Policy Platform
The AMF Public Policy Platform and accompanying resolutions — formally approved by the AMF Board of Directors — set the direction for our advocacy work across the country.
These foundational documents serve as a blueprint for how AMF approaches public policy, ensuring our positions remain consistent, evidence-based, and grounded in the lived experiences of people affected by mental illness.
Our Policy Platform reflects our core values: equity, dignity, access, recovery, and inclusion.
It guides our efforts in shaping laws, regulations, and programs at the federal, state, and local levels.
Purpose of the Policy Platform
Provide a clear and unified stance on critical mental health policy issues.
Equip advocates and affiliates with consistent messages when engaging policymakers.
Ensure that AMF’s advocacy efforts remain aligned with our mission and vision.
Influence legislation and regulations to better serve individuals and families affected by mental illness.
How It’s Developed
The Policy Platform is the result of a collaborative process that includes:
Input from AMF members, affiliates, and grassroots advocates nationwide.
Review by policy experts in mental health, law, and public health.
Approval by the AMF Board of Directors after careful consideration.
This ensures that our platform is informed by both lived experience and professional expertise.
Guiding Principles
The AMF Policy Platform is rooted in several core principles:
Mental Health as a Human Right
Every person should have access to high-quality, affordable mental health care.
Care must be equitable and culturally competent.
Recovery and Resilience
Dignity and Respect
Equity and Inclusion
Collaboration and Partnership
Effective mental health policy requires collaboration among providers, advocates, policymakers, and people with lived experience.
Core Policy Areas
The Policy Platform addresses a wide range of topics, including but not limited to:
1. Access to Care
Enforcing mental health parity in insurance coverage.
Expanding telehealth and integrated care models.
Increasing funding for community-based services.
2. Crisis Response
Supporting nationwide implementation of the 988 Suicide and Crisis Lifeline.
Expanding mobile crisis teams and crisis stabilization units.
Promoting non-police responses for mental health emergencies.
3. Workforce Development
Addressing the shortage of mental health professionals.
Supporting peer specialists and community health workers.
Promoting cultural competence and trauma-informed care.
4. Criminal Justice Reform
Diverting people with mental illness from jails and prisons into treatment.
Improving in-custody mental health services.
Supporting reentry programs that connect people to care, housing, and employment.
5. Youth and School-Based Services
Increasing mental health education in schools.
Expanding access to counseling and support services for students.
Promoting early intervention to address issues before they escalate.
6. Housing and Employment
Expanding affordable housing programs.
Supporting Housing First models.
Enforcing workplace accommodations under the Disability Discrimination Act (DDA).
7. Research and Innovation
Funding research into causes, prevention, and treatment of mental illnesses.
Supporting development of innovative care models.
Resolutions
In addition to the Policy Platform, the AMF Board adopts resolutions on specific policy issues. These resolutions:
Clarify AMF’s stance on emerging or complex topics.
Provide immediate guidance to affiliates and advocates.
Serve as reference points when engaging in public debates or legislative hearings.
Examples include resolutions on:
Suicide prevention strategies.
Criminal justice and mental health collaboration.
Equity in access to mental health care.
Use of technology in treatment.
How the Platform Guides Our Work
The Policy Platform informs every aspect of AMF’s advocacy, including:
Legislative testimony before Parliament and state legislatures.
Policy briefings for elected officials and staff.
Development of advocacy toolkits for affiliates.
Public awareness campaigns on key issues.
It ensures that our message remains consistent, whether we are meeting with a federal senator, a state representative, or a local council.
Why a Unified Platform Matters
Without a unified policy framework, advocacy efforts can become fragmented or inconsistent.
The AMF Policy Platform keeps our movement focused, strategic, and impactful.
When thousands of advocates speak with one voice, our message becomes stronger — and harder to ignore.
How Advocates Can Use the Policy Platform
Educate Lawmakers: Share platform positions during meetings or public hearings.
Train Volunteers: Use it to prepare advocates for speaking engagements.
Guide Local Policy Work: Align state or local advocacy priorities with AMF’s national stance.
Strengthen Coalitions: Show partners that AMF’s positions are well-researched and widely supported.
Ongoing Updates
The mental health landscape is constantly evolving — and so is our Policy Platform.
The AMF Board periodically reviews and updates the platform to address:
New research findings.
Emerging public health challenges.
Changes in laws or regulations.
