global mental health policy - where next?
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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?
