ODI: Global mental health from a policy perspective: a context analysis
Characterising mental health and recommending engagement strategies for the Mental Health Innovation Network
Overseas Development Institute; Jessica Mackenzie, author
November 2014 :: 44 pages
Report pdf: http://www.odi.org/sites/odi.org.uk/files/odi-assets/publications-opinion-files/9285.pdf

Abstract
Mental health is a critically important issue in global health today and yet does not receive due policy attention. This report characterises mental health as a policy issue, and draws upon the experience of different social movements across global health to provide lessons for this field. It presents an array of engagement strategies to specifically inform how the Mental Health Innovation Network (MHIN) can best help to improve policy influence across aspects of the global mental health community.

Executive Summary [excerpt]
Mental health is a critically important issue in global health today, and yet does not receive due policy attention. Mental illness will likely affect one in four people within their lifetime and neuropsychiatric conditions now account for 13% of the global burden of disease – with 70% of that burden in low- and middle-income countries (WHO, 2001; Lopez et al., 2006). Despite this, mental health has not yet achieved the policy influence that would be proportionate to its burden, nor ‘commensurate visibility, policy attention, or funding’ that is warranted (Tomlinson and Lund, 2012).

This report applies several theoretical approaches to analyse mental health as a policy issue and the particular challenges it faces. This report applies the Overseas Development Institute (ODI)’s ‘Knowledge, Policy and Power’ (KPP) framework to assess the characteristics of mental health as a policy issue. It also applies other supporting analytical approaches regarding the tractability of a policy issue and for assessing the effectiveness of global health networks. The report focusses on mental health at a global level, but highlights the need for more detailed analysis at a more local level, given that policy traction is highly dependent on local context, actors and systems of decision-making.

By characterising the different aspects of mental health as a policy issue, it becomes easier to understand why it has faced problems achieving policy influence to date and what opportunities there are to harness change. Characteristics such as stigmatisation, heterogeneity, a recently emergent user movement, the individualistic nature of treatment, the role of the informal sector, low financial investment and lack of data, all act as barriers to achieving policy traction (as well as appropriate access to care, prevention and treatment). These features mean that the salience of the issue is diminished, its actual severity and prevalence is concealed and its ‘solvability’ negatively influenced.

However some positive entry points are also identified in the characteristics of mental health as a policy issue. Public interest in mental health, particularly in high income countries, is growing. Over the past 20 years the interest in promoting mental health and providing solutions has grown dramatically (Friedli, 2009; Secker, 1998; WHO, 2001; WHO, 2013). As public interest increases there will be corresponding demand for information and advice, which leaves the global mental health community (and networks like the Mental Health Innovation Network) well placed to be heard and have influence. While more detailed and rigorous political economy analysis is required, the changing international policy environment suggests that there could be a tipping point approaching in coming years for mental health. Increased international commitments and reporting against set targets will help to mitigate many of the current barriers, and the role of donors like Grand Challenges Canada (with funding from the Government of Canada) will be crucial in future. If the network can engage in the most effective way, and harness this potential upcoming opportunity, there could be a vast improvement in the way that mental health is treated as a policy issue…