The document discusses the global mental health agenda, highlighting the significant burden of acute mental health conditions such as PTSD, major depressive disorder, and schizophrenia. It emphasizes the urgent need for improved mental healthcare access, workforce training, and stigma reduction strategies, particularly for older adults. Additionally, the document outlines the roles of various healthcare professionals and the importance of integrating mental health care within broader healthcare systems.

1. ilcuk.org.uk
What happens next
What are the policy priorities
for the WHO?
Mental Health Matters
Roundtable alongside WHA77
Tuesday 28 May 2024

2. Mental health matters:
A global policy agenda
Welcome
Isabelle Gillespie, Head of Programmes, ILC-UK

3. Mental health matters:
A global policy agenda
Project overview
Esther McNamara, Senior Health Policy Lead,
ILC-UK

4. Mental health matters:
A global policy agenda
What is this project about?
• Global burden of acute mental health conditions
• Mental healthcare needs currently unmet
• What this means in the context of demographic
change progresses
• Socioeconomic opportunities of preventing and
managing mental health disease burden

5. China Germany Japan UK USA
ILC Index
overall
ranking
49 22 20 14 31
ILC Index
happiness
ranking
52 19 62 25 32
%of
health
spending
on MH
.
10%
(2020)
2%
(2021)
6%
(FY
2020-
2021)
6.8%
(2020)
Suicide
rate per
100,000 in
2021
5.25 11.16 16.8 10.7 14.5
Global average
= 9.15
New rankings
from 2024
updated Index
Mental health matters:
A global policy agenda

6. Mental health matters:
A global policy agenda
We are looking at this issue through the
lens of the following diagnoses:
• Post-traumatic stress disorder
• Major depressive disorder
• Schizophrenia

7. Mental health matters:
A global policy agenda
Psychiatrists 2.2 13.2 11.8 7.6 10.5
Psychologists 1.89 49.5 3 36 29.8
Mental
health nurses
5.4 56 83.8 56 4.2
Mental health professionals per 100,000 people

8. Mental health matters:
A global policy agenda
Awareness
Diagnosis
Treatment
Management
Perception

9. Mental health matters:
A global policy agenda
Findings so far
• Investment and workforce provision are insufficient
amidst demographic change
• Availability of data on incidence, spending, and demand
for healthcare today, let alone in the future
• Access to appropriate care pathways across longer lives
• Healthcare system structures and sustainability

10. Mental health matters:
A global policy agenda
What are we looking for from this discussion
today?
• What does demographic change mean for mental health and
healthcare in your field?
• How can we continue to meet people’s acute needs around
the world?
• What do you think needs to change to effectively manage
PSTD, major depressive disorder, and schizophrenia across
our longer lives?

11. Mental health matters:
A global policy agenda
Keynote address
Dr Natasha Azzopardi-Muscat, Director of the
Division of Country Health Policies and
Systems, WHO Regional Office for Europe

12. Mental health matters:
A global policy agenda
Setting the scene
Mental health perspectives from around the globe

13. Mental health matters:
A global policy agenda
Prof Tsuyoshi Akiyama
President, World Federation of Mental Health

14. From Cost to Asset
Tsuyoshi Akiyama
President
World Federation of Mental Health
May 28, 2024 Mental Health Matters: What are
the policy priorities for the WHO?
International Longevity Centre UK

15. Cost due to mental illness
No asset?
Required supports
Normalization support

16. Medical costs
Non-medical costs
Productivity losses
Cost due to mental illness

17. No asset?

18. There are a vast number of
people who live with mental
illness.
Many of them work and
contribute to society.
Even more can work with
appropriate support.