Feedback from the AMF community.
Your Role in Advancing the Platform
The Policy Platform is only as powerful as the advocates who use it.
When you bring AMF’s policy positions to your community, you:
By working together, we can turn the Policy Platform into real-world progress — better laws, better systems, and better lives.
The AMF Policy Platform is more than a document — it’s a roadmap for change.
It represents our collective vision for a future where mental health care is accessible, compassionate, and equitable for all.
Together, we can make that vision a reality.
Introduction
Relationship or Marriage is a serious matter or business. It must have some ups and downs, profit and loss.
But meaningful relationship needs some patience and gratitude (Shukr and Sabr) even in shiny or stormy time.
There is no magic there, only magic is strive to make it right and repair if there is need to necessary adjustments to hold that serious bond or relationship intact and running.
Always remember, breaking something is very easy but to repair it is a hard business.
Creating a Meaningful Relationship
To create a meaningful relationship, striving toward balance or middle path is the best way to define a healthy relationship.
This is also relative in patterns towards individual choices, belief, social status and portfolio.
Four Mainstream Categories of Individuals Portfolios
There are four mainstream categories of individuals portfolios needed to address to understand bigger picture of relationship.
First Category: The major poor population in Bangladesh which does not fall in this relationship discussions.
Second Category: People with higher Islamic beliefs with more content and satisfaction lifestyles, usually look for good Islamic values individual for future meaningful relationships.
Third Category: The rich people with very high wealth, fame and status who look for similar portfolios individual with very lavish wedding ceremonies and subsequent lifestyle.
Fourth Category: Middle and higher middle class categories who are confused and lost in their life goals and identity — stuck in the crossroad between religious values and money and fame matter.
Example:
One particular sample of portfolio holding modest good income with decent caring character may be very boring and less attractive to rich or higher middle class individuals, but the same sample could be very attractive towards lower middle class and religious individuals.
If the relationship gauges are only dependent on money, fame, good profession and dashing fun individuality, this category of people will look for partners either rich or higher middle class individuals.
So adjusting the expectations gauge is very much necessary to engage primarily to make a meaningful relationship.
If people stubbornly stick to refusing to adjust the expectation gauge, there is a huge chance that the individual would end up with a times up scenario and will be less attractive as time passes by.
Consequently, there is a possibility to be permanently single which is a new norm of this civilisation.
Meaningful Relationships
Meaningful or purposeful relationships are the new norm of happy relationships.
Usually in the past, there were unwritten boundaries which implied to run a good relationship as a package — which included couples, families, and surrounding friends and neighbours.
It was a total bonding of happiness and meaningful relationship.
Nowadays, that changed drastically.
People think they are all in one — very independent with no real friends and families, meaning all about me or myself.
This new norm of social fabric is hurting a beautiful relationship in rocky drive.
4 Levels of Relationship Pattern
Admiration
One way butterflies feel.
Mutual Attraction
Two-way chemistry — the most dangerous level, butterflies kicking in.
Are you really committing for relationships? Most of the time, the answer is negative.
It’s just a pot of land to build something.
Now it is time to ask: do you need a builder to make a beautiful castle?
Level 2 is an experience and dream.
Now it is time for serious conversation to start building the castle — start to give and share values.
Sometimes too much is already given but taking is very less.
Must realise this in early stages because relationships need to have hard conversations.
Commitments
Actually saying Yes to each other, respecting their values and likings — this is a builder.
Compatibility
Readjusting and reshaping mutual expectations and values to establish an unshakable bond and relationship.
Relationships Myth
Look for right person like hero, funny, mentor, lover, best business partner, best sensual affection and highly established in professional portfolio.
Unconditional love with one and only soul mate.
Remember: real soul mate is God, not person.
Good Things:
Happiness and joy. Always think you will be happy.
Don’t pursue happiness — just pursue content, joy, sadness, satisfaction, caring for someone, admiring, gratitude, and growth.
Bad Things:
Anxiety, depression, sadness and storm in the relationship.
These are not bad things — rather mental challenges to face hand to hand.
Monogamy is myth in this era but it is essential to keep healthy relationships.
Expectation in Relationships and Redline
Expectation vs Engagement:
There may be lots of expectations and dreams. Its existence may be Bollywood movies or social media but in real life, it’s a myth.
If you expect your partner to bring a nice coffee or tea early in bed — don’t dream.
