Community-based mental health care shows better outcomes: WHO

New Delhi: Community-based mental health care shows better outcomes and countries in the South-East Asia region should prioritise the transition from long-stay institutional mental health services to community-based care to ensure these services are accessible and stigma-free, the World Health Organisation said on Tuesday.

Transitioning from long-stay tertiary psychiatric institutions to community-based care is beneficial for both individuals and the society at large, Saima Wazed, Regional Director, WHO South-East Asia, said in a virtual address to the regional meeting on 'Transitioning from long-stay services to community mental health networks: towards deinstitutionalisation in WHO South-East Asia Region'.

When these services are integrated into the fabric of communities, it becomes easier for individuals to seek help without the fear of judgment or discrimination. This shift also allows for greater personal autonomy, improved quality of life, and personalised care options, she said.

"Community-based settings provide individuals opportunities to regain a sense of independence and engage in social and vocational activities, which can significantly improve their overall well-being," Wazed said.

An estimated 13.7 per cent of the population in the region suffers from mental health conditions.

The treatment gap for mental health conditions remains as high as 95 per cent. More than 2,00000 people die of suicide every year. People with severe mental disorders die 10 to 20 years earlier than others. However, investment in mental health remains very low across the region, Wazed said.

The regional director also released a report on 'Deinstitutionalisation of people with mental health conditions in WHO South-East Asia Region', which while acknowledging the complexities and unique contexts of each country, offers recommendations that can be adapted to local realities.

"This report can serve as a catalyst for change, igniting a process that results in every person leading a life of dignity, purpose, and fulfilment," Wazed, who champions the cause of mental health and has set it as one of her top priorities as regional director, said.

Long-stay mental health institutions, including psychiatric hospitals and asylums, are often characterised by the absence of effective treatment, segregation, poor living conditions, lack of resources, and overcrowding.

The transition from institutional care to community-based care is driven by a growing understanding of the negative impact of long-term institutionalisation, advances in treatments, and recognition of human rights and dignity of individuals with mental disorders.

"Historically mental health care has been synonymous with institutionalisation. Large asylums were built with the intention of providing a place of refuge for those grappling with mental illnesses. However, as our understanding of mental health has evolved, so too must our methods of care," Wazed said.

Earlier, the Paro Declaration on universal access to people-centred mental health care and services, adopted by member countries of the Region in 2022, and the Regional Action Plan for Mental Health for the WHO South-East Asia Region 2023-2030, emphasised on the shift to community-based services.

Besides being more efficient, community-based services are also better equipped to identify mental health concerns at an early stage, reducing the need for crisis intervention. This approach benefits individuals, alleviates the burden on emergency services and reduces the overall cost of mental health care, she said.

Community-based mental health care shows better outcomes, reduces treatment gap, and increases coverage, Wazed stated.

Community-based care models emphasise the creation of safe and supportive living environments within the broader society, which not only benefits individuals with mental disorders but also promotes empathy and understanding among the public, dispelling misconceptions, and reducing stigma.

Successful deinstitutionalisation, moving from tertiary care to community care, requires careful planning, collaboration, additional financial resources, and continuous monitoring. It needs parallel expansion of community care services and networks.