WHO Urges Shift from Institutional to Community-Based Mental Health Care

Ahead of World Mental Health Day, the World Health Organization (WHO) released a new guide supporting countries to shift away from institutionalized mental health care based on long stays in psychiatric hospitals, towards person-centred care in the community that respects people's rights and choices.

The guide sets out practical actions for psychiatric hospital leaders to implement deinstitutionalization (DI), defined here as helping people who have spent six months or more in psychiatric hospitals to return to and live in their communities with the care and support they need. It focuses on reducing admissions and long stays, changing institutional practices to better protect people's rights, and supporting discharge into community life. WHO is clear that DI cannot be achieved by hospitals alone: access to housing, health care, social support, education, employment and family support is essential.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said people should not have to give up their freedom, dignity or place in their community to receive ongoing mental health support, and that countries must accelerate the shift of investment from institutions to rights-based community care.

The scale of the gap is documented in WHO's Mental Health Atlas. Only 9% of reporting countries had fully shifted to community-based mental health care, while more than half (53%) were still at an early stage of reform. More than one in four (28%) people admitted to psychiatric hospitals stayed longer than six months, and nearly half of those living in large psychiatric hospitals and social care institutions are kept there involuntarily, in some cases for years or decades.

The guide aligns with this year's World Mental Health Day theme, "Lived experiences heard: real voices, real change", and was developed with experts from around the world including people with lived experience. WHO is calling on governments to build mental health systems together with people who have lived through institutional care, not simply for them.

For suppliers and procurement partners, deinstitutionalization changes where medicines are consumed and therefore how they must be supplied. Psychotropic and neurological essential medicines are currently concentrated in a small number of large hospital pharmacies; as care moves into community and primary-care settings, demand fragments across many smaller, more dispersed dispensing points. That shifts the critical capability from bulk hospital delivery towards last-mile distribution, smaller and more frequent orders, and dependable regional warehousing. It also raises the importance of uninterrupted supply, since treatment continuity for chronic conditions leaves little tolerance for stock-outs at community level. Buyers reforming national mental health services will favour suppliers able to support decentralized distribution, provide stable multi-year availability, and supply the registration and quality documentation needed for national essential medicines lists.

Artemisine Medicines Technology works with buyers to match supply and documentation packages to decentralized public health programmes across Africa and Central Asia.

Source: WHO, WHO urges shift from institutional to community-based mental health care, https://www.who.int/news/item/09-10-2026-who-urges-shift-from-institutional-to-community-based-mental-health-care