People with psychosocial disabilities are often ‘invisible’, have limited access to services and are excluded from full participation in community life. This is particularly true in developing countries, where already scarce resources are often not allocated to mental health and support services. CBM and partners take a community-based approach in tackling these issues.
Mental Health is a Development Issue
Good mental health is essential for the well-being and functioning of individuals, families, communities and societies. There is increasing evidence to show that apart from the personal impact of social exclusion that psychosocial disability can result in, there is an enormous loss to communities and the economy if people with psychosocial disabilities cannot participate in society and the economy. A 2016 World Bank report calculated that over 1 trillion dollars is lost to the global economy due to mental illness every year, a figure that will rise to 6 trillion dollars by 2030 if urgent action is not taken to address growing needs.
Psychosocial disabilities are a leading cause of disability worldwide, accounting for around 1/3 of all disability globally (measured using Years Lives with Disability) according to the WHO. Suicide is estimated to be a cause of a million deaths annually around the world. In many countries this is the highest cause of death among young people. Despite this, few resources are dedicated to this group, and mental health services are among the least prioritised in many countries.
The last decades have seen a significant growth in interest in mental health as a development issue. This is evident in the Sustainable Development Goals (SDGs), which includes many important references to mental health and wellbeing. Psychosocial disabilities are increasingly recognised as an essential component of disability inclusive development, and in many countries stronger organisations of people with psychosocial disabilities are growing, where they previously did not exist. The UN Convention on the Rights of Persons with Disabilities (CRPD) provides a basis for people with psychosocial disabilities to challenge their exclusion, and hold governments accountable to commitments regarding their rights.
CBM and Community Mental Health
In many of the poorest countries in the world, where CBM focuses its work, the populations are exposed to poverty and unemployment, migration, and have poor health and education systems. All these increase risks of poor mental health. Therefore, CBM works to address these environmental factors, working with communities to reduce stigma, exclusion, and barriers to participation. CBM also works in emergency contexts, reducing the impact of emergencies on communities through mental health and psychosocial support, and strengthening community resilience and preparedness for future events.
A strong evidence base for effective, culturally appropriate, community-based interventions has grown, and CBM partners with many health providers, including governments, to strengthen health systems, education, social protection and other systems to help people to access quality care, and close the treatment gap. CBM and partners contributed to the development and field trials of the WHO’s mhGAP programme, and the QualityRights Toolkit, which helps local actors to advocate and act to bring mental health services more in line with the CRPD. The Community Mental Health Initiative builds on this work.
This previously invisible group is now starting to be better organised so that they can speak with their own voice. There is a long way to go, but there are now many positive signs that more people with psychosocial disabilities are starting to be able to find their own path to recovery and full participation in communities.