Comprehensive planning for mental health system reform: lessons learned from the WHO Special Initiative for Mental Health.

Abstract

The WHO Special Initiative for Mental Health is an ambitious cross-country program currently operating in nine countries: Argentina, Bangladesh, Ghana, Jordan, Nepal, Paraguay, Philippines, Ukraine and Zimbabwe. The goal of the program is to promote mental health system reform at the national level, shifting from an institutional care model to community-based care following a person-centered and rights-based approach. An initial planning phase of the program involved developing country-specific implementation plans through multi-stakeholder workshops, which resulted in national-level logical frameworks. Through the present study, a thematic analysis was carried out to explore the main commonalities across all countries' plans. The results show that countries converge on a number of commonalities, including the broad-reaching, multifaceted and multi-sectoral nature of national reform strategies, a focus on person-centered and community-driven initiatives and recognition of the added value of institutional structures and expert advice on key issues such as monitoring and evaluation. The results of the present study can help guide future exercises of this kind in other countries.