WHO’s $60 million mental health initiative should not ignore nursing
Nurses are strangely absent from the World Health Organisation’s five-year plan on mental health
Nurses are strangely absent from the World Health Organization’s five-year plan on mental health
A five-year mental health initiative launched by the World Health Organization (WHO) seeks to ensure access to high quality, affordable mental healthcare for an additional 100 million people in 12 as yet unnamed countries.
This is a laudable aim that is supported by the International Council of Nurses (ICN) – high quality care for mental health is one of our priorities. Nurses around the world will no doubt work tirelessly to achieve this goal.
Nurses are not only advocates, but on the front line
The WHO admits that ‘mental healthcare has had many advocates but there has been limited commitment and funding for sustained implementation and scale-up of services’.
Though governments must decide how they spend their health budgets, the WHO guidance should have an impact on the future funding of mental health services, and that can only be a good thing.
However, the four-page document that describes the WHO’s $60 million initiative does not mention nurses or nursing, and that is a missed opportunity.
Having a chief nursing officer at the WHO since 2017 has helped massively in raising the profile, status and recognition of nurses, but clearly there is still some way to go in the field of mental health.
WHO focus on nurses could make a difference
One area where the WHO could fruitfully spend some of that $60 million is on nurses.
Some countries, the UK included, have specialist registered mental health nurses who have unique skills that can make a world of difference to people who are in desperate need of help, support and treatment.
But all registered nurses should be educated and equipped to provide holistic care for patients, whatever their problems.
The toll of mental health problems worldwide
- 800,000 lives are lost to suicide each year
- Mental health conditions are the cause of one in five of all years lived with disability
- Anxiety and depression cost the global economy $1 trillion a year
- People with mental health conditions often experience severe human rights violations, discrimination and stigma
- Effective evidence-based care is available, but provision of services is lacking
Nurses challenge stigma and discrimination
Nurses are a vital link because they can intervene to prevent problems developing when patients are exhibiting early signs of mental distress. And they can also be there at the patient’s side in the long term.
The stigma and discrimination that people with mental health problems face are hard to bear, but nurses can help to change societal norms and values, and nursing care can help people maintain their dignity in the face of what can feel like societal indifference.
Of course, the kind of support that is needed for chronic debilitating mental health conditions cannot be achieved in a one-off ten-minute intervention: it is time-consuming and demanding, and it can put pressure on the workforce over the long term.
Around the world there are shortages of nurses in all areas of nursing, and that is especially true when it comes to those providing mental health care.
‘If expert mental health nursing is missing from the narrative it can become invisible, and that makes securing investment in the profession more difficult’
In physical healthcare we have strong evidence about how increasing the number of registered nurses on wards improves outcomes for patients.
In mental health nursing we do not have the same level of evidence, but we know from the UK NHS Confederation and anecdotally that shortages of mental health nurses lead to services being put under increased strain.
What this means is that mental health nurses are working in trying conditions, and patients may not be getting optimal care.
The ICN is working closely with the WHO on a number of issues relating to mental health care, and we are pleased to have recently given special affiliate status to the International Nurses Society on Addictions.
Nurses’ role in mental healthcare: addressing the knowledge deficit
It’s becoming a bit of a mantra for me, but what we need are sufficient numbers of well-educated and supported nurses who have the time and resources to do the job they are paid to do.
When people talk about mental healthcare they often speak of medical and social care and fail to mention nursing care. If expert mental health nursing is missing from the narrative it can become invisible, and that makes securing increased investment in the profession and improved education so much more difficult.
Clearly there is a job to be done to increase global leaders’ understanding of the critical contribution nurses bring to improving mental health care, and the ICN is committed to working with the WHO to correct that knowledge deficit.
Howard Catton is chief executive of the International Council of Nurses