19. Work skills support
Resilience building programs
communication
monitoring
acceptance of illness
hope for recovery
Consultation to the employers
Required supports

20. Workforce with registered (serious) disability
All Mental
2018 561,000 78,000
2023 642,000 130,000
Increase 81,000 52,000
Rate 14.4% 66.7%
Much more workforce with less serious
mental illness.
Workforce with Serious
Mental Illness (Japan)

21. Normalization support programs
should help persons to attain
their life goals, dreams or
ambitions without relapse of
mental illness.
WHO should prioritize the
provisions of these programs.
It is Time to Prioritize Mental
Health in the Workplace.（WFMH)
Normalization support

22. The concept shift by WHO “people
with mental illness can be asset to
society” will motivate the
governments to invest positively
for people with mental illness.
It is time to prioritize programs to
have more workforce in spite of
their mental illness.
（Recommended WHO mission)
Comments

23. Thank you for your attentive listening

24. Mental health matters:
A global policy agenda
Dr Meenakshi Jhala
Academic Physician and Honorary Clinical
Researcher, Imperial College London

25. Mental health matters:
A global policy agenda
Dr Daragh Connolly
FIP Chair Board of Pharmaceutical Practice

26. Mental Health Matters
The role of the pharmacist
Dr Daragh Connolly, FIP Chair Board of Pharmaceutical Practice
28 May 2024

27. FIP Publications on Mental Health Care

28. “Think Health, Think Pharmacy”
A new global campaign by FIP
LINK: www.bit.ly/4bFGTn7

29. “Think Health, Think Pharmacy”
29
A new global campaign by FIP
References: www.bit.ly/4bFGTn7

30. Thank you!

31. Mental health matters:
A global policy agenda
Tiago Horta Reis da Silva
Lecturer in Nursing Education AEP, King’s College
London

32. Mental health across the globe and
the policy priorities for the WHO
Tiago Horta Reis da Silva
Maintaining Good Mental Health: The Role of Nurses
in Supporting Patients with Acute Diagnoses

33. Introduction
• Mental health issues
affect millions
globally, with
significant impacts on
individuals, families,
and societies.
• Key Statistics:
• Major Depressive
Disorder: Affects
approximately 280
million people
worldwide.
• Schizophrenia: Impacts
about 20 million people
globally.
• PTSD: Experienced by
This Photo by Unknown Author is licensed under CC BY

34. Promoting Mental Health in Older
Adults
• • Nurses play a crucial role in ensuring positive health
outcomes for individuals with mental health conditions like
major depressive disorder, schizophrenia, and PTSD.
• • Mental health literacy is vital for overcoming barriers
to mental health care.
• • Nurses can enhance mental health literacy through
education and training programs.
• • Integrated service arrangements enhance access to mental
health and substance abuse services for older adults.
• • Person-centred care approaches support autonomy and self-
management, leading to better mental health outcomes.
• • Addressing stigma and discrimination in mental health
care is essential.
• • Training nurses to coordinate mental and physical health
care and provide mental health interventions can enhance
care quality.
• • Innovative approaches like digital technology can
complement mental health care, but preferences may differ
among individuals.
• • Community-based interventions like home-based exercise
programs promote independence recovery and reduce long-term
care needs.
This Photo by Unknown Author is licensed under CC BY-SA-NC

35. What does the current provision
of care for acute mental health
conditions look like in older
adults in the UK?
Different categories of
older adults require mental
health care: severely
mentally ill, acutely
distressed individuals,
dementia patients, and
substance abuse issues.
•Knight & Kaskie, 1995
Nurses in older adult acute
inpatient units understand
the complexities of mental
illness, cognitive changes,
and physical health
conditions.
•McKenna et al., 2014
Transitioning from adult to
older adult mental health
services is crucial for
older individuals with
enduring mental disorders.
•Heslop et al., 2014
Crisis Resolution Teams
(CRTs) provide short-term
home-based treatment for
adults experiencing mental
health crises.
•Rubio et al., 2020
Improving crisis care is a
recognized need for better
mental health services.
•Lamb et al., 2019
Factors influencing mental
health care for older adults
include policy decisions and
the interface between adult
and old age psychiatry.
•Lavingia et al., 2020; Brenes et
al., 2015
Addressing mental health
care needs in non-specialty
settings is essential.
•Conner et al., 2010
Challenges persist in
providing ethically
competent care to
incarcerated older adults
with mental illness.
•Conwell & Thompson, 2008; Raue &
Sirey, 2011

