Strengthening Mental Health Systems in Africa

Dr. Chido Rwafa Madzvamutse, Regional Mental Health Focal Point for the World Health Organization (Africa Office), presented a powerful overview of the current state of mental-health systems in Africa — and the collective work underway to close the gaps.

She began with the sobering reality: mental, neurological, and substance-use disorders affect nearly 150 million people in the WHO African Region, yet the majority receive no treatment. Suicide rates remain the highest globally, and government spending on mental health averages just seven cents per person per year.

“We cannot make progress in mental health without strengthening systems — from policy and financing to training and community delivery,” Dr. Rwafa emphasized.

A Framework for Regional Progress

Dr. Rwafa outlined WHO’s Regional Framework for Mental Health (2023–2030), aligned with the Global Comprehensive Mental Health Action Plan. Its priorities include:

1. Strengthening leadership, governance, and financing for mental health.
2. Expanding integration into primary care and community health systems.
3. Increasing the mental-health workforce through task-shifting and training.
4. Enhancing data collection and monitoring to guide evidence-based policy.
5. Promoting community-based services while reducing reliance on long-stay institutions.

While 29 African countries now have national mental-health policies, only 16 are supported by dedicated budgets. Dr. Rwafa called for sustained advocacy, reminding participants that policy without funding is aspiration without action.

She also highlighted the need to strengthen higher-level, specialist, or “upstream” care, where trained CBT professionals play an essential role in supervision, mentoring, and treating complex presentations.

“Task-shifting expands reach, but it must be supported by robust specialist care upstream,” she noted. “Without that, the system cannot stand.”

Dr. Rwafa illustrated how effective systems integrate care across all levels — from community-based interventions like the Friendship Bench and StrongMinds, to WHO scalable programs such as Problem Management Plus and Self Help Plus, and finally to specialist-delivered CBT and supervision led by professionals trained to global standards.

She concluded by underscoring the importance of partnership — across governments, NGOs, universities, and organizations such as the WCCBT.

“Africa’s mental-health future depends on collaboration,” she said. “By aligning global frameworks with local leadership — and by investing in both community and specialist care — we can build sustainable systems that bring quality psychological care to every level of society.”

Her address encapsulated the spirit of the WCCBT–WHO alliance: bridging policy and practice, scaling access while safeguarding quality, and ensuring that every level of the system — from community volunteers to trained CBT professionals — works together to make evidence-based care a reality across Africa.