Addressing comorbidities and risk factors for tuberculosis (TB) is a crucial component of the World Health Organization (WHO)’s End TB Strategy. This WHO operational handbook on tuberculosis. Module 6: tuberculosis and comorbidities aims to support countries in scaling up people-centred care, based on the latest WHO recommendations on TB and key comorbidities, and drawing upon additional evidence, best practices and inputs from various experts and stakeholders obtained during WHO processes. It is intended for use by people working in ministries of health, particularly TB programmes and the relevant departments or programmes responsible for comorbidities and health-related risk factors for TB such as HIV, diabetes, undernutrition, substance use, and tobacco use, as well as programmes addressing mental health and lung health. This operational handbook is a living document and will include a separate section for each of the key TB comorbidities or health-related risk factors. The second edition includes guidance for HIV-associated TB and on mental health conditions, which are two conditions strongly associated with TB and which result in higher mortality, poorer TB treatment outcomes and negatively impact health-related quality of life. The operational handbook aims to facilitate early detection, proper assessment and adequate management of people affected by TB and comorbidities. Full implementation of this guidance is expected to have a significant impact on TB treatment outcomes and health-related quality of life for people affected by TB.
These guidelines were produced by the World Health Organization (WHO), Department of Mental Health and Substance Abuse, in collaboration with the United Nations Office on Drugs and Crime (UNODC) a Guidelines Development Group of technical experts, and in consultation with the International Narcotics Control Board (INCB) secretariat and other WHO departments. WHO also wishes to acknowledge the financial contribution of UNODC and the Joint United Nations Programme on HIV/AIDS (UNAIDS) to this project. " - p. iv
This integrated operational framework provides an overview of the connections between mental health, neurological and substance use (MNS) conditions, and their links to health, well-being and the broader public health and sustainable development agenda. The need for integrated approaches is increasingly recognized as critical to address the complex interactions between mental health, brain health, substance use, and physical health, particularly in light of global threats such as the COVID-19 pandemic. The framework also provides a series of actions for governments and health service planners and advisors to achieve integration across four domains: leadership and governance; care services; promotion and prevention; and health information systems, evidence generation and research.
This atlas is aimed at collecting, compiling and desseminating information on mental health resources in the world. It presents updated and expanded information from 192 countries with analyses of global and regional trends as well as individual country profiles. Newly included in this volume is a section on epidemiology within the profiles of all low and middle income countries. It shows that mental health resources within most countries remain inadequate despite modest improvments since 2001. Availability of mental health resources across countries and between regions remains substantially uneven, with many countries having few resources. The atlas reinforces the urgent need to enhance mental health resources within countries.
An explicit mental health policy is an essential and powerful tool for a mental health section in a ministry of health. When properly formulated and implemented through plans and programs, policy can have a significant impact on the mental health of populations. This module sets out practical steps for the development of policies, plans and programmes and for their implementation. Specific examples from countries are used to illustrate the process of developing policy, plans and programs throughout the module. Also available: WHO Mental Health Policy and Service Guidance Package--14 modules Other modules included in the package: Improving Access and Use of Psychotropic Medicines Child and Adolescent Mental Health Policies and Plans Mental Health Context Mental Health Financing Advocacy for Mental Health Quality Improvement for Mental Health Organization of Services for Mental Health Planning and Budgeting to Deliver Services for Mental Health Mental Health Legislation and Human Rights Mental Health Policies and Programmes in the Workplace Mental Health Information Systems Human Resources and Training in Mental Health Monitoring and Evaluation of Mental Health Policies and Plans
This report discusses a range of issues related to the concept of mental health promotion, including the relationship of mental health to mental illnesses; a rationale for the place of mental health promotion within public health, alongside prevention of mental illness and the treatment and rehabilitation of people living with mental illnesses and related disabilities; various perspectives on mental health as a public health issue, types of evidence and the feasibility of mental health promotion strategies; examples of the interventions possible and the responsibility of various sectors; and activities that could be undertaken immediately within a variety of resource settings.
