The Centre for International Mental Health approach to mental health system development

Abstract

Although mental disorders are a major public health problem, the development of mental health services has been a low priority everywhere, particularly in low- and middle-income countries. Recent years have seen a growing understanding of the importance of population mental health and increased attention to the need to develop mental health systems for responding to population mental health service needs. In countries and regions where mental health services are all but nonexistent, and in postconflict and postdisaster settings, there are many impediments to establishing or scaling up mental health services. It is frequently necessary to act simultaneously on multiple fronts: generating local evidence that will inform decision makers; developing a policy framework; securing investment; determining the most appropriate service model for the context; training and supporting mental health workers; establishing or expanding existing services; putting in place systems for monitoring and evaluation; and strengthening leadership and governance capabilities. This article presents the approach of the Centre for International Mental Health in the Melbourne School of Population Health to mental health system development, and illustrates the way in which the elements of the program are integrated by giving a brief case example from Sri Lanka.

Figure 1

Structure of the CIMH mental health system development program.

Figure 2

Structure of the CIMH mental health system development program and outcomes of the Health for the South project. CIMH, Centre for International Mental Health; CSO, community service officer; iMHLP, International Mental Health Leadership Program; MoH, Ministry of Healthcare and Nutrition; MOMH, medical officers of mental health; NIMH, National Institute of Mental Health; SL, Sri Lanka; WHO, World Health Organization; WVA, World Vision Australia.