A process study of early achievements and challenges in countries engaged with the WHO Special Initiative for Mental Health.

Background: There is increasing awareness of the importance of the transformation of mental health systems. Launched in 2019, the WHO Special Initiative for Mental Health seeks to accelerate access to quality and affordable care for mental health conditions as an integral component of Universal Heal...

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Publicado en:International Journal of Mental Health Systems Vol. 18; no. 1; pp. 1 - 12
Autores principales: Ager, Alastair, Hermosilla, Sabrina, Schafer, Alison, Kestel, Dévora
Formato: research tables/charts Journal Article
Publicado: BioMed Central 10/21/2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 10/21/2024
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      pub: BioMed Central
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        atl: A process study of early achievements and challenges in countries engaged with the WHO Special Initiative for Mental Health.
      aug:
        au:
          Ager, Alastair
          Hermosilla, Sabrina
          Schafer, Alison
          Kestel, Dévora
        affil: https://ror.org/002g3cb31 Institute for Global Health and Development, Queen Margaret University, Edinburgh, Scotland
      sug:
        subj:
          World Health Organization
          Mental Health
          Program Evaluation
          Program Development
          Implementation Science
          Human
          Funding Source
          Structured Interview
          Stakeholder Participation
          Thematic Analysis
          Health Care Delivery
          Leadership
          Clinical Governance
          Workforce
          Legislation
          Health Policy
          Politics
          Quality of Health Care
          Healthcare Disparities
          Descriptive Statistics
      ab: Background: There is increasing awareness of the importance of the transformation of mental health systems. Launched in 2019, the WHO Special Initiative for Mental Health seeks to accelerate access to quality and affordable care for mental health conditions as an integral component of Universal Health Coverage. Nine countries are currently engaged with the initiative. Methods: This study reviewed processes of implementation—and progress achieved—across all settings by late 2022. It involved review of 158 documents provided by WHO relating to Special Initiative activities and 42 interviews with country-level stakeholders, WHO Regional and HQ personnel engaged with the initiative, and core donors. Documents were thematically coded using a template based upon the WHO framework of health system building blocks. Responses to structured interviews were coded based on an emergent thematic framework. Results: Documentation reported similar achievements across all domains; however challenges were reported most frequently in relation to service delivery, leadership and governance, and workforce. Issues of financing were notable in being twice as likely to be reported as a challenge than a success. Interviews indicated four major areas of perceived achievement: establishing a platform and profile to address mental health issues; convening a multi-stakeholder, participatory engagement process; new, appropriate services being developed; and key developments in law, policy, or governance around mental health. The planning process followed for the initiative, senior country-level buy-in and the quality of key personnel were the factors considered most influential in driving progress. Ambivalent political commitment and competing priorities were the most frequently cited challenges across all interviewees. Conclusions: The role of the Special Initiative in raising the profile of mental health on national agendas through a participatory and inclusive process has been widely valued, and there are indications of the beginnings of transformational shifts in mental health services. To secure these benefits, findings suggest three strategic priorities: increasing political prioritisation and funding for systems-level change; clearly articulating sustainable, transformed models of care; and promoting feasible and contextualised measures to support accountability and course correction. All are of potential relevance in informing global strategies for mental health systems transformation in other settings.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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