Strive, engage and do yourself first several times, then ask partner for your expectations.
Don’t switch off yourself and keep inside your head and roar — it is unhealthy expectation and love.
In this digital world and new era of lifestyle, perfect relationships is a myth.
If a person had tumultuous childhood and thinks that to make it right this time means carrying an unfinished business to fix — it’s also a myth.
Also, in a relationship process, if one person brings up all previous arguments and carryover pain and dumps it all in the sink to clean it first to resolve the relationship — it is also a myth to create a meaningful resolution.
Relationship Red Lines
Contempt:
Always put down and badly humiliate other partner with enormous envy and ego. Essentially don’t give any minimum value or respect.
Neglect:
Don’t care attitude, rather care about others or something else like pet, business priorities etc. It’s like taking the partner as granted and start complacent.
Violence:
Treating partner with harshness or rudeness, tendencies to hit physically which can become patterns of partner behaviour.
Infidelity:
Cheating intentionally, mostly physical means for long periods of time.
Relationship Factsheet
How we would restrain ourselves in ethical compass or red line — how far we can stretch red line.
Sometimes space or brief separation is good.
In between that bridging period, reflect oneself and keep communicating with old school style like letter.
Infidelity or cheating words need to be redefined in this era of fitnah or fake world to save a relationship.
Two Major Norms in Relationships
Responsibility, love, taking care of kids, cooking, everyday boring housework.
Sensuality, fun, adventure and mingling with friends — the most popular notions in recent times.
There are hundreds of real people around you but you are busy looking for the right person on social media — a complete bubble of false sense of purpose.
Maybe there is a perfect match for you sitting next to you, but sadly you missed that real person because you are swallowed by social media bubble.
Women and Men in Relationships
Women are motherly, compassionate, beautiful and beautiful.
Please show your motherly caring attitude.
Do not start to compare, feel better and instigate ego — it is dangerous.
Women have enormous power to control men if she behaves as loving motherly attitude.
Nature made male and female in different perspectives and personalities.
Men, please be respectful and show love to women.
Turning Conflict into Connection
First, recognise and face the conflict.
Arguments:
Take it positively to create a healthy relationship. In this difficult era of social dynamics, conflict and arguments are part of a healthy relationship.
There is no point in avoiding and ignoring this savage reality.
Beautiful couples with great romance and desire may become distressed at some point of life — they can’t tolerate each other anymore.
They both are committed and good human beings.
During arguments, the level of language must be gentle and not hurtful.
Never use slang or bad language.
Keep arguments short in length.
If one partner starts to cry, that means some words were very hurtful — stop and say sorry immediately.
Constructive vs Destructive Conflict
In a distress or unhealthy relationship, one partner dehumanises and flattens the other person, not giving any chance to the partner.
Sometimes those couples may carry lots of value and commonality, but one partner always wants to keep upper hand by dehumanising and making noise.
This is unhealthy and distressful argument.
The difference between constructive and destructive conflict is not empathy — it is differentiation.
We live in a world where selfishness becomes new norm rather than communal harmony.
Conflict Parameters
There is a scale in conflict to differentiate parameters such as:
Parameters need to be adjusted accordingly to have constructive conflict.
Sometimes there is some overlap.
If respect persists — it is easy.
If threat persists — it becomes toxic.
Fight for Three Things in Conflict
Power dynamics — who is in control, who is the boss.
Trust and care — who values love and affection more.
Respect and recognition — who values me and why do I matter.
At some point in life, a pinnacle question arises:
Is it time to let him or her go for better?
Or is there a glimpse of light to get back again — a second chance?
Resentment and guilt both play a big role.
Positive Outlook
I am a positive person. I don’t believe in breakdowns in relationships; I am always on the side of reconciliation.
Life is challenging and full of uncertainty — facing those challenges is fun, exhausting but worth it.
Never say no and give up. This is life; it is not a bed of roses.
Ego or unhealthy love doesn’t have compassion.
End of the day, after an exhausting workday — come back to sweet home, that matters.
Home is a place where you can rest, watch your favourite show or have a meal that brings the family together.
Break the ego barrier and go for a little kiss or hug even after a nasty argument.
Who will first say sorry — it’s become a competition.
A simple sorry can break big walls.
Don’t build up garbage of resentment, ego and anger in your heart.
If it starts, anxiety and loss of identity creep in.