36. What are the key challenges facing the UK when it comes to delivering effective treatment for acute mental
health conditions? (1)
Stigma and negative
attitudes towards mental
health treatment hinder
access to care.
•Conner et al., 2010
Late-life suicide prevention
is hindered by factors at
individual, provider,
system, and social/cultural
levels.
•Conwell & Thompson, 2008
Elderly adults' needs,
including problematic opioid
use and bereavement-related
complications, require
holistic services.
•Dufort & Samaan, 2021; Shear et al.,
2013
Barriers include limited
access to affordable
services, availability of
providers in rural areas,
transportation issues, and
healthcare system
navigation.
•Lavingia et al., 2020; Brenes et
al., 2015
Older adults are less likely
to utilize mental health
care services compared to
younger individuals,
highlighting service
utilization disparities.
•Garrido et al., 2011
Underutilization of mental
health services and non-
adherence to interventions
pose significant challenges.
•Raue & Sirey, 2011
Enhancing access requires
addressing disconnection of
mental healthcare from the
broader healthcare system,
need for integrated care,
and promotion of access for
minority populations.
•Miller & Wilfong, 2020; Das et al.,
2016; Ojeda & McGuire, 2006
Overcoming barriers involves
improving referral systems,
implementing community-based
care, and integrating
primary and psychiatric
care.
•Bartels et al., 2004
Addressing discrimination,
promoting peer educators,
and understanding attitudes
and beliefs about mental
health among older adults
are crucial steps.
•Conner et al., 2018; Temple et al.,
2020

37. From a nursing perspective, how can we best deliver mental health care for older adults? What examples of
good practice have you seen around the world? (1)
Enhancing nurses'
knowledge and
attitudes towards
older adults through
specialized education
and training programs.
•Mattos et al. (2015)
Integrating mental
health assessment,
care, and treatment
skills into nursing
education.
•Halcomb et al., 2018
Promoting active
learning strategies
like role-play and
case studies.
•Tweedie, 2023
Incorporating person-
centred care
approaches that focus
on the individual's
specific needs and
preferences.
•McKenna et al., 2014
Emphasizing the
importance of self-
management to improve
community
participation and
recovery outcomes.
•McKenna et al., 2014
Utilizing nurse care
coordination and
technology to assist
frail older adults in
self-managing their
health care.
•Marek et al., 2013
Addressing stigma and
discrimination in
mental health care.
•Benjenk et al., 2019
Actively dismantling
ageist views and
practices to provide
more inclusive and
effective mental
health care.
•Tweedie, 2023

38. Case Study: Integrative Approach in
a Community Setting
•Mr. Robert is a 78-year-old retired teacher who
recently moved to an assisted living facility
after his wife passed away. He has a history of
hypertension and type 2 diabetes, which are
well-controlled with medication. Recently, Mr.
Robert was admitted to a psychiatric unit with
acute symptoms of Major Depressive Disorder
(MDD) and Post-Traumatic Stress Disorder (PTSD)
following his wife's death and a traumatic car
accident.
Background
•Mr. Robert exhibited severe depressive symptoms,
including persistent sadness, lack of energy,
loss of interest in daily activities, insomnia,
and significant weight loss. Additionally, he
experienced flashbacks, nightmares, and
hypervigilance related to the car accident,
significantly impairing his quality of life.
Clinical Presentation:
•A comprehensive nursing care plan was
implemented, focusing on both acute psychiatric
care and long-term community support.
Intervention:
This Photo by Unknown Author is licensed under CC BY-SA-
NC

