From: Possibilities for the future of global mental health: a scenario planning approach
Universal standards for care | Worldwide coordination of research | Making use of diversity | Focus on social factors | Globalised care through technology | Mental health as a currency in global politics | |
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Main features | Universal standards for the treatment of patients with mental health disorders | All research activity is coordinated on a global level | Mental health care and research is focused on embracing diversity rather than striving for similarity or universality | Global consensus on social determinants of mental health | Remote and virtual delivery of mental health care | Situations traditionally requiring political action are understood in terms of mental health |
Healthcare | Adaptation of local procedures to new set of worldwide standards; Regular audits | Increasingly evidence-based care meeting local needs | Both the organisation and content of care is developed out of or adapted to the local context | Public mental health services providing social interventions; Worldwide community tackling underlying social factors on a global and local level | All treatment can be delivered remotely or virtually, leading to redundancy of services | Increased funding and availability of public mental health services; Clinicians act as consultants for policy-making and government decision-making |
Research | Research procedures also adapt to new standards, e.g. informed consent procedures | Centralised management of all research funding and activity; More innovative research; No duplication | Localised research that aims to explore specific and unique aspects rather than striving to produce generalisable evidence; Qualitative methods | Focused on exploring associations between wider social and economic factors and mental health on a global and local scale | Research focuses on developing new technology-assisted diagnostic tools and interventions | Public health and prevention focus |
Governance | Global intergovernmental organisations e.g. United Nations | Global governance through centralised research organisation | Local leadership driven by mental health professionals | Greater role of social services and local communities; National and regional governments | Multi-national organisations; Private health firms; Technology companies | National governments and international organisations |
Key drivers | Increasing human rights movement; Increasing funding for mental health services; Increasing universal access to information (e.g. through information technology) | More efficient use of funding for mental health research; Increasing research accessibility in LMICs; Advances in technology; Rising role of big data | Increasing national economic growth; Increasing funding for mental health service development | Rapid social and economic change;Increasing urbanisation; Increasing migration; Widening inequalities within countries | Rapid increase in global development; Advances in technology; Stronger role of virtual relationships | Political instability; Climate change; Increasing war and conflict; Increasing prioritisation of mental health issues |
Potential concerns and implications | Reliant on one concept of human rights and consensus on standards being accepted universally | Dependent on the views of the central committee members, Potentially strengthening mainstream approach rather than overcoming it; Management of all research worldwide may be difficult to manage in practice | Differences may be so great that there is no scope for learning across contexts (i.e. highly unique healthcare in different settings) | Requires government support and working across different organisations and agencies that may be difficult to bridge in practice; May clash with other political priorities | Potentially less creative, innovative and personalised approaches in mental health care (i.e. replaced by algorithmic software); Potential to drive people further apart through reduced need for face-to-face interactions | Potential neglect of more severe mental disorders; Potential trivialisation of mental health distress |