Sleep deprivation and irritation follow — taking away your good qualities.
It becomes toxic and unhealthy.
The matter is — who makes the first move to surprise the other.
Men and Women: Respect and Awareness
Women are motherly, loving, caring — they take most of the anxiety, burden and responsibility in conjugal life.
Men and women are made differently by God.
Women face extra challenges — monthly menstruation, childbirth and post-childbirth struggles.
So men should be very aware and respectful towards women.
Motherhood is not easy.
On the other hand, women should be aware — there is no place to make yourself competitive with men, flexing confidence to overpower.
Men always portray women as loving, caring by nature — God built them to nurture.
Loving and caring doesn’t mean women are weak — it means women are resilient, strong and the backbone of relationship.
Women are in charge when they keep themselves as women.
Love, care and security are the final words for women.
Respect is the final word for men.
Perception in Modern Relationships
Sometimes men avoid overly career-focused women for serious relationships — not because they feel inferior, but because they may feel the nature of womanhood is missing, which men crave.
Sometimes women misunderstand — thinking that being feminine means being sensual only.
Men are not always craving for sensuality — they crave respect and care.
This stigma needs to be rectified in relationships.
Imperfection is Perfection
Nothing is called perfection for human beings.
Only God is absolute perfection.
Main slogan: Imperfection is the perfection.
Find the imperfect person with lots of perfection.
Look for a good person with some bad.
Nowadays, people look for all-in-one: handsome, funny, wealthy, caring, loving, sensually attractive, plus domestic.
What a beautiful dream — but expectations and dream barometer must be adjusted to reality.
Real life is much different from social media or Bollywood bubbles.
Bangladeshi Cultural Context
In our BD culture, often the mother-in-law is a real stigma or fear for many girls — and it is a real challenge.
Mothers don’t want to give their hard-raised, sacrificing boy with blank cheque to a stranger girl.
It’s natural and obvious expectation for mother.
So, in this very real and cultural scenario in BD, the best part is middle path.
There should not be competition, ego, or power struggles here.
ChatGPT said:
🇧🇩 Government of the People’s Republic of Bangladesh
Ministry of Health and Family Welfare
National Mental Health Policy
(Public Policy and Expert Panel Overview)
🧭 Key Policy Goals
Mental Health:
A state of well-being in which individuals realize their own abilities, can cope with normal life stresses, work productively and fruitfully, and contribute positively to their community.
Substance Abuse / Addiction:
Defined as a chronic, relapsing disorder characterized by compulsive drug seeking and use despite harmful consequences. It is considered a brain disease because drugs alter brain structure and function, often leading to long-lasting behavioural changes.
Mental Health Condition:
A syndrome marked by clinically significant disturbances in cognition, emotion regulation, or behaviour reflecting dysfunction in psychological, biological, or developmental processes.
Mental Illness:
Refers to disorders characterized by dysregulation of mood, thought, and/or behaviour, as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association (DSM).
Neurodevelopmental Disorders or Disabilities:
A group of heterogeneous conditions involving delays or disturbances in the acquisition of developmental skills (motor, social, language, cognition).
Autism Spectrum Disorder (ASD):
Defined by persistent deficits in social communication and interaction, and by restricted, repetitive patterns of behaviour, interests, or activities.
Mental Health Promotion:
Creation of individual, social, and environmental conditions that empower people to achieve optimal mental health and quality of life.
📊 Public Policy Reports
Mental Health Conditions Prevention:
Aims to reduce the incidence, prevalence, recurrence, and duration of mental health conditions, prevent relapses, and decrease the societal and familial impacts.
Mental Health Policy:
An organized framework of values, principles, and objectives to improve mental health, reduce mental disorder burdens, and define a national vision for future action.
🏛️ Policy Platform
Mental Health Plan:
Outlines strategies, budgets, and timeframes to implement policy objectives, along with expected outputs, targets, and performance indicators.
Mental Health Services:
Includes outpatient clinics, day treatment centres, psychiatric hospital wards, community mental health teams, supported housing, and mental hospitals.
Mental Health Experts:
Psychiatrists and psychologists.
Mental Health Professionals:
Includes psychiatrists, psychologists, and psychiatric social workers.
