Global mental health policy - where next?

Global mental health

policy – where next?

Findings from our report Global mental health from a

policy perspective.

Jessica Mackenzie, Research Fellow at the Overseas Development

Institute, Research and Policy in Development (RAPID) Programme

October 2014

ODI Report for the

Mental Health Innovation

Network (MHIN)

STIGMA

UNDER-DIAGNOSE

LOW FUNDING

LIMITED DATA

TREATMENT TYPE INFORMAL/HETEROGENEOUS

Initial thoughts

CONTENTS OF THE REPORT

Chapter 1Theory & analytical framework

Chapter 2Characterist

ics as a policy issue

Chapter 3Lessons

from other movements

Chapter 4Engagement strategies

CONTENTS OF THE REPORT

Chapter 1Theory & analytical framework

Chapter 2Characterist

ics as a policy issue

Chapter 3Lessons

from other movements

Chapter 4Engagement strategies

CONTENTS OF THE REPORT

Chapter 1Theory & analytical framework

Chapter 2Characterist

ics as a policy issue

Chapter 3Lessons

from other movements

Chapter 4Engagement strategies

CONTENTS OF THE REPORT

Chapter 1Theory & analytical framework

Chapter 2Characterist

ics as a policy issue

Chapter 3Lessons

from other movements

Chapter 4Engagement strategies

CONTENTS OF THE REPORT

Chapter 1Theory & analytical framework

Chapter 2Characterist

ics as a policy issue

Chapter 3Lessons

from other movements

Chapter 4Engagement strategies

CHAPTER

CHAPTER 1

• Sabatier and Mazmanian (tractability of policy issues)

• Shiffman and Smith (effectiveness of global health networks)

• Knowledge Policy and Power (KPP) Framework

(for assessing context, dynamics and power relationships behind

policy barriers)

Theoretical approach and frameworks

CHAPTER

CHARACTERISTICS OF MENTAL

HEALTH AS A POLICY ISSUE

10

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER 2

HETEROGENITY

STIGMA

AGENCY SERVICE USER

LACK OF DATA

UNDER DIAGNOSIS

INDIVIDUALISED TREATMENTS

LOW FINANTIAL

INVESTMENT

ROLE INDIVIDUAL SECTOR

INT. COMMITMENTS

AND ENGAGEMENT

EFFECTIVENESS

NETWORKSC

HA

RA

CT

ER

IST

ICS

OF

ME

NTA

L H

EA

LT

H A

S A

PO

LIC

Y I

SS

UE

CHAPTER

LESSONS LEARNED FROM

OTHER SOCIAL MOVEMENTS

5

LESSONS LEARNED FROM

OTHER SOCIAL MOVEMENTS

5

HIVPneumoniaTuberculosisAlcoholTobacco

A SIDE NOTE…

‘The effectiveness of global health policy networks’

Jeremy Shiffman

A study funded by the Gates Foundation (2015)

DISCREPANCIES BETWEEN NETWORKS

There are similar characteristics,

yet very different success occurring

TOBACCO vs ALCOHOL

DISCREPANCIES BETWEEN NETWORKS

Disability affected years: 4.5% (alcohol)

3.7% (tobacco)

Policy attention: Framework Convention on Tobacco Control

No equivalent on Alcohol (…yet)

PNEUMONIA vs TUBERCULOSIS

DISCREPANCIES BETWEEN NETWORKS

Deaths: 1.5 million (pneumonia) – children only

1.1 million (tuberculosis)

Policy attention: 180 countries DOTS

Half see a doctor, medicines

CHAPTER 3

How did they do it?

1. Policy coherence with one united ‘policy request’

2. Reframed the issue (severity, causal connection)

3. Advocacy and communication strategy

4. Institutions

5. Selectivity and timing.

CHAPTER 3

How did they do it?

