Mental health represents a critical indicator of human development, serving as a key determinant of well-being, quality of life, and hope. As such, mental health has an impact on a range of development outcomes. There is growing recognition within the international community that mental health is one of the most neglected yet essential development issues. The adoption of the Convention on the Rights of Persons with Disabilities in 2006 by the United Nations General Assembly provided momentum to highlight the importance of the nexus between disabilities and mental health in the context of human rights, peace and security, humanitarian activities and in development work including response to AIDS. In addition, the Ministerial Declaration on Implementing the Internationally Agreed Goals and Commitments in Regard to Global Public Health, in the high-level segment of the substantive session of the Economic and Social Council in July 2009, highlighted the importance of integrating mental health into the implementation of the MDGs and other internationally agreed development goals and commitments, in order to achieve development outcomes. Based on these new developments, the Department of Economic and Social Affairs (DESA) of the Untied Nations and the World Health Organisation (WHO) issued the “United Nations-WHO Policy Analysis: Mental Health and Development: Integrating Mental Health into All Development Efforts including MDGs” in 2010. This document serves as a foundation for further mainstreaming of mental health into the development agenda including response to AIDS in the United Nations system and the broader international community. In the area of HIV, the United Nations Population Fund (UNFPA) integrated mental health into one of three goals and an outcome of its Strategic Plan: Universal access to reproductive health and comprehensive HIV prevention for improved quality of life. Based on this, UNFPA started to integrate mental health into its fund-wide policies and guidelines, and programmes at regional and country levels. In addition, the United Nations Children‟s Fund held a round table on adolescent mental health with partners in April 2011, and placed an emphasis on mental health and AIDS among adolescents. Poor mental health is both a cause and a consequence of ill-health including issues related to HIV, poverty, compromised education, gender inequality, violence and other global challenges. It impedes the individual's capacity to realize their potential and make a contribution to their community. On the other hand, positive mental health is linked to a range of development outcomes. Dialogue and consultations on a post-MDGs framework will present critical opportunities to ensure the explicit inclusion of mental health in any emerging development framework for 2015 and beyond. In addition, utilizing best practices from UNFPA and others, it is also important to continue efforts to integrate mental health into strategic plans and other policies and programmes of the United Nations implementing entities. Now is the time to include mental health as an integral part of development through increased recognition of the link between development and mental/emotional well-being, as well as the inclusion of persons with mental and intellectual disabilities, to achieve development for all.

In Japan, the number of people with mental illness, especially depression and dementia, is growing. Although mental health care in Japan is in its transition phase from traditional hospital-based care to community-based in the recent decades, it has been characterized by orientation to large psychiatric institutions. This paper aims to provide recommendations for achieving well-balanced mental health care both in hospital and the community in Japan by reviewing facilitators and barriers of current mental health care system. A narrative literature review was conducted to identify facilitators and barriers to implementing community-based mental health care in Japan. The databases PsycInfo, Medline, Pubmed, CiNii and Google Scholar were searched in English and Japanese. 46 studies published from 1980 to 2016 were included in the review. The review identified six categories of mental health care services provided in the Japanese community: Outpatient clinics, Outreach services, Rehabilitation and Living support, Case management and public health centers, Community-based residential care, and Work and Occupation. The crosscutting themes of facilitators and barriers to implement these services in the community were funding, staff management, and collaboration among community resources. To further promote the transition to community mental health care in Japan, this paper recommends the following actions: to shift funding and human resources from inpatient to community care services, to strengthen a capacity building system and supportive environment for service providers in the community, and to set a clear policy and strategic framework integrating medical and social welfare services in the community.
Mental health services ; mental health care system ; community mental health care ; Mental disorders ; Japan