Mental health is determined by an interplay of individual, social and structural factors that can strengthen or weaken mental well-being. These determinants may be local or global and include threats such as poverty, violence, disasters, economic downturns, disease outbreaks, conflict, humanitarian emergencies and forced displacement as well as environmental stresses including climate change.
The determinants of mental health can be influenced by interventions that reduce risks, build resilience and establish supportive environments. These include promotion and prevention programmes that are embedded within and across sectors. The health sector can facilitate the reshaping of the determinants by advocating, initiating and facilitating multisectoral collaboration. These programmes can be designed for specific groups or whole populations and involve sectors such as education, labour, justice, transport, housing, environment and social welfare.
People living on the margins are particularly vulnerable to mental health conditions. They often live with insufficient income and lack access to affordable healthcare. In addition, they are subject to stigma and discrimination and are unable to participate in the democratic process.
While the majority of low-income and middle-income countries are able to treat their citizens with mental illnesses, there remains a significant gap between the treatment burden and the amount of public funding allocated for mental health services. The gap is exacerbated by the fact that governments prioritize spending on infectious diseases and neglect mental health care. Nonetheless, there is growing evidence that the vast majority of conditions can be effectively treated with a combination of non-specialist psychological counselling and medications.
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