This module examines key aspects of monitoring and evaluation as they relate to a mental health policy and plan including how to monitor a plan and the different ways to evaluate a policy and plan. It presents a five-step process for conducting evaluations and explains how results of an evaluation can be utilized to improve policies and plans. The module then provides a detailed case study of a policy and plan of a hypothetical country. It describes various ways that evaluation can be used over a period of time to assess and influence policy and the plan that arises from it including the practical steps involved in policy evaluation and the policy decisions that can be made on the basis of monitoring and evaluations. Also available: 14-module package: WHO Mental Health Policy and Service Guidance Package - 14 modules Other modules included in the package: Improving Access and Use of Psychotropic Medicines Child and Adolescent Mental Health Policies and Plans Mental Health Policy Plans and Programmes. Updated version Mental Health Context Mental Health Financing Advocacy for Mental Health Quality Improvement for Mental Health Organization of Services for Mental Health Planning and Budgeting to Deliver Services for Mental Health Mental Health Legislation and Human Rights Mental Health Policies and Programmes in the Workplace Mental Health Information Systems Human Resources and Training in Mental Health Monitoring and Evaluation of Mental Health Policies and Plans
This introductory module describes the current global context of mental health. Beginning with an outline of the current burden of mental disorders the module sets the stage by describing the historical background to the current situation and summarising recent developments in the understanding treatment and care of people with mental disorders. An analysis is provided of trends in global health reform and their implications for mental health. To illustrate how these global trends can be addressed by governments and to introduce the reader to the guidance package a summary is then provided of the modules in the guidance package. This module will enable readers to gain an understanding of the global context of mental health and to select which modules will be useful to them in their particular situations. Also available: 14-module package: WHO Mental Health Policy and Service Guidance Package - 14 modules Other modules included in the package: Improving Access and Use of Psychotropic Medicines Child and Adolescent Mental Health Policies and Plans Mental Health Policy Plans and Programmes. Updated version Mental Health Context Mental Health Financing Advocacy for Mental Health Quality Improvement for Mental Health Organization of Services for Mental Health Planning and Budgeting to Deliver Services for Mental Health Mental Health Legislation and Human Rights Mental Health Policies and Programmes in the Workplace Mental Health Information Systems Human Resources and Training in Mental Health Monitoring and Evaluation of Mental Health Policies and Plans
Mental health can be improved through the collective action of society. Improving mental health requires broadly based policies and programmes, as well as specific activities in the health field relating to the prevention and treatment of ill health. .
This publication highlights key issues and principles to be considered in the drafting, adoption and implementation of mental health legislation and best practice in mental health services. It contains examples of diverse experiences and practices, as well as extracts of laws and other legal documents from a range of different countries, and a checklist of key policy components. Three main elements of effective mental health legislation are identified, relating to context, content and process.
The purpose of this module is to present a clear and rational planning model for assessing the needs of local populations for mental health care and planning services. The module includes detailed technical information to assist planners to assess their current mental health services, use epidemiological data to calculate the resources required for mental health care, set budgeting and planning targets and implement those targets. Using practical examples to illustrate the calculations throughout, the module aims to provide countries with a set of planning and budgeting tools to assist with the delivery of mental health services. Other modules included in the package: Improving Access and Use of Psychotropic Medicines Child and Adolescent Mental Health Policies and Plans Mental Health Policy, Plans and Programmes. Updated version Mental Health Context Mental Health Financing Advocacy for Mental Health Quality Improvement for Mental Health Organization of Services for Mental Health Mental Health Legislation and Human Rights Mental Health Policies and Programmes in the Workplace Mental Health Information Systems Human Resources and Training in Mental Health Monitoring and Evaluation of Mental Health Policies and Plans
Quality determines whether services increase the likelihood of achieving desired mental health outcomes and whether they meet the current requirements of evidence-based practice. Quality is important in all mental health systems because good quality ensures that people with mental disorders receive the care they require and that their symptoms and quality of life improve. This module sets out practical steps for the improvement of the quality of mental health care.