Mental Health Workforce:
Comprises occupational therapists, speech therapists, physiotherapists, and related professionals.
mhGAP-IG (Mental Health Gap Action Programme Intervention Guide):
A WHO technical tool for non-specialist health settings, guiding the management of priority conditions such as depression, psychosis, bipolar disorder, epilepsy, developmental and behavioural disorders, dementia, alcohol/drug use disorders, self-harm, and others.
Recovery:
For individuals with mental illness, recovery means gaining hope, understanding strengths and limitations, developing autonomy, and finding meaning and purpose in life. Recovery focuses on empowerment and social reintegration, not merely cure.
Rehabilitation:
(Also known as psychiatric rehabilitation) — promotes recovery, community integration, and quality of life through evidence-based, person-directed services that build functional and social skills.
Psychosocial Disabilities:
Refers to people diagnosed with mental health conditions who face stigma, discrimination, and exclusion. Includes current or former service users and self-identified individuals.
E-Mental Health:
Use of digital communication technologies — such as mobile apps, online platforms, and social media — to support and improve mental well-being.
Vulnerable Populations:
Includes the economically disadvantaged, minorities, uninsured, elderly, homeless, people with HIV/AIDS, and those with chronic or severe mental illnesses.
📚 Bibliography
A comprehensive list of 39 key policy, research, and WHO references supports Bangladesh’s national mental health framework — including WHO Mental Health Atlas reports, mhGAP resources, National Mental Health Policy, and surveys conducted by NIMH, DGHS, and WHO Bangladesh between 2003–2019.
👥 Expert / Resource Persons
(Not listed according to seniority)
Saima Wazed – WHO Goodwill Ambassador for Autism, Chairperson, National Advisory Committee on Autism and NDDs, Bangladesh; Chairperson, Shuchona Foundation.
Prof. Dr. Md. Golam Rabbani – Chairperson, Neuro Development Disability Protection Trustee Board, Ministry of Social Welfare, Bangladesh.
Prof. Dr. Abul Kalam Azad – Director General, DGHS, Mohakhali, Dhaka.
Professor AHM Enayet Hossain – Additional Director General, DGHS, Mohakhali, Dhaka.
Professor Md. Waziul Alam Chowdhury – President, Bangladesh Association of Psychiatrist (BAP).
Prof. Dr. Md. Abdul Mohit – Director-cum-Professor, National Institute of Mental Health (NIMH), Dhaka.
Dr. Nazneen Anwar – Regional Adviser, Mental Health, WHO Regional Office for South-East Asia, New Delhi, India.
Professor MSI Mullick – Department of Psychiatry, BSMMU, Dhaka.
Professor Jhunu Shamsun Nahar – Department of Psychiatry, BSMMU, Dhaka.
Prof. Dr. Md. Faruq Alam – Former Director-cum-Professor, NIMH, Dhaka.
Dr. Nur Mohammad – Line Director, NCDC, DGHS, Mohakhali, Dhaka.
Prof. Dr. Mahadab Chandra Mandal – Former Professor, NIMH, Dhaka.
Prof. Dr. Nilufer Akhter Jahan – Professor, NIMH, Dhaka.
Prof. Dr. Mohammad Khasru Pervez Chowdhury – Professor, NIMH, Dhaka.
Brig. Gen. Prof. Dr. Azizul Islam – Professor & Adviser in Psychiatry, Armed Forces Medical College, Dhaka.
Professor Shalahuddin Qusar Biplob – Chairman, Department of Psychiatry, BSMMU, Dhaka.
Dr. Mohammad Mahmudur Rahman – Professor of Clinical Psychology, University of Dhaka.
Prof. Dr. Shahin Islam – Professor of Education & Counselling Psychology, University of Dhaka.
Prof. Nahid Mahjabin Morshed – Professor & Course Coordinator, Dept. of Psychiatry, BSMMU, Dhaka.
Dr. Md. Rizwanul Karim – Program Manager-2, NCDC, DGHS, Dhaka.
Dr. Syed Mahfuzul Huq – National Professional Officer (NCD), WHO Country Office, Dhaka.
Malka Shamrose – Chief Operating Officer, Shuchona Foundation.
Dr. Tara Kessaram – Medical Officer, Noncommunicable Diseases, WHO Country Office, Dhaka.
Dr. Sultana Algin – Associate Professor, Psychiatry, BSMMU, Dhaka.
Dr. Avra Das Bhowmik – Associate Professor, Shaheed Ziaur Rahman Medical College, Bogra.
