Mental health in general health care
Mental health care in general health-care settings includes the development and integration of inpatient and outpatient services in general hospitals and polyclinics, and the treatment and prevention of common mental disorders in community-based and/or primary health care.
The WHO European Mental Health Action Plan 2013–2020 emphasizes the need for collaborative and multidisciplinary partnerships, and for community-based care. The shift from hospital-based service delivery to service delivery in general health-care settings necessitates training and education for primary health-care professionals. General practitioners play a key role in identifying and referring people with mental health complaints.
The WHO Mental Health Gap Action Programme Intervention Guide (mhGAP-IG) for mental, neurological and substance use disorders in non-specialized health settings is a valuable tool for scaling up mental health services and making them accessible, competent, affordable and available in communities.
The substantial level of comorbidity between mental disorders and other noncommunicable diseases (NCDs) is a key reason to integrate mental health into general health care. Mental disorders affect, and are in turn affected by, major NCDs; they can be precursors to or consequences of chronic conditions such as cardiovascular diseases, diabetes or cancer. Risk factors for these diseases, such as sedentary behaviour and harmful use of alcohol, are also risk factors for mental disorders.
Although comorbidities between mental disorders and major NCDs are substantial and lead to both worse outcomes for those affected and higher costs for health systems, they are often unaddressed in clinical practice.
A stronger focus on comorbidities between mental disorders and major NCDs is needed. WHO/Europe’s 2017 report “Addressing comorbidity between mental disorders and major noncommunicable diseases” provides insight into this issue and suggests approaches for improving integrated care.