Financing is a critical factor in the implementation of a viable mental health system. This module provides guidance on how to assess current financing mechanisms for mental heath maximise the resource base for mental health and make the best use of available funds to promote mental health reforms. Also available: 14-module package: WHO Mental Health Policy and Service Guidance Package - 14 modules Other modules included in the package: Improving Access and Use of Psychotropic Medicines Child and Adolescent Mental Health Policies and Plans Mental Health Policy Plans and Programmes. Updated version Mental Health Context Mental Health Financing Advocacy for Mental Health Quality Improvement for Mental Health Organization of Services for Mental Health Planning and Budgeting to Deliver Services for Mental Health Mental Health Legislation and Human Rights Mental Health Policies and Programmes in the Workplace Mental Health Information Systems Human Resources and Training in Mental Health Monitoring and Evaluation of Mental Health Policies and Plans
The organisation of mental health services has an important bearing on the effectiveness of service delivery and on the achievement of objectives of national mental health policies. This publication does not aim to prescribe a single model for service organisation, as this depends on the social, cultural, political and economic context within individual countries; rather it seeks to highlight examples of good practice in successful service delivery models in order to provide guidance to countries in different regions of the world on the key issues involved. This publication is also available as part of a set of eight mental health policy and service publications containing practical guidance to assist policy-makers and planners in WHO member countries (ISBN 0119894173).
This report presents compelling evidence that people with mental health conditions meet major criteria for vulnerability. The report also describes how vulnerability can lead to poor mental health, and how mental health conditions are widespread yet largely unaddressed among groups identified as vulnerable. It argues that mental health should be included in sectoral and broader development strategies and plans, and that development stakeholders have important roles to play in ensuring that people with mental health conditions are recognized as a vulnerable group and are not excluded from development opportunities. The recommended actions in this report provide a starting point to achieve these aims."--Page xxiv.
All over the world, people with mental disabilities, intellectual disabilities and substance abuse problems are subject to poor-quality care and violations of their human rights. Mental health services fail to integrate evidence-based treatment and practices, resulting in poor recovery outcomes. The stigma associated with these conditions means that people experience exclusion, rejection and marginalisation by society. Misconceptions about people with such disabilities - that they are incapable of making decisions or taking care of themselves, that they are dangerous or objects of pity and welfare - mean they face discrimination in all aspects of life. They are denied opportunities to work, to get an education and to live fulfilling, independent lives in the community. The aim of the WHO QualityRights tool kit is to support countries in assessing and improving the quality and human rights of their mental health and social care facilities. The tool kit is based on an extensive international review by people with mental disabilities and their organisations. It has been pilot-tested in low-, middle- and high-income countries and is designed to be applied in all of these resource settings.
Prevention of mental disorders: effective interventions and policy options, on which this summary report is based, offers an overview of international evidence-based programmes and policies for preventing mental and behavioural disorders. It focuses on primary prevention rather than secondary or tertiary prevention. It describes the concepts relating to prevention; the relationship between prevention of mental disorders and the promotion of mental health; malleable individual, social and environmental determinants of mental disorder; the emerging evidence on the effectiveness of preventive interventions; the public health policy and practice implications; and the conditions needed for effective prevention"--Preface.
This report presents the recommendations of a WHO Expert Committee responsible for reviewing information on psychoactive substances to assess the need for their international control. The report contains a summary of the Committee's evaluations of y-hydroxybutyric acid (GHB) and ketamine. GHB was recommended to be rescheduled from Schedule IV to Schedule II of the Convention on Psychotropic Substances. The report also discusses the nine substances that were prereviewed: dextromethorphan, tapentadol, N-benzylpiperazine (BZP), 1-(3-trifluoromethylphenyl)piperazine (TFMPP), 1-(3-chlorophenyl)piperazine (mCPP), 1-(4-methoxyphenyl) piperazine (MeOPP), 1-(3,4-methylenedioxybenzyl)piperazine (MDBP), y-butyrolactone (GBL), and 1,4-butanediol (1,4-BD). Of these, tapentadol, BZP, GBL and 1,4-BD were recommended for critical review. Issues identified for consideration at future Expert Committee meetings are also listed. Furthermore, the report discusses the use of terms, the use of pharmacovigilance data for the assessment of abuse and dependence potential, balancing medical availability and prevention of abuse of medicines manufactured from controlled substances, and improving the process for substance evaluation.
