By Atlantic Reports

The World Health Organization (WHO) has called on governments worldwide to accelerate the transition from long-term psychiatric institutionalisation to community-based mental health services, warning that existing systems continue to deprive many people of their freedom, dignity and opportunities for independent living.

The appeal follows the release of new WHO guidance aimed at helping countries reform psychiatric care, reduce prolonged hospital admissions and develop support systems that allow people with mental health conditions to receive appropriate treatment while remaining connected to their families and communities.

In a statement issued on Friday, October 9, 2026, the global health body expressed concern that large psychiatric hospitals and social care institutions continue to accommodate people for extended periods, sometimes without their consent.

According to WHO, nearly half of people in some institutional settings are reportedly held involuntarily for months, years or even decades, raising serious questions about human rights protections and the availability of alternative care.

The organisation maintained that mental health treatment should promote recovery, personal choice and social inclusion rather than unnecessarily separating people from society.

WHO Raises Concerns Over Prolonged Psychiatric Admissions

The new guidance focuses on deinstitutionalisation, a process through which people who have spent extended periods in psychiatric hospitals or similar facilities are supported to return to community life.

WHO specifically highlighted individuals who have remained in institutional care for six months or longer, noting that their transition requires careful planning and sustained access to appropriate services.

The organisation warned that prolonged institutionalisation could weaken family relationships, limit personal independence and restrict opportunities for education, employment and community participation.

However, it emphasised that moving people out of institutions must not mean abandoning them without medical treatment, housing or social assistance.

Instead, countries are being encouraged to develop comprehensive systems that provide continuity of care and protect the rights of individuals receiving mental health services.

The proposed approach recognises that people experiencing mental health conditions may require different levels of support, including specialist treatment, community follow-up and assistance with everyday living.

Mental Health Care Must Respect Human Dignity, Says WHO Chief

WHO Director-General, Dr Tedros Adhanom Ghebreyesus, said access to mental health treatment should not require individuals to surrender their freedom, dignity or relationships with their communities.

He urged governments to reduce dependence on long-term institutional care and redirect resources towards services that respect human rights and individual preferences.

According to him, meaningful reform cannot be achieved by psychiatric hospitals acting alone.

The WHO chief explained that successful community-based care requires cooperation across healthcare, housing, social welfare, education and employment systems.

These services are particularly important for individuals who have spent years in institutions and may need assistance rebuilding social connections, securing accommodation or returning to work.

Ghebreyesus also stressed the importance of supporting families, who frequently provide ongoing care for relatives experiencing mental health challenges.

Without adequate professional and social support, families may struggle to meet complex care needs, potentially increasing the risk of treatment interruptions or repeated hospital admissions.

Only 9% of Countries Have Fully Transitioned to Community Care

Data from the WHO Mental Health Atlas reveal the scale of the challenge confronting governments.

According to the organisation, only nine per cent of reporting countries have fully transitioned towards community-based mental health care.

Another 53 per cent remain at an early stage of reform, indicating that institutional models continue to dominate mental health service delivery in many parts of the world.

The report also found that more than one in four people admitted to psychiatric hospitals remained there for longer than six months.

These figures suggest that progress towards community-based treatment has been uneven despite increasing international attention to mental health rights and service reform.

The statistics relate to countries reporting to WHO and should not be interpreted as evidence that every country has identical admission practices or institutional conditions.

Nevertheless, they highlight the need for stronger policies, sustained financing and practical alternatives to prolonged hospitalisation.

New Guidelines Focus on Patients' Rights and Independent Living

WHO said its new guide provides practical measures to help governments and mental health institutions manage the transition towards community-based services.

The guidance addresses reducing unnecessary long-term admissions, improving conditions within existing institutions and ensuring that people leaving psychiatric facilities receive appropriate follow-up support.

A central principle is that individuals should participate in decisions affecting their treatment, living arrangements and recovery.

The organisation also emphasised the importance of protecting people against discrimination, coercion and unnecessary restrictions on their personal freedoms.

Community-based mental health services may include outpatient treatment, supported accommodation, psychosocial rehabilitation, counselling, crisis response and assistance with employment or education.

