Mental health is an integral part of health and well-being and a fundamental human right for all people. The inclusion of mental health in the Sustainable Development Agenda signifies that there can be no sustainable development without mental health: good mental health is an important facilitator of socioeconomic development. The global burden of mental disorders is enormous: an estimated 1.1 billion persons are affected by mental disorders worldwide. This concerns individuals and communities in both low and high-income countries because treatment gaps, stigma, inequity and gender disparities in mental health exists across different contexts. The global mental health agenda of the future is not merely about reducing the treatment gap for people affected by mental disorders. It is about promoting mental health and well-being of entire populations. Red Cross and Red Crescent National Societies support and accompany people in all situations. They offer a continuum of care through a person’s life course, from birth through childhood, adulthood and into their older years. Now is the time for the Red Cross Red Crescent network to scale up these efforts and contribute to meeting the global mental health needs of the future. But how will psychosocial vulnerabilities change in the future and how can the Movement address this? This think piece poses five key questions to our network that can help us identify mental health and psychosocial needs of the future and ways in which we can address this.

• How do we provide flexible support systems for volunteers in a changing world of volunteering?
• What are the key health needs of the future and how do they intersect with mental health and psychosocial needs?
• How are communities changing and what does this mean for the types of social support structures available to individuals and families?
• How can we as a network ensure that the upcoming Movement policy on mental health and psychosocial support (MHPSS) is implemented and that MHPSS is integrated into all humanitarian responses? 

The future of health – including mental health

The rise of non-communicable diseases globally and increasing threats from pandemics will continue to challenge already stretched health systems across the world. It is well established that many people living with non-communicable diseases also suffer mental health problems including depression, stress and anxiety. Mental health services should be integrated into existing services – including primary health care and general health services at the community level– and scaled up as an essential component of universal health coverage. As community-based organizations, acting as auxiliaries to public authorities, National Societies are well positioned to strengthen the link between communities and the formal health services and contribute to bridging the access and treatment gap in human resources for mental health. The task-shifting or task sharing approach – defined as the transfer of some health-care responsibilities from more specialized to less-specialized staff or volunteers, under supervision – is gaining increasing recognition in mental health research and practice. This is one possible avenue for the Red Cross and Red Crescent to scale up its mental health and psychosocial support services in the future.  Epidemics and disease outbreaks can have profound impacts on individuals, communities and societies. They can generate fear of sickness or death, confusion and distrust of authorities or organizations. People who get sick, or volunteers who work directly with those who are sick (including the mentally ill) or with safe and dignified burials, can be stigmatized and ostracized by their families and communities. Experience from recent outbreaks such as Ebola and Zika viruses have shown that psychosocial support for communities, families, volunteers and staff needs to be incorporated throughout epidemic preparedness, response and recovery. More work remains to be done with families and communities to combat stigma and discrimination of persons with mental health disorders. Educating communities and families on positive mental health (well-being) and mental health disorders, through awareness raising activities and campaigns are useful approaches. 

The future of community-based psychosocial support

Looking ahead, different trends and transformations will change protection concerns and psychosocial vulnerabilities in the future. Demographic changes as a result of migration, urbanization, the growing young population on the one hand, and ageing populations on the other, alter the make-up of society. This changes our traditional notion of ‘family’ and “community” and affects the type of social support structures that are available to people. Psychosocial problems such as loneliness might increase for some groups, including adolescents and ageing populations. At the same time, advances in technology offer new ways of staying connected and creating networks that have not always been accessible for people. Red Cross and Red Crescent National Societies are uniquely positioned to identify emerging psychosocial needs through knowledge, presence in communities, a tradition of community-based approaches and dedicated and committed staff and volunteers. Together with global, regional and national partners and as the auxiliary to governments they work toward improved mental health and psychosocial well-being. National Societies help build the resilience of individuals and families to tackle the challenges of the future and to build resilient and sustainable communities.  Technology also offers new ways in which National Societies can provide psychosocial support, which can increase the scope and coverage of mental health and psychosocial services.

The future of psychosocial support in humanitarian response

Climate-related impacts are expected to intensify significantly in the coming years and food and water security of communities will be a growing issue. At the same time, extreme poverty in the world will increasingly be concentrated in countries experiencing conflict and fragility. Many ‘already’ vulnerable communities will struggle even more and global migration will continue to rise. A common denominator for these emergencies are the disruption of social connections, often accompanied by the experience of loss in some shape or form.

Even though individuals and communities show great resiliency in such situations, climate change, armed conflict, natural disasters and other emergencies exacerbate existing vulnerabilities and give rise to specific protection concerns. Mental health and psychosocial support can improve well-being and help restore day-to-day functioning and recovery and National Societies are uniquely positioned to reach vulnerable or marginalised populations, who are not served by their formal health and social care systems. But how do we scale up psychosocial support in emergencies and ensure that it is integrated in all humanitarian responses? And how do we strengthen the integration of psychosocial support into other sectors such as livelihoods, WASH and DRR? And how can we leverage psychosocial support to (re-)build trust in communities?