39. Case Study: Integrative Approach in
a Community Setting
Inpatient Nursing Care:
•Medication Management: Mr. Robert was prescribed antidepressants and anti-anxiety medications. The nursing staff closely monitored his
response to these medications and managed side effects.
•Psychotherapy: He received individual therapy sessions with a psychiatric nurse specializing in cognitive-behavioural therapy (CBT) and
trauma-focused therapy to address both MDD and PTSD symptoms.
•Routine and Structure: Nurses helped establish a daily routine that included physical activity, balanced meals, and scheduled therapy
sessions, promoting stability and predictability.
•Discharge Planning and Community Integration:
•Transition Plan: As Mr. Robert’s condition stabilized, the nursing team, in collaboration with a social worker, developed a comprehensive
discharge plan that included follow-up appointments with a community mental health nurse and a geriatric psychiatrist.
•Community Mental Health Services: The community mental health nurse continued to provide CBT and trauma-focused therapy in an outpatient
setting, ensuring continuity of care.
•Support Groups: Mr. Robert was introduced to local support groups for older adults dealing with grief and trauma, providing peer support and
reducing feelings of isolation.
•Family Involvement: The nursing staff educated Mr. Robert’s family on his conditions, the importance of adherence to treatment plans, and
ways to provide emotional support.
Outcomes:
•Over the next six months, Mr. Robert showed significant improvement in his mental health. His depressive and PTSD symptoms were greatly
reduced, and he began to re-engage in social activities and hobbies he previously enjoyed. Regular follow-up with the community mental
health nurse ensured ongoing support and adjustment of his treatment plan as needed.
•Community Link:
•This case study illustrates the crucial role of nursing in both acute psychiatric care and community integration for older adults. The
collaboration between inpatient psychiatric services and community mental health resources ensured a seamless transition from hospital to
home, providing Mr. Robert with comprehensive, continuous care.
Conclusion:
•Nurses play a vital role in managing acute mental health conditions in older adults, particularly during the critical transition from
inpatient care to community-based support. By integrating clinical expertise with community resources, nurses can help ensure sustained
mental health improvements and enhance the overall well-being of older patients. This holistic approach is essential for addressing the
complex needs of older adults with acute mental health diagnoses.

40. Conclusion
Nurses play a crucial role
in maintaining good mental
health, particularly for
those with acute diagnoses.
• Call to Action:
Strengthening nurse
training, increasing
support for mental health
initiatives, and fostering
global collaboration.

41. Mental health matters:
A global policy agenda
Roundtable discussion
How can we better address acute mental health
conditions across the globe?

42. Mental health matters:
A global policy agenda
• What can we say about the current level of healthcare provisions for those with acute
mental health conditions; and how do we democratise access to these services
throughout our longer lives?
• What are the current barriers to accessing mental healthcare? How is stigma associated
with mental health, and does this differ between generations?
• What are the social and economic costs and implications of acute mental health
conditions for individuals, their support network, and the wider economy?
• What are the key policy priorities for the WHO in this area? How can we build a
framework for mental healthcare that alleviates the socioeconomic impact, and the
impact on individuals’ lives and wellbeing?

43. Mental health matters:
A global policy agenda
Conclusions
Isabelle Gillespie, Head of Programmes, ILC-UK

44. Mental health matters:
A global policy agenda
Upcoming project events
Mental health
matters report
launch
Online webinar
October 2024
Details TBC
Breakfast roundtable
discussion on mental
health alongside UNGA
New York, US
Tuesday 24 September
Research symposium:
What are the policy
priorities for Japan?
Tokyo, Japan
Thursday 5 September

45. Next ILC event
Awards ceremony – Going for gold: How do countries
compete when it comes to healthy ageing?
Tuesday, 16 July 2024
Maison du Danemark, Paris
Register: ilcuk.org.uk/going-for-gold-awards-ceremony

46. Mental health matters:
A global policy agenda
Thank you