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On World Mental Health Day, the World Health Organization (WHO) has urged countries to move away from long-term institutional mental health care towards person-centred, community-based services that respect people’s rights, dignity and choices.
The organisation has also released a new guide outlining practical steps to help countries implement deinstitutionalisation (DI) and support people in returning to community life.
According to WHO, many people with mental health conditions continue to live in large psychiatric hospitals and social care institutions. Nearly half are held in these facilities involuntarily for months, years or even decades, often isolated from the outside world.
Deinstitutionalisation involves supporting people who have spent long periods, typically six months or longer, in psychiatric hospitals to return to their communities, with access to the care, support and opportunities needed to lead fulfilling lives.
“People should not have to give up their freedom, dignity or place in their community to receive ongoing mental health support,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.
“Countries must move away from relying on long-term institutional care and accelerate the shift of investments from institutions to rights-based mental health care and support in communities,” he added.
WHO guide outlines steps for psychiatric hospitals
WHO’s new guide sets out practical actions for psychiatric hospital leaders to facilitate deinstitutionalisation. It focuses on reducing psychiatric hospital admissions and long stays, changing institutional practices to better protect people’s rights and supporting people to leave hospital and return to community life.
The organisation emphasised that hospitals alone cannot achieve deinstitutionalisation. Access to housing, healthcare, social support, education, employment opportunities and support for families are essential to ensure people live well in their communities.
The new DI guide also aligns with this year’s World Mental Health Day theme, “Lived experiences heard: real voices, real change”. It underscores the importance of involving people with lived experience in shaping mental health policies, services and decisions that affect their lives.
“Shifting towards community-based mental health care must be done with people who know what it means to go through institutional care, not for them. Their expertise, alongside that of others, is essential to building services that support choice, recovery and participation in community life,” said Grace Gatera, independent lived experience consultant and advocate.
Progress towards community-based care remains uneven
Although many countries are working to strengthen community-based mental health services, WHO said progress remains uneven.
According to WHO Mental Health Atlas, only 9% of reporting countries had fully transitioned to community-based mental health care, while 53% remained at an early stage of reform. The data also showed that more than one in four (28%) people admitted to psychiatric hospitals stayed for longer than six months.
WHO has called on governments and mental health services to accelerate the transition from institutional care to community-based support and build mental health systems in partnership with people with lived experience.
