WHO urges countries to expand community-based mental health care

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By: Azzat Manal

WHO urges countries to expand community-based mental health care

The World Health Organization (WHO) is calling on countries to accelerate the shift from long-term psychiatric hospitalisation towards community-based mental health services that protect individual rights, dignity and personal choice. The appeal, issued ahead of World Mental Health Day on October 10, 2026, comes with the publication of a new guide designed to help governments and healthcare providers support people transitioning out of long-stay mental health institutions.

The guidance aims to help countries develop alternatives to institutional care and enable people who have spent extended periods in psychiatric hospitals or residential facilities to return to community life. This transition requires more than discharge from hospital: it involves ensuring that individuals can access appropriate treatment, stable housing and the practical support needed to live independently or with their families.

WHO Director-General Tedros Adhanom Ghebreyesus stressed that receiving ongoing mental health care should not come at the expense of a person’s freedom, dignity or place in society. He urged governments to direct greater investment towards services delivered within communities, where people can receive support while maintaining their social connections and participating in everyday life.

According to the organisation, many people with mental health conditions continue to live in large psychiatric hospitals or social care institutions for months, years or even decades. Around half of those living in such settings remain there against their wishes, the WHO said, highlighting concerns about prolonged institutionalisation and the isolation it can create. Extended stays may separate individuals from their families, neighbourhoods and opportunities to participate in society.

The new guide outlines practical measures for psychiatric hospital administrators and healthcare authorities. These include reducing unnecessary admissions and prolonged stays, reviewing institutional practices that may undermine patients’ rights, and developing pathways that help residents leave hospital safely. The approach also calls for changes in how mental health services are organised, with greater emphasis on personal autonomy, recovery and inclusion.

The WHO emphasises that hospitals cannot carry out this transformation on their own. Successful community-based care depends on a coordinated network of services, including accessible housing, primary and specialist healthcare, social assistance, education and employment opportunities. Support for families and caregivers is also important, particularly when people need continuing assistance after leaving an institution.

Figures from the WHO’s Mental Health Atlas indicate that progress remains uneven worldwide. Only 9% of countries that provided data had completed the transition to community-based mental health care, while 53% were still at an early stage of reform. The report also found that 28% of people admitted to psychiatric hospitals remained there for more than six months, illustrating the persistence of long-term institutional care in many health systems.

The organisation is also urging governments to involve people with direct experience of mental health services in decisions that affect them. Their participation should extend to policy development, service design and the evaluation of care. The WHO argues that lived experience can help decision-makers better understand the barriers people face during recovery and identify support that enables them to rebuild their lives within their communities.

Developed with contributions from international experts, including people who have previously received institutional mental health care, the guide is intended to be adapted to different national circumstances. Countries will need to consider their existing healthcare systems, available resources and local social conditions when implementing its recommendations.

The WHO’s appeal places mental health reform within a broader human rights framework. Moving away from prolonged institutionalisation requires governments to ensure that treatment is not separated from freedom, social participation and personal choice. The challenge ahead is to translate these principles into accessible, adequately funded services that allow people experiencing mental health conditions to receive care while remaining connected to their communities.