financing Areas for Action ProgrammesInterventionsResourcesBudgetPolicyVisionValuesPrinciplesObjectives

7. WRITTEN MH POLICY, PLAN & PROGRAMME POPULATION’S NEEDS EVIDENCE CONSULTATION & NEGOTIATION DETERMINING MAIN AREAS PILOT PROJECTS DEVELOPING A PLAN & PROGRAMME D ISSEMINATION SUPPORTINGORGANIZATION MANAGEMENT REGULATION POLICYIMPLEMENTEDTHROUGH PLAN & PROGRAMME EMPOWERMENT OF PROVIDERS INTERSECTORALCOORDINATION DevelopmentImplementation

8. Developing a Mental Health Policy Step 1 : Assess the population’s needs. Step 2: Gather evidence for effective policy. Step 3: Consultation and negotiation. Step 4: Exchange with other countries. Step 5: Vision, values, principles and objectives. Step 6: Determine areas for action. Step 7: Identify major roles and responsibilities. Step 8: Conduct pilot projects..

9. Developing a Mental Health Plan Step 1. Set priorities for the major strategies. List areas for action from the Policy: -Financing -Human resources and training -Etc. Evaluate each using a SWOT analysis: -Strengths and Weaknesses of the present mental health services and programmes -Opportunities and Threats in the country (or in an administrative division) Set priorities.

10. (cont.) Developing a Mental Health Plan (cont.) Step 2. Establish the time frame and resources. Determine the time frame of the strategies. Calculate the cost of each strategy and the total cost of the plan for every year. Adjust the time frame of the strategies to the amount of financial resources. Replan the time frame and resources annually.

11. Developing a Mental Health Programme Step 1: Identify the issue or problem to be addressed. Step 2: Set out programme objectives. Step 3: Choose appropriate programme interventions. Step 4: Describe programme activities.

12. Step 5: Identify responsible agents. Step 6: Set out a time frame. Step 7: Draw up a budget. Step 8: Evaluate the programme. Developing a Mental Health Programme (cont.)

13. Implementation Issues for Policy, Plans and Programmes Step 1: Disseminate the policy.  Organize a public event with the media.  Print and distribute booklets, posters and leaflets.  Hold meetings with health teams, consumers, families, advocacy groups and other stakeholders.  Organize national and international seminars.

14. Implementation Issues… Step 2: Generate political support.  Well-placed persons who can advocate at the highest levels of government and in key agencies.  The mental health professionals in the ministry of health should become involved in meetings with authorities. The goal of these actions is to demonstrate the importance of mental health!

15. Implementation Issues… Step 3: Develop supportive organization.  Ministry of Health: A multidisciplinary team (psychiatrists, public health physicians, psychologists, psychiatric nurses, social workers and occupational therapists).  Health District: A multidisciplinary team.  Community Mental Health Teams: A coordinator with a few hours a week.  Primary Health Care Teams: A mental health coordinator.

16. Implementation Issues… Step 4: Set up a demonstration area.  A region or a sector of a city where the policy, plan and programme can be implemented more rapidly and evaluated more thoroughly.  The knowledge from a demonstration area is vital for the success of the policy.  It is helpful to orient MH professionals at Health Districts.  It serves as a training center for other districts.

17. Implementation Issues… Step 5: Empower MH providers.  Public mental health providers  Private mental health providers  Traditional health workers  Mutual aid groups  Non-governmental, voluntary and charitable organizations  Mental health consumers and families as providers

18. Implementation Issues… Step 6: Intersectoral coordination.  Coordinating with professionals from other Ministries  Supporting MH professionals in health districts to implement intersectoral interventions  Enhancing coordination among local health teams and other sector teams

19. Implementation issues… Step 7: Interactions among stakeholders  Ministry of Health and other national or regional stakeholders  Health districts and the Ministry of Health  Health districts and providers  Consumers and providers

20. Conclusion Mental health outcomes from Policy, Plans and Programmes:  Alleviation of symptoms  Improved functioning in various areas  Enhancement of productivity at work  Improvement in the quality of life  Prevention of psychological and social disability  Reduction in mortality (e.g. suicide)

21. WHO RESOURCES… …for developing and implementing mental health policies, plans, laws and services in line with international best practice and human rights standards.

22. WHO MiNDbank More Inclusiveness Needed in Disability & Development National resources  Mental health policies, strategies and laws  Substance abuse policies, strategies & laws  Disability related policies, strategies & laws  Health policies, strategies and laws  Health & mental health service standards  Capacity related legislated  Human rights & child rights legislation  National constitutions  Poverty reduction & development strategies International & Regional resources  International and regional human rights conventions and treaties  CRPD Member States reports, Shadow Reports & Concluding Observations  UN Special Rapporteurs reports  Key World Health Organization resources  UN and WHO resolutions http://www.mindbank.info/

23. 14 inter-related Modules Practical, step by step guidance Essential components of mental health system development, e.g.: o policy, plans and programmes o service organization o financing o advocacy o information systems o quality improvement o human resources and training Checklists for mental health policies & plans Improving Health Systems and Services for Mental Health – executive summary of WHO Package WHO Report on Integrating Mental Health into Primary Care: A Global Perspective WHO Mental Health Policy and Service Guidance Package

24.  How to conduct a comprehensive assessment of inpatient and outpatient mental health facilities  How to report the findings of the assessment  How to use the results and recommendations to improve quality of care and human rights WHO QualityRights Toolkit

25.  A call to action to all development stakeholders to focus attention on mental health  Evidence that persons with mental disabilities are a vulnerable group  Appropriate policies and programmes to reach out to persons with mental disabilities  Inclusion of mental health interventions into development strategies  Describes key interventions as a starting point for these efforts WHO Report on Mental Health and Development: targeting people with mental health conditions as a vulnerable group