Expert Speak Health Express
Published on Sep 09, 2023
Can mental health become a priority pillar for future G20 Presidencies?

World Suicide Prevention Day (WSPD) on September 10th annually serves as a poignant reminder of the pressing need to address the global scourge of suicide. With an estimated 703,000 lives lost to suicide each year, equivalent to one life every 40 seconds, the urgency for concerted action is undeniable. WSPD transcends mere observance; it embodies a call to action, emphasising the urgency to destigmatise conversations surrounding mental health and to implement evidence-based preventive strategies. Amidst the gravity of these numbers, the G20's potential to drive mental health into the limelight emerges as a transformative opportunity.

Addressing suicide complexity through collective action 

Suicide is a complex and multifaceted issue, transcending demographic boundaries and influenced by psychological, social, and situational factors. Vulnerability is heightened among those contending with mental health disorders or traumatic experiences. The importance of accessible healthcare and support cannot be overstated, underscoring the critical role of addressing underlying factors such as poverty, inequality, and education. While suicide reduction aligns with the Sustainable Development Goals (SDGs), progress has been marred by conflicts, climate change, and the global upheaval caused by the COVID19 pandemic.

Collaborative endeavours between governments and international entities have paved the way for suicide prevention measures. National plans have been implemented to identify and support individuals at risk. However, while global bodies like the World Health Organisation (WHO) have aggregated data and endorsed strategies, challenges remain due to partial implementation, necessitating enhanced commitment and better coordination.

Objectives Comprehensive Mental Health Action Plan 2013–2020 targets Progress achieved and values for 2019. (Mental Health Atlas 2020)
Objective 1: To strengthen effective leadership and governance for mental health Target 1.1: 80% of countries will have developed or updated their policy or plan for mental health in line with international and regional human rights instruments (by 2020) 99 countries, 51% of WHO Member States (Value is based on a self-rating checklist)
Target 1.2: 80% of countries will have developed or updated their laws for mental health in line with international and regional human rights instruments (by 2020) 74 countries, 39% of WHO Member States (Value is based on a self-rating checklist)
Objective 2: To provide comprehensive, integrated, and responsive mental health and social care services in community-based settings Target 2: Service coverage for mental health conditions will have increased at least by half (by 2020) -  A global median of 29% of persons with psychosis are receiving mental health services. -  A global median of 40% of persons with depression are receiving mental health services
Objective 3: To implement strategies for promotion and prevention in mental health-based settings Target 3.1: 80% of countries will have at least two functioning national, multisectoral mental health promotion and prevention programmes (by 2020) 101 countries, 52% of WHO member states (self-completed inventory of current programmes)
Target 3.2: The rate of suicide will be reduced by 10% (by 2020) 9.0 per 100 000 population (Value is based on an age-standardised global estimate). Global age-standardised suicide rate reduced by 10%
Objective 4: To strengthen information systems, evidence and research for mental health Target 4: 80% of countries will be routinely collecting and reporting at least a core set of mental health indicators every two years through their national health and social information systems (by 2020) -  62 Member States, 31% of WHO Member States, compile mental health-specific data at least in the public sector -  Additionally, 78 Member States, equivalent to 40% of WHO Member States, compile mental health data as part of general health statistics only. (Value is based on self-rated ability to regularly compile mental health-specific data covering at least the public sector).
Table 1: Comprehensive Mental Health Action Plan 2013–2020: progress values for global targets and objectives. Source: Mental Health Atlas 2020

The G20's transformative potential in mental health governance 

Initially established for economic cooperation, the G20 has evolved into a platform addressing global crises and health concerns. Acknowledging mental health in the G20 Rome Leaders' Declaration underscores its potential impact on mental health governance. By consistently prioritising mental well-being, allocating resources, enhancing provider training, and sharing effective practices, G20 member nations can pave the way for transformative global mental health governance. While individual nations approach mental health uniquely, a collective effort can establish ground-breaking standards.

During its G20 presidency, India has actively prioritised and advocated for the importance of mental health in various sectors. The nation called upon G20 leaders to establish national environmental health policies, emphasising strategies for mental health and the significance of holistic inner development for sustainable peace. In the realm of employment, India underscored the imperative of integrating human-centric mental health policies and training in workplaces. The country is also committed to crafting resilient and inclusive health systems, aiming for Universal Health Coverage (UHC) that guarantees comprehensive mental and physical well-being, especially for women and vulnerable groups. G20 co-branded event focused on adolescent health and initiatives such as Tele-Manas were introduced. This program provides a specialised tele-mental health service for the youth at no cost and highlights the importance of healthcare tailored to adolescents, particularly in the realm of mental health. Furthermore, the event emphasised the need to foster international cooperation and collaboration. This entails sharing effective models, harmonising policies, and rallying resources to address adolescent health challenges globally.

A holistic approach encompassing both top-down and bottom-up strategies can propel mental health to the forefront. The G20's influence in shaping global priorities is significant, and integration into core G20 dialogues, resource mobilisation, and standardised best practices are top-down approaches that can drive progress. Simultaneously, a bottom-up strategy involves engaging local communities through awareness campaigns and initiatives. Collaborations with community groups, schools, and leaders reinforce the significance of mental well-being. Civil society participation bridges the gap between policy formulation and practical implementation, yielding a richer understanding of challenges and solutions.

