Comprehensive mental health action plan 2013-2020.

Twenty years ago, a book was published entitled World mental health: problems and priorities in low-income countries (1). A few years later in 2001, the World Health Organization (WHO) devoted its World Health Report to Mental health: new understanding, new hope (2), and the Institute of Medicine in the United States of America brought out Neurological, psychiatric, and developmental disorders: meeting the challenge in the developing world (3). These publications were among the first to seize upon the finding that, due to their chronic course and disabling nature, mental, neurological and substance use disorders contribute very significantly to the global burden of disease. Each report also drew strong attention to the desperate situation in most lowand middle-income countries regarding the availability, quality and range of treatment services, and produced a series of recommendations for research and training, service provision and policy. In a number of respects, much progress has been made since then. Awareness and acceptance of the value of mental health and the challenge posed by mental ill-health has continued to grow, both at the international level and in an increasing number of countries. New alliances and partnerships have been formed, including civil society organizations advocating for better rights and service access for persons with mental disorders and their families. In addition, the evidence base around what resources are available in countries and which interventions are effective, feasible and affordable to implement in the context of lowand middle-income countries has improved dramatically (4–7). In other respects, however, the situation now is not greatly different to how it was 20 years ago. There continues to be widespread stigma, discrimination and human rights violations against persons with mental disorders and psychosocial disabilities (8). Resources allocated to mental health remain extremely modest; the treatment gap is as large as ever (5,9). This, then, was the backdrop against which a concerted new effort has taken place to put mental health higher on the health and development agenda of countries throughout the world. Culminating in the endorsement of the Comprehensive mental health action plan 2013–2020 in May 2013 by the 194 Member States of WHO (10), this new effort now commits governments, as well as WHO and other partners, to taking defined actions across a number of areas of implementation. This article briefly sets out what these actions are, whose responsibility they are, and how they support the proposed regional framework to scale up action on mental health in the WHO Eastern Mediterranean Region.