Dr. Helal Uddin Ahmed – Associate Professor, Child, Adolescent & Family Psychiatry, NIMH, Dhaka.
Nazish Arman – Coordinator, Content Development, Shuchona Foundation.
Dr. Md. Delwar Hossain – Associate Professor, NIMH, Dhaka.
Dr. M. M. Jalal Uddin – Consultant, Mental Health, WHO Country Office, Bangladesh.
Dr. Mekhala Sarker – Associate Professor, NIMH, Dhaka.
Dr. Mohammad Tariqul Alam – Associate Professor, NIMH, Dhaka.
Dr. Niaz Mohammad Khan – Associate Professor of Psychiatry, OSD, DGHS, Deputed to BSMMU.
Hasina Momotaz – National Consultant, Mental Health, WHO Country Office, Dhaka.
Dr. Farjana Rahman Dina – Assistant Professor, Community and Social Psychiatry, NIMH, Dhaka.
Dr. Zinat De Laila – Assistant Professor, Adult Psychiatry, NIMH, Dhaka.
Dr. Sifat E. Syed – Assistant Professor, Psychiatry, BSMMU, Dhaka.
Dr. Tanjir Rashid – Consultant, NDD Trust.
Dr. Maruf Ahmed Khan – DPM, NCDC, DGHS, Dhaka.
Dr. Mohammad Shahnewaz Parvez – DPM, NCDC, DGHS, Dhaka.
Dr. Md. Rahanul Islam – Central Drug Addiction Treatment Centre, Dhaka.
Shishir Moral – Special Correspondent, The Daily Prothom Alo.
Md. Kamrul Ahsan – Sr. ASP, School of Intelligence, SB, Dhaka.
Andalib Mahmud – Psychosocial Program Coordinator, Innovation for Wellbeing Foundation.
Subodh Das – Development Manager, ADD International, Dhaka.
Md. Jamal Hossain – Psychiatric Social Worker, NIMH, Dhaka.
Jakia Ahmed – Special Correspondent, Sara Bangla.
Razia Sultana – Project Coordinator, CRP, Ganakbari, Sreepur, Savar.
Farid Uddin Ahmed – Senior Reporter, Daily Manab Zamin.
Pathan Sohag – Staff Reporter, Protidiner Sangbad.
Rafiqul Islam – Staff Reporter, The Daily Amader Samay.
Aneeqa R. Ahmad – Secretariat Coordinator, Shuchona Foundation, Dhaka.
Public Policy Reports
National Mental Health Policy, Bangladesh – 2022
Executive Summary
Introduction
There is increasing global recognition of the importance of mental health and well-being, and the significant global burden of mental health conditions in both developing and developed countries. The World Health Organization (WHO) advocates to Member States to develop national mental health policies and plans.
Mental well-being is a fundamental component of WHO’s definition of health and is included in the unified global agenda. When world leaders adopted the Sustainable Development Goals (SDGs) in 2015, they also committed to prioritize “prevention and treatment of noncommunicable diseases, including behavioural, developmental and neurological disorders, which constitute a major challenge for sustainable development.”
Good mental health enables people to realize their potential, cope with the normal stresses of life, work productively and contribute to their communities.
In Bangladesh, the prevalence of mental health conditions is 18.7% among adults and 12.6% among children. Considering the magnitude, the country needs to emphasize on the promotion of mental health and well-being. The number of trained mental health professionals is insufficient and most of the services are confined to large cities. In the context of stigma and discrimination, the treatment gap is high with significant familial and social consequences.
Rationale
Having a mental health policy in place is an essential step towards improving the mental health of the population. A mental health policy provides an overall direction by establishing a broad framework for action and coordination, through common vision and values for all programmes and services related to mental health.
This policy document acknowledges the significance and importance of relevant and useful local knowledge and practices. The document adheres to global and regional thinking, taking into perspective the country context. The social determinants of mental health, such as poverty, environmental issues and education, have been given due recognition.
Mental health will be made an integral part of the social and economic development of Bangladesh. In line with the UN Convention on the Rights of Persons with Disabilities, human rights aspects are to be taken into consideration. The mental health condition of the caregivers of children with neurodevelopmental disabilities is an important issue included in the national mental health policy.
Why Public Policy Reports Matter
The mental health policy has been formulated based on the mental health needs of the population, available services, pilot projects, as well as experiences of other countries and international experts.