Leveraging Brazil's G20 Presidency for mental health 

Brazil's imminent G20 presidency offers a critical juncture to confront the complexities entrenched within mental health. Drawing upon its history of engagement in international cooperation and its stature as a prominent emerging economy, Brazil is poised to spearhead collaborative efforts among member nations. The far-reaching impact of the pandemic serves as a stark reminder of the imperative for global action on mental health, underscoring the significance of international cooperation and the exchange of knowledge. In addition to these efforts, Brazil can take a pioneering stance in advocating for the inclusion of marginalised populations, ensuring that mental health services are not only accessible but also culturally sensitive. Embedding mental health within wider developmental agendas resonates with a holistic approach to well-being, tackling the underlying social determinants that influence mental health outcomes.

As Brazil takes the helm of the G20, the global spotlight turns towards harnessing its leadership to prioritise mental health on the international stage. Building upon its rich history of diplomatic engagement and its status as a significant emerging economy, Brazil stands poised to orchestrate a harmonious symphony of collaboration among G20 member countries. The ongoing pandemic has illuminated the pressing need for unified global action in the realm of mental health, accentuating the urgency of international cooperation and the shared dissemination of knowledge.

Beyond these vital efforts, Brazil has the opportunity to blaze a trail in advocating for marginalised communities, ensuring that mental health services are not only accessible but also attuned to the diverse cultural contexts they serve. Furthermore, integrating mental health within the broader spectrum of developmental agendas underscores a holistic vision of well-being that acknowledges and addresses the intricate social determinants that influence mental health dynamics. As Brazil guides the G20 towards a future of collective well-being, mental health assumes a central role in shaping a healthier and more equitable world for all.

Analysing stakeholders in mental health development 

Recent research published by the Observer Research Foundation shows that mental health assistance exposes a stark misalignment between donor priorities and recipient needs. Fragmented services, inadequate resources, and pervasive stigma plague mental health in low- and middle-income countries. International collaboration is vital to share knowledge and implement effective strategies for detection, prevention, and treatment.

Development assistance for mental health (DAMH) serves as a vital conduit for providing essential resources to these countries. Scrutinising funding patterns uncovers the significance of mental health assistance (MHA) within health sectors. Donor funding patterns have experienced fluctuations, with an abrupt increase in 2018 followed by a dip in 2020 due to the redirection of funds to address the COVID-19 pandemic.

The researchers further show that donor contributions to MHA have remained relatively modest, comprising only a fraction of total health assistance. Private sector financial contributions by corporations, foundations, and individuals have led the way. While upper-middle-income countries often report higher Disability Adjusted Life Years (DALYs), they receive minimal mental health assistance. Conversely, low-middle, and lower-middle-income countries receive more aid. Recipients of MHA primarily encompass non-governmental organisations (NGOs), international bodies, and bilateral agencies.

The journey towards global mental well-being 

As World Suicide Prevention Day approaches, the world's attention turns to the pressing need for mental health prioritisation and suicide prevention. The G20 stands as a powerful platform for global cooperation, holding the potential to propel mental well-being to the forefront. Through collaborative efforts, the integration of strategic approaches, and the strategic utilisation of Brazil's presidency, the G20 can usher in significant progress in global mental health governance. The urgency surrounding suicide prevention necessitates united action, and the G20 can serve as a catalyst for change in this critical endeavour. With commitment, collaboration, and a comprehensive approach, the G20 has the capacity to guide us toward a future where mental health occupies a central place in global priorities, saving lives and nurturing holistic well-being for all.

Viola Savy Dsouza is a PhD Scholar at Department of Health Policy, Prasanna School of Public Health.

Jestina Rachel Kurian is a research scholar at Prasanna School of Public Health pursuing her Ph.D. in data science related to biomedicine.

Sanjay Pattanshetty is Head of the Department of Global Health Governance and Coordinator of Centre for Health Diplomacy, Prasanna School of Public Health, Manipal Academy of Higher Education.

Oommen C. Kurian is Senior Fellow and Head of Health Initiative at the Observer Research Foundation.

The views expressed above belong to the author(s). ORF research and analyses now available on Telegram! Click here to access our curated content — blogs, longforms and interviews.


Viola Savy Dsouza

Viola Savy Dsouza

Miss. Viola Savy Dsouza is a PhD Scholar at Department of Health Policy Prasanna School of Public Health. She holds a Master of Science degree ...

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Jestina Rachel Kurian

Jestina Rachel Kurian

Mrs. Jestina Rachel Kurian is a research scholar at Prasanna School of Public Health pursuing her Ph.D. in data science related to biomedicine. She has ...

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Oommen C. Kurian

Oommen C. Kurian

Oommen C. Kurian is Senior Fellow and Head of Health Initiative at ORF. He studies Indias health sector reforms within the broad context of the ...

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Sanjay Pattanshetty

Sanjay Pattanshetty

Dr. Sanjay M Pattanshetty is Head of theDepartment of Global Health Governance Prasanna School of Public Health Manipal Academy of Higher Education (MAHE) Manipal Karnataka ...

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