Law and Policy Are Essential but Insufficient to End Stigma and Discrimination in Mental Health

It is a terrible indictment on us as humans that we stigmatise and discriminate against individuals or groups because of their perceived difference or “otherness”. We welcome this new Lancet Commission 1 Thornicroft G Sunkel S Alikhon Aliev A et al. The Lancet Commission on ending stigma and discrimination in mental health. Lancet. 2022; (published online Oct 9.)https://doi.org/10.1016/S0140-6736(22)01470-2 Summary Full Text Full Text PDF PubMed Google Scholar and its aim to end stigma and discrimination in mental health, rather than merely reduce it. The Commission comes at a time when mental health movements are gaining momentum globally, and the UN and its agencies are advocating greater recognition of mental health and transformed mental health services. 2 WHOWorld mental health report: transforming mental health for all. World Health Organization, Geneva2022https://www.who.int/publications/i/item/9789240049338Date accessed: September 12, 2022 Google Scholar , 3 UNICEFThe state of the world's children 2021: on my mind—promoting, protecting and caring for children's mental health. United Nations Children's Fund, New York, NY2021https://www.unicef.org/reports/state-worlds-children-2021Date accessed: September 12, 2022 Google Scholar The importance of mental health to economic and social development is now also conclusive. 2 WHOWorld mental health report: transforming mental health for all. World Health Organization, Geneva2022https://www.who.int/publications/i/item/9789240049338Date accessed: September 12, 2022 Google Scholar However, the WHO Mental Health Atlas shows that most countries lag behind in mental health policy, laws, and services and real change in mental health is distressingly slow. 4 WHOMental health atlas 2020. World Health Organization, Geneva2021https://apps.who.int/iris/handle/10665/345946Date accessed: September 12, 2022 Google Scholar Globally, budgets and resources for mental health services are hugely inadequate and unequally distributed. 5 Saxena S Thornicroft G Knapp M Resources for mental health: scarcity, inequity, and inefficiency. Lancet. 2007; 370: 878-889 Summary Full Text Full Text PDF PubMed Scopus (1067) Google Scholar , 6 Vigo D Kestel D Pendakur K Thornicroft G Atun R Disease burden and government spending on mental, neurological, and substance use disorders, and self-harm: cross-sectional, ecological study of health system response in the Americas. Lancet Public Health. 2019; 4: 89-96 Summary Full Text Full Text PDF PubMed Scopus (68) Google Scholar The extent to which neglect of mental health can be attributed directly to a perception by governments that mental health is not as important as physical health and to other stigma-related concerns is not straightforward 7 Freeman M Investing for population mental health in low and middle income countries—where and why?. Int J Ment Health Syst. 2022; 16: 38 Crossref PubMed Scopus (0) Google Scholar but these factors are likely to be involved. Centring lived experience in anti-stigma programmesWe welcome the Lancet Commission on ending stigma and discrimination in mental health by Graham Thornicroft, Charlene Sunkel, and colleagues.1 Ending stigma and discrimination in mental health is an ambitious request, but the Commission's six goals for stigma reduction and eight recommendations for action by global organisations, governments, employers, the health-care and social-care sectors, the media, people with lived experience, local communities, and civil society provide a blueprint for the way forwards “to act now to stop stigma and start inclusion”. Full-Text PDF The Lancet Commission on ending stigma and discrimination in mental healthIt is time to end all forms of stigma and discrimination against people with mental health conditions, for whom there is double jeopardy: the impact of the primary condition and the severe consequences of stigma. Indeed, many people describe stigma as being worse than the condition itself. This Lancet Commission report is the result of a collaboration of more than 50 people worldwide. It brings together evidence and experience of the impact of stigma and discrimination and successful interventions for stigma reduction. Full-Text PDF