Consultations and negotiations occurred through working groups and consensus meetings, involving representatives from the government, international organizations, professionals’ associations, universities, nongovernmental organizations (NGOs) and persons with mental health conditions and their families.
The consultation process was held at the National Institute of Mental Health and Hospital, Dhaka, with support of the WHO.
Vision
The vision of the national mental health policy is to ensure mental health and well-being of all people through promotion, prevention, treatment and rehabilitation based on self-empowerment, community and family support and enhancement of resources. The aim is to ensure participation of individuals in decision-making and inclusion in community life.
Values
The values and principles of the policy are equity and justice, integrated care, evidence-based service, holistic approach, quality assurance, rights-based approach, community care, intersectoral collaboration, and life-course approach.
Objectives
The objectives of this policy are to:
strengthen effective leadership and governance for mental health to create a mental health friendly society;
provide mental health care at all levels of the health care system (primary, secondary, tertiary) and facilitate access to and utilization of comprehensive mental health services by persons with mental health conditions, and increase access to mental health services for vulnerable groups according to universal health coverage;
promote mental health, prevent mental health conditions and enhance awareness by reducing the stigma associated with mental health conditions;
support the recovery process of people suffering from mental health conditions through rehabilitation;
provide mental health and psychosocial support to survivors of disaster, trauma and humanitarian emergencies;
give special attention to children and adolescents with mental health conditions and neurodevelopmental disabilities;
enhance availability and equitable distribution of skilled human resources for better mental health;
promote evidence generation and research;
ensure the rights and protection of persons with mental health conditions;
update the academic curriculum on mental health and substance abuse;
ensure representation from various stakeholders;
address substance abuses and addictive disorders;
reduce risk and incidence of suicide and attempted suicide;
provide support services for caregivers of persons with mental health conditions through a multisectoral approach; and
establish a regulatory body for mental health professionals and services.
Areas for Action
The mental health policy considers the development of several areas for action such as: coordination, financing, organization of services, academic curriculum, mental health promotion, prevention of mental health conditions, rehabilitation, development of a nonpharmacological approach at all levels of the health system, mental health services for vulnerable populations, standardized skilled human resources, e-mental health services, evidence-based research and guidelines, neurodevelopmental disabilities, suicide prevention, regulatory body for mental health professionals, family-based training for providing mental health support.
Way Forward
A national mental health action plan will be developed for implementation of various policy options. This policy document is a part of the government’s assurance and reflects its political commitment to mental health issues.
Dissemination of the policy to all the stakeholders and public using varied strategies will be a crucial step for advocacy and raising awareness. Advocacy at all levels will be done to generate political and public support for policy and funding.
1. Introduction
Global Context
There has been increasing global recognition of the importance of mental health and the significant global burden of mental health conditions in both developing and developed countries.
According to the World Health Organization (WHO), approximately 450 million people worldwide are affected by mental and neurological conditions. Mental health conditions account for 13% of the global burden of disease. This is expected to increase to nearly 15% by 2030.
Depression alone is likely to be the highest contributor to the global burden of disease by 2030. Mental health conditions are also associated with more than 90% of the one million suicides that occur annually (1). People with mental health conditions have a heightened risk of suffering from physical illnesses; the economic and social costs of mental health conditions are substantial.
Effective treatments are available for a wide range of mental health conditions but treatment gap of more than 75% exists in many low-income countries (2).
Mental health is one of the integral parts of health and well-being as per WHO’s definition of health:
“A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Determinants of mental health and mental health conditions include not only individual attributes, such as the ability to manage one’s thoughts, emotions, behaviours and interactions with others, but also social, cultural, economic, political and environmental factors, such as national policies, social protection, living standards, working conditions and community social support.
Exposure to adversity at a young age is an established preventable risk factor for mental health conditions. These factors need to be addressed through comprehensive strategies for promotion, prevention, treatment and recovery in a whole-of-government approach (3).
The Sixty-fifth World Health Assembly (WHA) held in 2012 approved and adopted WHA65.4 resolution on the global burden of mental health conditions and acknowledged the need for a comprehensive, coordinated response from health and social sectors at the community level (4).
A comprehensive Mental Health Action Plan 2013–2020 was adopted in the Sixty-sixth World Health Assembly (3).
