Elsevier

The Lancet

Volume 392, Issue 10157, 27 October–2 November 2018, Pages 1553-1598
The Lancet

The Lancet Commissions
The Lancet Commission on global mental health and sustainable development

https://doi.org/10.1016/S0140-6736(18)31612-XGet rights and content

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Executive summary

The Sustainable Development Goals (SDGs) represent an exponential advance from the Millennium Development Goals, with a substantially broader agenda affecting all nations and requiring coordinated global actions. The specific references to mental health and substance use as targets within the health SDG reflect this transformative vision. In 2007, a series of papers in The Lancet synthesised decades of interdisciplinary research and practice in diverse contexts and called the global community

The journey so far

In 2015, all nations united around a shared mission of achieving the Sustainable Development Goals (SDGs). The SDGs were an exponential advance from the Millennium Development Goals, both in their aspiration to encompass a substantially broader agenda and through their recognition that these were global concerns, affecting all nations and requiring global actions to address them. A notable example of this transformative vision was the recognition that health burdens went beyond the focus of the

Reframing mental health

In this section, we present the three guiding principles that underpin this Commission. The first principle is the expansion of mental health from the existing focus on clinically defined mental disorders to a broader dimensional approach to mental health (panel 3). The second principle is one of convergence, which refers to the alignment of evidence from diverse fields, including the genetic, developmental, social, and biological determinants of mental health. The final principle upholds

Interventions for mental health

In this section we address the interventions that we consider necessary to prevent mental and substance use disorders, and to provide treatment and care to enhance recovery. We present these interventions according to stages of the life course, particularly stressing aspects that we find innovative, with the potential for scaling up, and which could be delivered either through routine health care or other platforms.156 We use case studies to show the implementation of these interventions in the

The way forward

Considerable progress has been made in the global mental health agenda in the past decade, but much more needs to be achieved in all countries, especially in resource-poor settings, by overcoming the barriers already described. The sustainable development framework provides an opportunity to reframe mental health and make it an integral component of the broader global development agenda. Although mental health is explicitly recognised in SDG 3, all other SDGs have been conceptualised to be

Mental health is a global public good

Mental health has often been considered as a concern exclusive to people with biomedically defined mental disorders. Although that focus continues to be important, mental health should be viewed as a universal human attribute and an indivisible component of overall health—important to all people in all countries and at all ages. Indeed, mental health is a global public good. In its simplest conceptualisation, global public goods are those that should be accessible to all people worldwide, to

Conclusion

When world leaders adopted the SDGs, they were committing themselves to action on a much larger scale than ever before in the history of humanity. Promoting mental health, preventing mental disorders, and including mental health care in universal health coverage are part of this agenda. Although “no health without mental health”267 is an important aspiration, the era of “no sustainable development without mental health” has begun. Mental health has remained in the shadows for far too long.

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