For a large proportion of the global population, mental health and work are integrally intertwined. Mental health is more than the absence of mental health conditions. Rather, mental health is a state of mental well-being that enables people to cope with the stresses of life, to realize their abilities, to learn well and work well, and to contribute to their communities. Mental health conditions occur irrespective of whether work has causally contributed to them. Poor mental health has a negative effect on a person’s cognitive, behavioural, emotional, social and relational well-being and functioning, their physical health, and their personal identity and well-being as related to work. A person’s capacity to participate in work can be consequently impaired through a reduction in productivity and performance, reduction in the ability to work safely, or difficulty in retaining or gaining work. Presenteeism (or lost productivity, which is where the largest financial costs lie), absenteeism and staff turnover affect both workers and employers and, in turn, the society’s economy. An estimated 15% of working-age adults have a mental disorder at any point in time. The size of the public health problem of mental health conditions is greater than the volume of investment to address it. This is the case despite international conventions calling for the protection of workers’ physical and mental health through national policies in occupational safety and health.
About four out of five people in low- and middle-income countries who need services for mental, neurological and substance-use conditions do not receive them. Even when available, the interventions often are neither evidence-based nor of high quality. WHO recently launched the mental health Gap Action Programme (mhGAP) for low- and middle-income countries with the objective of scaling up care for mental, neurological and substance-use disorders. This mhGAP Intervention Guide has been developed to facilitate mhGAP-related delivery of evidence-based interventions in non-specialised health-care settings. The Intervention Guide is brief so as to facilitate interventions by busy non-specialists in low- and middle-income countries. It describes in detail what to do but does not go into descriptions of how to do. It is important that the non-specialist health-care providers are trained in using the mhGAP Intervention Guide in assessing and managing people with mental, neurological and substance-use disorders.
This volume is part of a series of publications which contain practical guidance to assist policy-makers and planners in member countries with policy development to address public mental health needs and service provision. This volume highlights the importance of advocacy in mental health policy and service development, a relatively new concept, aimed at reducing stigma and discrimination, and promoting the human rights of people with mental disorders. It considers the roles of various mental health groups in advocacy and sets out practical steps for implementation, indicating how governments can support advocacy services. The full package of eight volumes in the series is also available (ISBN 0119894173).
This exceptional book responds to the intense current interest in defining and understanding the contribution of traditional medical knowledge and the intervention techniques of traditional healers to national mental health services around the world. First book on traditional healing and transcultural psychiatry Delineates the knowledge and clinical skills of traditional healers from diverse cultural areas around the world Describes the clinical and social roles of traditional healers in their communities and the challenges of constructing national mental health programs that include traditional knowledge and healing techniques Assesses issues on efficacy and safety of traditional healers' interventions Includes contributions from leading scholars in this field from South Africa, India, New Zealand, Andorra, Canada, USA, Italy, and the Quichua and Sioux Lakota Nations of South and North America Theme of culture versus science: The psychiatrists discuss the effects of local culture upon mental health and consider the impact, benefit and incorporation of traditional healing as a tool for the clinical psychiatrist Easy to use with case studies and vignettes throughout and a glossary to explain any technical terms Psychiatrists and Traditional Healers: Unwitting Partners in Global Mental Health is a valuable addition to the bookshelf of a wide array of mental health trainees, researchers and professionals interested in cultural psychiatry in general and the role of traditional healers around the world.
The Mental health policy and service guidance package was produced under the direction of Michelle Funk and supervised by Benedetto Saraceno. Soumitra Pathare and Alberto Minoletti prepared this module--P. iii.
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