Overview
DFID’s strategy on disability inclusion recognises mental health as a “fundamental part of being human” (DFID, 2018), and momentum has slowly grown for the promotion of mental health, including prevention and care, and protection of the rights of those with lived experience. First formally recognised in the World Health Organisation’s (WHO) inaugural Global Mental Health Action Plan 2013-2020 (2013), mental health has become a global health and development priority. International and high-level commitment has been reinforced through a variety of multisectoral efforts. These include introduction of relevant targets within the UN Sustainable Development Goals (SDG) (e.g. 3.4, 3.5, and 3.8) (Patel et al., 2018) and the Global Reference List of 100 Core Health Indicators (WHO, 2018), ratification of the Convention on the Rights of Persons with Disabilities (CRPD) (UN, 2006; DFID, 2018), and development of leadership in knowledge generation and priority setting through collaborative bodies such as the Lancet Commission on Global Mental Health (Patel et al., 2018).
Mental health is also undergoing a reconceptualisation as the current global agenda around the SDGs aims to reframe priorities, looking beyond the historically narrow focus on mental disorder, to incorporate “a full spectrum from everyday well-being through to mental health conditions and long-term psychosocial disabilities (DFID, 2018). Emerging data is beginning to demonstrate the increasing contribution of mental health conditions and psychosocial disabilities to disability prevalence worldwide and secondly, that there is routinely poorer quality of care in mental health compared to physical health conditions (Patel et al., 2018). It is LMICs however facing a triple disadvantage as they bear the greatest burden of poor mental health outcomes, with the most limited evidence, and significant care gaps of up to 85% (WHO, 2017).
2. Methodology
This rapid research query has been conducted as systematically as possible within 3 days of research time. SRHR and maternal health are both broad areas and for this reason it has not been possible to cover all related aspects through this query – the authors have had to be selective. The methodology is described below. Search strategy: Studies were identified through a variety of search strategies: • Google and relevant electronic databases (PubMed, Science Direct, and Google Scholar) for priority sources using a selection of key search terms.2 • Review of key disability portals and resource centres, such as the Lancet Commission on Global Mental Health, the Archives of Women’s Mental Health, Leonard Cheshire Disability and Inclusive Development Centre, the Global Alliance for Maternal Mental Health, Mental Health Innovation Network, and PRIME. • Mental health-focused journals, such as Lancet Psychiatry, BMC Psychiatry, International Journal of Public Health, and PLOS Med. • Contacted the DFID Disability Inclusive Development Programme consortium partners3 and experts for evidence recommendations (see Section 5 for experts who replied). The review prioritised existing syntheses, evidence reviews, and systematic reviews where possible in order to draw on the fullest range of evidence possible.