Mental Health Atlas 2024

As many as 85 per cent of the member states who responded had compiled data on mental health in the two years preceding the survey. Around 42 per cent did it as part of general health survey while the rest did it as part of specific mental health survey for either the public or private sectors. In the past 10 years, only 36 per cent of member states had conducted a national mental health survey.

Availability of national level digital health records including those on mental health was reported by 44 per cent of responding low-income countries and 74 per cent of high-income countries. About 79 per cent of the countries with digital health records stated having unique identification numbers to track individual use of mental health services.

The atlas also collected information on the kinds of mental health related indicators collected by countries. It notes that around 82 per cent of respondent countries collected data on the number of patient admissions to psychiatric units in general hospitals. A slightly fewer percentage (76 per cent) maintained records of the number of people using mental health outpatient services. Data on the outcomes of mental health treatments were collected by even fewer countries – just 54 per cent.

Implementation of mental health policies in responding countries was also noted in the 2024 atlas. Plans and policies were considered implemented only if two of the following three conditions were met: estimation and allocation of necessary human resources; estimation and allocation of necessary financial resources; specification of indicators or targets to aim for under the plans and policies.

Around 61 per cent of the respondents stated they had published or updated their policies since the previous atlas, most of them from the south east Asia region. This, the atlas says, is an important finding since only 25 per cent of countries had updated or published policies between 2013 and 2020, and only 14 per cent before 2013.

About three quarters of the of the responding countries (72 per cent) stated they had distinct laws for mental health. But the laws of only 45 per cent of the countries with such legislation were fully compliant with human rights instruments.

In 50 per cent of responding countries patients contributed less than five per cent towards the cost of inpatient and outpatient care, and psychotropic medication. They also took up less than half of the psychological therapy cost. In some other countries, patients contributed most of the financing for their treatment.

The global median government health expenditure on mental health was 2.1 per cent of the overall health expenditure, the same as in 2017 and 2020. It varied a little from around 1.5 per cent in low-income countries to 4.3 per cent in high income countries.

Data from responding countries showed that the global median number of specialised mental health workers is 13.5 per 100,000 people. The atlas admits to some possible under-estimation of workers from the non-governmental sector due to lack of data but says that despite it, most of the health care workers are working in the public sector and number just 9.6 per 100,000 people.

The progress in mental health reform is still slow, the atlas notes. Around 53 per cent of participating countries are only in early stages of transition from psychiatric hospitals to community-based care. In such countries, beds and services are still located mostly in psychiatric hospitals. Only nine per cent of countries have fully completed the transition, that is, there were no more psychiatric hospitals and mental health care was provided in general hospitals or community care.

The atlas notes that 70 per cent of countries operated hospital-based mental health outpatient services for children and adolescents. The availability differed drastically between low-income and high-income countries with only 30 per cent of the former countries reporting such services compared to 90 per cent of the latter.

Only 47 per cent of responding countries reported having a national policy or plan for suicide prevention, a slight increase from the 40 per cent in 2020. However, the disparity was high amongst countries – only six per cent of low-income countries had a strategy compared to 67 per cent of high-income countries.

Focus and Factoids by Saismit Naik.

PARI Library's health archive project is part of an initiative supported by the Azim Premji University to develop a free-access repository of health-related reports relevant to rural India.