Time for hard choices: A new global order for mental health

Geopolitical determinants of mental health: Towards a global perspective

“…Persaud et al (2022) have interestingly commented data from the World Health Organization (WHO, 2020) Mental Health Atlas reporting the results of WHO Comprehensive Mental Health Action Plan. A qualitative analysis of this document suggests a disappointing report on the adequacy of mental health services in the triennium 2017 to 2020, globally.…”

“…Migration is one of the most important geopolitical determinants of mental health and a growing body of evidence confirms that risk factors associated to migration are: migration- related traumas, social adjustment, acculturation and socio-cultural bereavement, economic distress and unemployment, stigma and racial discrimination (Bhugra et al, 2020). In this regard, Persaud et al (2022) reported that the COVID-19 pandemic added insecurity among fragile populations and increased the global burden of displacement with +20 million of migrants in the last six years, mostly moving to get out the poverty trap. Migration is also associated to the process of globalization which has led to a rapid urbanization and increase of pollution, both impacting on individual well-being and mental health.…”

“…Parameters considered in the evaluation included policies, promotion and prevention as well as financing actions adopted over time, all described as below the expected standards. Persaud et al (2022) also argued that the impact of the ongoing COVID-19 pandemic seemed to be relatively poor on the quality and utilization of mental health services in the 2017 to 2020 triennium. Nonetheless, it has been largely described that the cope with the continuing emergency is leading to a growing need for mental health support.…”

“…In fact, the ongoing pandemic may be considered as one of multiple determinants which contribute to global mental health. It is of interest that a set of geopolitical issues may shape the mental health needs and services across different countries and cultures, as proposed by Persaud et al (2022): climate changes, urbanization and pollution, migration and human traffic, poverty and gross national product, access to health care and vaccines, governance and policies, etc. It is of note that climate changes and climatic conditions (e.g.…”

“…Access to the health care system is also geopolitically determined: poverty and lower gross national product have been recognized as leading causes of mental illness even if the economic development does not necessarily improve the national mental health spending (Gupta et al, 2016). In addition, as pointed out by Persaud et al (2022), there has been a decline in democracy in the last years, above all in the course of pandemic, International Journal of Social Psychiatry 69 (1) with leaders opting to autocratically oriented governments, as demonstrated by the ongoing Russo-Ukrainian crisis.…”