The Government of Bangladesh has shown a strong political commitment for issues related to autism and neurodevelopmental disabilities. Bangladesh hosted the largest regional conference on autism in July 2011. In the conference, the Dhaka Declaration on Autism Spectrum Disorders was ratified by seven countries of the WHO South-East Asia Region.
The Dhaka Declaration was referred to in the Regional Office for South-East Asia’s document “Comprehensive and coordinated efforts for the management of autism spectrum disorders (ASD) and developmental disabilities.”
Improving Mental Health, Well-being and Mental Health Services
Improving mental health, well-being and mental health services is an integral part of achieving the Sustainable Development Goals (SDGs), particularly:
SDG 3, Target 3.4: By 2030, reduce by one third premature mortality from noncommunicable diseases through prevention and treatment and promote mental health and well-being. Suicide mortality rate is the chosen indicator to monitor progress towards this target.
SDG 3, Target 3.8: Achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.
Furthermore, improving mental health, ensuring inclusion of persons with mental health conditions in society, and protecting the human rights of those with mental health conditions will enable social and economic development as reflected in several other SDGs, including SDG 8 and SDG 10 and their respective targets:
SDG 8, Target 8.5: By 2030, achieve full and productive employment and decent work for all women and men, including for young people and persons with disabilities, and equal pay for work of equal value.
SDG 10, Target 10.2: By 2030, empower and promote the social, economic and political inclusion of all, irrespective of age, sex, disability, race, ethnicity, origin, religion or economic or other status.
SDG 10, Target 10.3: Ensure equal opportunity and reduce inequalities of outcome, including by eliminating discriminatory laws, policies and practices and promoting appropriate legislation, policies and action in this regard.
Rationale
Mental health outcomes are optimized when mental health is an essential component of public health and government policies (5).
Having in place a comprehensive mental health policy is an essential step towards improving mental health of the population. The national mental health policy marks an important milestone in establishing the foundation for addressing mental health in Bangladesh.
The policy provides the overall direction for mental health by instituting a common vision, values, objectives and a broad framework for action, which in turn helps to establish benchmarks for the prevention, treatment and rehabilitation of mental health conditions, as well as the promotion of mental health.
The principal guideline of the national mental health action plan, programmes and service-related activities would be based on the policy document.
Stigma regarding mental health is a huge challenge for Bangladesh. Promotion of mental health by de-stigmatization and desegregation of this issue is very much needed.
With the increasing prevalence rates of neurodevelopmental disabilities, it is also important to take into consideration the mental health of persons with neurodevelopmental disabilities, as well as their caregivers (such as depression rate is high among mothers of persons with autism spectrum disorder).
Process
The mental health policy has been formulated based on the mental health needs of the population, services available, pilot projects, as well as experiences of other countries and international experts.
Consultations and negotiations occurred through working groups and consensus meetings involving representatives from the government, international organizations, professional associations, universities and nongovernmental organizations (NGOs).
The consultation and development processes were held at the National Institute of Mental Health and Hospital, Dhaka, with the support of WHO.
The proposed national mental health policy is in agreement with WHO’s Comprehensive Mental Health Action Plan 2013–2020, which was adopted by the Sixty-sixth World Health Assembly (WHA66.8).
Key National Documents Integrating Mental Health
Mental health is an integral part of the social and economic development of Bangladesh and has been integrated in the following key policy documents:
Bangladesh Health Policy 2011
National Rural Development Policy 2001
National Social Protection Strategy of Bangladesh 2014
Bangladesh: Poverty Reduction Strategy Papers 2011
Millennium Development Goals to Sustainable Development 2015
Bangladesh has ratified the UN General Assembly Convention on the Rights of Persons with Disabilities, as well as the Comprehensive and Coordinated Efforts for the Management of Autism Spectrum Disorders (WHA67.8) adopted in the Sixty-seventh Session of the World Health Assembly in May 2014.
Persons with Disabilities Rights and Protection Act 2013 and Neurodevelopmental Disabled Persons Protection Trust Act 2013 were also enacted in Bangladesh.
The National Parliament on October 2018 enacted the Mental Health Act 2018. This was a huge milestone for mental health services in Bangladesh. This Act protects the rights of a person with mental health conditions.
The National Institute of Mental Health and Hospital developed a document on “Integration of Mental Health Services with Primary Health Care in Bangladesh” (6). Based on this document, community mental health services, such as training of health professionals, as well as awareness and advocacy programmes, are being undertaken.
