The Lancet's Series on Global Mental Health: 1 year on

A little over a year ago, The Lancet published a Series of fi ve articles on Global Mental Health that documented the current evidence for global mental health, with a focus on low-income and middle-income countries. The fi nal paper in the Series made a call to scale up evidence-based packages of services for people with mental disorders with a commitment to the protection of human rights. The Series and the call to action that concluded it has received support from leaders in world health (panel 1). 1 year on, we take stock of the eff ect of this Series, focusing on implementation of the call for action. Although 1 year is a short time to see substantial outcomes, and defi nitively attributing events to the Series is impossible, our objective is to discern the commitment of stakeholders and the general direction they are taking since publication. We consulted the members of an advisory group set up soon after the Series was published to track major events. Only events that explicitly cited or were based on The Lancet’s Series were counted. We have organised our fi ndings in four broad themes: the eff ect on global advocacy; the eff ect on global-health programmes; the eff ect on policies, resources, and professional societies; and the launch of a new Movement for Global Mental Health. Raising awareness of mental health is key to improving policies and practices, increasing access to services, and reducing persistent stigma. The World Federation for Mental Health established World Mental Health Day in 1992, and coordinates and promotes its commemoration on Oct 10 every year. The only annual global awareness campaign focusing specifi c attention on mental health and mental disorders, World Mental Health Day is now marked in over 100 countries through public awareness and education events. The theme in 2008 is “Making Mental Health A Global Priority— Scaling Up Services through Citizen Advocacy and Action”. World Mental Health Day, 2008, uses the information and messages contained in The Lancet’s Series to encourage renewed attention to the need for well-informed mental-health public policy advocacy at all levels in countries throughout the world. The aim of this year’s campaign is to generate a sense of urgency and to fuel advocacy eff orts locally and globally to scale up services for people living with mental disorders. The central message of World Mental Health Day, 2008, is clear: “It is time for governments throughout the world to listen and act to improve mental health services and increase availability and access to services by those experiencing serious mental health problems and disorders such as schizophrenia, anxiety disorders, bipolar disorder, and depression.” The specifi c focus on civil society calls upon citizens, human-rights groups, and non-governmental organisations to implement the call for action through several interlinked strategies (panel 2). WHO has recently developed the Mental Health Gap Action Programme to address the large treatment gap for mental, neurological, and substance-use (MNS) disorders. The programme provides health planners, policy makers, and donors with clear and coherent activities and programmes for scaling up care for MNS disorders. The objectives of the programme are to reinforce the commitment of all stakeholders to increase the allocation of fi nancial and human resources for care of MNS disorders and to achieve higher coverage with key interventions, especially in countries with low and low-middle incomes that have large proportions of the global burden attributable to these disorders. The Mental Health Gap Action Programme provides criteria to identify the countries that have a high burden of MNS disorders and a high resource gap. This programme is grounded on the best available evidence about MNS disorders that have been identifi ed as priorities; it promotes the delivery of an integrated package of interventions and takes into account existing and possible barriers to scaling up care. Priority Lancet 2008; 372: 1354–57