Celebrated each year on 10 October, World Mental Health Day was established in 1992 by the non-governmental organization World Federation for Mental Health (WFMH). Its observance was designed with the goal of raising global awareness about mental health issues and to advocate for the fundamental importance of overall wellbeing. This annual event, which is also endorsed and promoted by the United Nations (UN), serves as a platform for open dialog, education and the destigmatization of mental health conditions. This year, it carries a powerful theme: ‘Mental health is a universal human right’. This underscores the fact that the attainment of one’s best standard of mental health should not be a privilege reserved for the few but a right extended to all humans and integral to leading a fulfilling life. In an international context, World Mental Health Day advocates for the protection and promotion of individual mental health and wellbeing and greater emphasis on creating communities and societies that espouse mental health equity and equality.

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The resonance between the causes that WFMH has championed through World Mental Health Day and much of the UN’s mental health promotion agenda is born out of the long history of engagement and collaboration between the two organizations around mental health initiatives. Owing to its consultative status to the UN Economic and Social Council, WFMH has helped to shape global mental health policy and advocacy within UN initiatives, most notably through the inclusion of mental health as a core priority of the UN Sustainable Development Goals (SDGs). More specifically, WFMH and the UN have promoted the integration of mental health into the broader agenda of achieving global development goals, recognizing the essential role of mental wellbeing in overall human development, which has crucially elevated the notion in recent years that mental health should be considered a human right.

To recognize mental health as a human right is to acknowledge the importance of preserving the emotional, psychological and social wellbeing of individuals. The SDG framework has reified the connection between mental health and the global development agenda through SDG 3, which aims to ensure healthy lives and promote wellbeing for all and includes the target to "promote mental health and well-being" (SDG 3.4). Importantly, mental health intersects with several other SDGs, including but not limited to SDG 1 (No Poverty), SDG 4 (Quality Education), SDG 5 (Gender Equality) and SDG 10 (Reduced Inequalities), which underscores the fundamental nature of mental health as a human right and the inter-relationships among development goals and provides a mechanism for spurring change in other domains. A classic example of this intersection is the call to provide greater access to mental health services and reduce stigma around experiencing a mental health disorder, which could permit a person to hold a job and to support themselves and thereby break the cycle of poverty.

Centering mental health as a human right within the SDG framework provides clear linkages between laudable and worthwhile goals, but it is necessary to also consider the extent to which individual contexts can complicate or undermine progress. Specifically, the social determinants in the mental health approach present a useful and complementary means by which we can identify and better understand the drivers of mental health inequity that the SDG framework seeks to address. Indeed, if we consider the principles of equality, non-discrimination and dignity as core values that constitute human rights, it is clear that the contexts in which people live have an outsized influence on perpetuating disparities and enabling societal failures in extending human rights protections to all.

The social determinants of mental health are the conditions into which a person is born, grows, lives, works and ages, which encompass education, housing, social support, economic stability and access to healthcare and mental healthcare. In other words, they are the deeply personal way in which the constellation of social factors that characterize our lives can enhance or hamper our ability to access our highest standard of mental health.

Ruth Shim, a professor of cultural psychiatry who has written extensively on the social determinants of mental health, has suggested that social determinants may affect mental health in pronounced ways because of their potential for being additive and intersectional. For example, people who are from racial and ethnic minorities may have less access to and poorer quality of mental health services, which compounds the experience of burdens such as discrimination, poverty, food insecurity, and unsafe or unhealthy housing. In response to this, Dr. Shim emphasizes the connection between addressing social determinants and pathways to improving mental health outcomes, “Because mental health is so intimately tied to the societal conditions in which people are born, grow up, live and work, attention to improving these societal conditions is an important lever for improving mental health and promoting mental wellness. Focusing on improving the social determinants of mental health ensures that everyone has an equitable opportunity to experience good mental health and positive mental wellbeing.”

Understanding the ways in which the experience of poor mental health is connected to rectifiable social disparities, such as exposure to violence in communities or food insecurity, makes obvious the need to extend the mental health agenda to include calls for human rights and the pursuit of social justice. In addition to moral arguments, there is also the very pragmatic need to consider the toll of failing to enact a comprehensive mental health agenda. Direct and indirect costs of mental health disorders are staggering and continue to rise, with estimates reaching about US$6 trillion by 2030 — a sum higher than the cumulative costs of cancer, diabetes and respiratory illnesses. The human capital costs due to disability are also profound, with at least 30–40% of disability in countries of the Organisation for Economic Co-operation and Development attributed to mental health and at least 20% of the working-age population affected at any given time. Drawing on the insights from greater understanding of the power of social determinants of mental health, it is clear that our focus must move to correcting underlying inequities as a humane and financially cost-effective way to reduce the global burden of mental ill health.

There is, therefore, an urgency and a gravity to World Mental Health Day that may sometimes be crowded out by the many worthy observances that seek our attention and support or our need for uplift and positivity. In light of ongoing global challenges, from ever-widening income inequality to cataclysmic climate change, the need to prioritize mental health as a foundational human right that supports other human rights, including security, equality and dignity, has never been more timely and needed. World Mental Health Day provides an opportunity to affirm that there is hope, that disparities can be narrowed, and that mental health as a universal human right is not simply aspirational but achievable.