WHO urges shift to community-based mental health care, citing gaps in global reform

The World Health Organization (WHO) has urged countries to accelerate the shift from long-term psychiatric institutional care to community-based mental health services, releasing a new guide to help hospitals support patients in returning to their communities while protecting their rights and dignity.

The guide, released on World Mental Health Day, outlines practical steps for psychiatric hospital leaders to reduce prolonged admissions, improve institutional practices and help people transition to community living with appropriate support.

WHO said many people with mental health conditions continue to live in large psychiatric hospitals and social care institutions, with nearly half held involuntarily for months, years or even decades.

The process of deinstitutionalisation involves supporting people who have spent six months or longer in psychiatric hospitals to return to community life, with access to the services and opportunities needed to live independently and participate in society.

“People should not have to give up their freedom, dignity or place in their community to receive ongoing mental health support,” said WHO Director-General Dr Tedros Adhanom Ghebreyesus.

He called on countries to reduce their reliance on long-term institutional care and redirect investment towards rights-based mental health services and support within communities.

WHO stressed that the transition cannot be achieved by psychiatric hospitals alone. Access to housing, healthcare, social support, education and employment opportunities, alongside support for families, is essential to helping people live in their communities.

The guide also calls for changes to institutional practices to better protect patients' rights, reduce unnecessary admissions and long stays, and ensure people receive the support they need after leaving hospital.

The recommendations come as countries continue to reform their mental health systems, although progress remains uneven.

According to WHO's Mental Health Atlas, only 9% of reporting countries had fully transitioned to community-based mental health care, while 53% remained at an early stage of reform. More than one in four people admitted to psychiatric hospitals stayed for longer than six months.

The figures highlight the gap between efforts to expand community-based services and the continued reliance on institutional care in many countries.

The new guidance aligns with the 2026 World Mental Health Day theme, “Lived experiences heard: real voices, real change”.

WHO emphasised that people with lived experience of mental health conditions should be active partners in shaping policies, services and decisions that affect their lives.

The organisation's recommendations place rights, individual choices and access to community support at the centre of mental health reform, calling for a shift towards services that enable people to receive ongoing care without losing their connection to family and society.