Such arrangements are intended to provide care within everyday community settings while preserving access to specialist services when clinically necessary.

WHO's approach does not suggest that psychiatric hospitals should immediately disappear or that inpatient treatment is never appropriate.

Rather, it calls for reducing unnecessary and prolonged institutionalisation while developing safe, accessible and adequately resourced alternatives.

People With Lived Experience Must Shape Mental Health Policies

The organisation also placed particular emphasis on involving people who have personally experienced mental health conditions and institutional care in designing services.

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

Ghebreyesus maintained that people directly affected by mental health policies should not be excluded from decisions about the systems intended to support them.

Their experiences, he explained, could help policymakers understand barriers to treatment, the challenges of institutional care and the practical support required for recovery and independent living.

The WHO Director-General said the guide was developed with contributions from experts across different regions, including individuals with lived experience.

He added that countries could adapt its recommendations to their national and local circumstances.

Independent lived-experience consultant and advocate Grace Gatera reinforced the importance of meaningful participation.

Gatera said people who understood institutional care through personal experience possessed valuable knowledge that should inform mental health reforms.

She maintained that their expertise, alongside contributions from healthcare professionals and other stakeholders, was essential to developing services that promote personal choice, recovery and community participation.

What the Reforms Could Mean for African Countries

The WHO recommendations carry particular significance for African countries, where access to specialist mental health services can be limited by shortages of trained professionals, inadequate funding and geographical inequalities.

In many communities, people experiencing mental health difficulties face additional obstacles, including stigma, transportation costs and limited availability of appropriate treatment.

For rural and underserved populations, travelling long distances to specialist psychiatric facilities may create financial and practical difficulties for patients and their families.

Expanding community-based services could help address some of these barriers by bringing mental health support closer to where people live.

Primary healthcare centres, community health workers and local support networks could play important roles, provided they receive appropriate training, supervision and resources.

However, integrating mental health services into community healthcare systems requires more than policy announcements.

Governments must consider staffing, medication availability, referral arrangements, emergency response services and long-term financing.

The transition must also protect individuals from neglect, homelessness or inappropriate transfer of care responsibilities to families without adequate support.

Nigeria's Mental Health System Faces Similar Questions

For Nigeria, the WHO's recommendations raise important questions about how mental health services can become more accessible beyond specialist hospitals and major urban centres.

Although specialist psychiatric institutions remain important components of the healthcare system, many Nigerians living in rural communities face difficulties obtaining timely mental health assessments and continuing treatment.

Integrating mental health services into primary healthcare could provide opportunities for earlier identification of conditions, routine follow-up and referral to specialist care when necessary.

Community-based approaches could also support people returning home after hospital treatment, particularly those requiring rehabilitation, medication management or social assistance.

However, expanding services would require investment in healthcare workers, facilities and systems that safeguard patients' rights.

Public education would also be necessary to address misconceptions that discourage people from seeking professional mental health support.

Importantly, community care must not be treated as a cheaper substitute for adequate medical services. Its effectiveness depends on providing appropriate clinical care alongside social and practical support.

Governments Urged to Move From Policy Commitments to Action

WHO's latest guidance presents governments with a challenge that extends beyond reforming psychiatric hospitals.

Countries must establish coordinated systems that connect healthcare with housing, education, employment and social protection.

They must also develop mechanisms for monitoring institutional conditions, protecting patients from abuse and evaluating whether community services improve people's quality of life.

The organisation's findings suggest that substantial work remains before rights-based community mental health care becomes widely accessible.

For people who have spent years in psychiatric institutions, meaningful reform could provide opportunities to rebuild relationships, regain independence and participate more fully in society.

Yet these outcomes cannot be guaranteed simply by reducing hospital admissions.

The real measure of progress will be whether individuals receive safe, continuous and appropriate care while exercising greater control over their lives.

As WHO urges countries to accelerate reform, its central message is that mental healthcare should protect human dignity, support recovery and ensure that people experiencing mental health conditions remain valued members of their communities.

Atlantic Reports: Voices. People. Facts.