1. Policy coherence with one united ‘policy request’

2. Reframed the issue (severity, causal connection)

3. Advocacy and communication strategy

4. Institutions

5. Selectivity and timing.

CHAPTER 3

How did they do it?

1. Policy coherence with one united ‘policy request’

2. Reframed the issue (severity, causal connection)

3. Advocacy and communication strategy

4. Institutions

5. Selectivity and timing.

CHAPTER 3

How did they do it?

1. Policy coherence with one united ‘policy request’

2. Reframed the issue (severity, causal connection)

3. Advocacy and communication strategy

4. Institutions

5. Selectivity and timing.

CHAPTER 3

How did they do it?

1. Policy coherence with one united ‘policy request’

2. Reframed the issue (severity, causal connection)

3. Advocacy and communication strategy

4. Institutions

5. Selectivity and timing.

CHAPTER 3

How did they do it?

1. Policy coherence with one united ‘policy request’

2. Reframed the issue (severity, causal connection)

3. Advocacy and communication strategy

4. Institutions

5. Selectivity and timing.

CHAPTER

WHAT CAN THE NETWORK TAKE FROM THIS?

4.1

CHAPTER 4

Lessons applied to Mental Health

1. Coherent, single ‘policy request’ ( or ‘policy ask’)

2. Costs

3. Institutions with targets

4. Anticipate focusing events

5. Strategic network operations

6. Severity of the issue

7. Knowledge Exchange

8. Monitoring and Evaluation system for policy influence

CHAPTER 4

Knowledge Exchange: Tools

1. Tactical examples

2. Capturing engagement techniques

3. ‘How to’ guides for policy influence

4. Stories of change, episode studies

5. Upcoming focussing events

6. Policy windows

7. Monitoring and Evaluation tools

CHAPTER 4

WHAT CAN YOU TAKE FROM THIS?

4.2

WHAT DO YOU NEED TO GET THE JOB DONE?

Requests for policy engagement assistance identified by the projects

30%

15%

13%

12%

8%

8%

6%

4%

4%

Influencing PM

Research

comms

Creating

incentives

Lessons from others

In Mental Health

Understanding PM

Processes better

Building relationships

with intermediaries

Support from community

leaders and champions

Global/local

policy changes

Toolkits/templates

1. ACCESS AND INFLUENCING POLICY MAKERS LOCALLY

CHAPTER 4

Alignment, Influence and Interest Matrix (AIIM)

Knowledge Policy and Power Analysis (KPP)

1. ACCESS AND INFLUENCING POLICY MAKERS LOCALLY

CHAPTER 4

Alignment, Influence and Interest Matrix (AIIM)

Knowledge Policy and Power Analysis (KPP)

Some immediate help?

CHAPTER 4

2. BETTER RESEARCH COMMUNICATIONS

CHAPTER 4

How to write a policy brief

How to communicate with policy makers in person

How to engage the media

TOOLKITS

CHAPTER 4

Nine Steps for Developing a Scale up Strategy.

A Guide on how to write a policy brief

How to broker knowledge and communicate it more effectively

Obvious and not-so-obvious strategies to disseminate research

Eight Strategies for Research into Practice, The Science of Improving Lives – Moving Evidence into Action

4. LEARNING FROM OTHERS IN MENTAL HEALTH

CHAPTER 4

Existing GCC conferences

Knowledge exchange

Workshops in-country for whole teams

7. GATHERING SUPPORT FROM COMMUNITY LEADERS AND CHAMPIONS

CHAPTER 4

Literature

Toolkits

Engaging innovative advocates

as public health champions:

www.fhi360.org/resource/

engaging-innovative-advocates-

public-health-champions

Draft is availableFinalised:

November 2014MHIN website

MHIN to follow through on:

Knowledge ExchangeTraining activities

ODI ROMA

NEXT STEPS

Question

time

Does the vacuum help you?

Did anything in the survey results surprise you?

Is a ‘Tipping Point’ emerging?

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THANK YOU!