Strengthening Mental Health in UN’s Sustainable Development Goals

The global burden of mental illness has long been a concern to many organizations, including APA. Issues of equity and compassion mandate that we help those who have been most marginalized and, absent focused efforts, would be left behind in efforts to achieve optimal health and well-being. Mental disorders are a major cause of human suffering and a threat to development and growing economies—one that has been almost completely neglected by the United Nations (UN). The UN made no reference to mental health in 2000 in its Millennium Development Goals. Now, as the UN considers the Post-2015 Sustainable Development Goals (SDGs) Agenda, a standardized international action plan for countries and nongovernmental organizations, there has been far too little significance attached to the global impact of mental disorders.

International agencies and foundations have not yet fully appreciated that mental illnesses are among the biggest causes—if not the biggest cause—of the global burden of disease. One in four people experiences mental health problems over the course of a lifetime, and around 600 million people worldwide are disabled as a consequence. The large majority of people with mental illness are not able to access effective treatment, and in low-income countries, less than 10 percent receive care, a huge “treatment gap.” Globally, mental health systems and services are consistently underfinanced, and on average, low-income countries allocate less than 1 percent of their health budgets for mental health services. Worldwide, people with mental health conditions often experience stigma, discrimination, and serious human rights violations, as well as shortened life expectancy from treatable mental and general medical conditions.

These issues alone make a strong case for strengthening reference to mental health in the SDGs. Yet, the implications of mental health to the SDGs’ wider social and economic goals are far more extensive. Mental health is a cross-cutting issue, having interdependencies with many of the UN development goals. A list of the goals is posted at here.

Poor nutrition is a risk factor for depression, and a poor diet among people with severe mental illness contributes to worse physical health (Goal 2). There are clear disparities in life expectancy; for people with mental illness, life expectancy is up to 20 years lower among men and 15 years lower among women. Comorbid physical and mental illness means poorer outcomes for both because, for example, of worse treatment adherence for people who have HIV/AIDS and depression (Goal 3). Educational stressors are risk factors for mental health problems and suicidality (Goal 4). Mental health also affects economic growth and employment. People with mental illness have far lower rates of employment than average, while economic recession relates to worse mental health in the population (Goal 8). Mental health is also interlinked with environmental issues, as disasters increase the prevalence of depression and anxiety in populations (Goal 15). Poorer mental health is a precursor for poorer resilience to conflict, while conflict itself raises the risks for adverse mental health consequences (Goal 16).

In the most recent draft of the SDGs, the UN only very briefly mentions mental health in Goal 3, which is “Ensure healthy lives and promote well-being for all at all ages.” It is imperative that mental illness is given its appropriate importance in the post-2015 agenda proportionate with its impact on populations across the world. APA has formally joined a global initiative called FundaMentalSDG, led by professional, consumer, and civil organizations in many countries, to advocate for strengthening reference to mental health in the SDGs by three editorial changes to Goal 3 (see box).

Time is of the essence, as the UN negotiations will conclude in a final SDG resolution in September. We strongly encourage you to join the FundaMentalSDG effort and to reach out to your governmental representatives including permanent representatives to the UN and the secretary of state to support the proposed edits. You can find a template letter here.

Mental health plays a key role in achieving social inclusion and equity, universal health coverage, access to justice and human rights, and sustainable economic development. APA is proud to work with colleagues across the world to include a strong mental health reference within the SDGs. Your help will increase the commitment of governments and organizations to provide more resources to address mental health issues and to achieve the fundamental equity and fairness that all those with mental health conditions deserve. ■