Mental Health Atlas Questionnaire

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1 Mental Health Atlas Questionnaire Department of Mental Health and Substance Abuse World Health Organization Context In May 2013, the 66th World Health Assembly adopted the Comprehensive Mental Health Action Plan Global targets have been established in order to measure collective action and achievement by WHO s Member States towards the overall goal and objectives of the Action Plan. A set of core mental health indicators have been developed to monitor progress in relation to these targets and other critical aspects of mental health system development (see below). It is expected that these core mental health indicators will be collated and reported on every two years, starting with a baseline assessment for the year Mental Health ATLAS 2014 Collation of core mental health indicators on a regular basis will be embedded within an updated version of WHO s Mental Health ATLAS. WHO first produced an ATLAS of Mental Health Resources around the world in 2001; updates were produced in 2005 and 2011 ( ATLAS project has become a valuable resource on global information on mental health and an important tool for developing and planning mental health services within countries. Subsequent to this baseline data collection in 2014, a Mental Health ATLAS survey will be sent to country focal points every two years so that progress towards meeting the targets of the Action Plan can be measured over time (until 2020). To support mental health ATLAS 2014, we are requesting that you complete the following questionnaire. The questionnaire covers critical areas of mental health system development, including governance and financing, human resources, service availability and delivery, promotion and prevention, and surveillance. We will provide you with a copy of the completed ATLAS and acknowledge all experts and informants who assisted with this process. WHO Secretariat is willing and available to provide technical guidance and support in the completion of this survey. Please contact us at the address shown below.

2 Instructions for filling out the questionnaire You have been provided with a link to an electronic version of this mental health ATLAS 2014 questionnaire; please use / complete the electronic version wherever possible. Once you have started completing the questionnaire, all entered data will be saved as you go, so it is possible to pause and return to it at a later time as long as you use the same computer each time. A Word version is also available, and you may wish to use / print out this version in order to preview, discuss or gather specific data with colleagues and experts working in your country. We kindly ask you to complete each section using the assistance or advice of different informants according to their personal backgrounds or expertise. For example, we encourage you to consult with senior government officials, academics and mental health professionals working in your country, as they may provide additional valuable information. Although other informants may contribute, one person only will be responsible for the completion and submission of the questionnaire, whether using the electronic version or the Word version. It is important to answer all of the questions because we would like mental health ATLAS 2014 to be as complete as possible. We understand that it may be difficult to find aggregated national data to use for some of the questions. However, please try to respond to each question even if official data is unavailable and you need to make some estimates in collaboration with other colleagues. All items defined in the glossary appear in italics with an asterisk* in the questionnaire. Please refer to the glossary enclosed at the end of the questionnaire. In addition, you will find notes at the top of each section that provide additional information about some of the items. If after consulting the Glossary and the item notes you still have questions about any of the items or need help with the on-line questionnaire, please do not hesitate to contact us at WHO Headquarters (mhatlas@who.int). Please only report national data, unless otherwise specified. If healthcare in your country is administered at the provincial or state level, please collect the information at the regional level and then aggregate to the national level. If data is not available for a particular question, please enter UN (unknown). If the question is not relevant, for example, if a particular facility does not exist in your country, please enter NA (not applicable). If you are filling out a paper version of the questionnaire, please send any relevant documentation when you submit your questionnaire by mail or as scanned copies at the following postal address or address: Mental Health Atlas 2014 Department of Mental Health and Substance Abuse World Health Organization Avenue Appia, Geneva 27 Switzerland mhatlas@who.int Thank you very much for your help and cooperation!

3 Core mental health indicators, by action plan objective and target The Comprehensive Mental Health Action Plan contains six indicators for assessing progress towards agreed objectives and targets (WHA66.8, Appendix 1; shown in green). WHO secretariat was requested to identify additional mental health indicators for Member States to report on (shown in blue as service development indicators). Together, these form the core set of mental health indicators. Action Plan Objectives Action Plan Targets Action Plan Indicators Service development indicators Objective 1: To strengthen effective leadership and governance for mental health Target 1.1: 80% of countries will have developed or updated their policies or plans for mental health in line with international and regional human rights instruments (by the year 2020). Target 1.2: 50% of countries will have developed or updated their law for mental health in line with international and regional human rights instruments (by the year 2020). Existence of a national policy/plan for mental health that is in line with international and regional human rights instruments Existence of a national law covering mental health that is in line with international and regional human rights instruments Financial resources: Government health expenditure on mental health Human resources: Number of mental health workers Capacity building: Number and proportion of primary care staff trained in mental health Objective 2: To provide comprehensive, integrated and responsive mental health and social care services in community-based settings Target 2: Service coverage for severe mental disorders will have increased by 20% (by the year 2020). Number and proportion of persons with a severe mental disorder who received mental health care in the last year Stakeholder involvement: Participation of associations of persons with mental disorders and family members in service planning and development Service availability: Number of mental health care facilities at different levels of service delivery Objective 3: To implement strategies for promotion and prevention in mental health Objective 4: To strengthen information systems, evidence and research for mental health Target 3.1: 80% of countries will have at least two functioning national, multisectoral mental health promotion and prevention programmes (by the year 2020) Target 3.2: The rate of suicide in countries will be reduced by 10% (by the year 2020). Target 4: 80% of countries will be routinely collecting and reporting at least a core set of mental health indicators every two years through their national health and social information systems (by the year 2020). Functioning programmes of multisectoral mental health promotion and prevention in existence Number of suicide deaths per year Core set of mental health indicators routinely collected and reported every two years Inpatient care: Number and proportion of admissions for severe mental disorders to inpatient mental health facilities that a) exceed one year and b) are involuntary Service continuity: Number of persons with a severe mental disorder discharged from a mental or general hospital in the last year who were followed up within one month by communitybased health services Social support: Number of persons with a severe mental disorder who receive disability payments or income support

4 Basic Information Note: If data is based on different years (e.g., some of the data are based on 2013 and others on 2012) please enter the year for which the majority of the data is based. Which WHO region are you from: African Region Region of the Americas South-East Asia Region European Region Eastern Mediterranean Region Western Pacific Region Country: Population of country: Year on which data is based : Contact details of the person responsible for approving the questionnaire: Name: Title/Position: Mailing Address :

5 Telephone : Name and title/position of authorizing official (if required). Name: Title/Position: Question 1 MENTAL HEALTH POLICY NOTES: 1. Policies or plans for mental health may be stand-alone or integrated into other general health or disability policies or plans 2. The mental health policy and/or plan is considered valid if it has been approved / published by the Ministry of Health or parliament 3. If both a mental health policy or plan are available, countries should assess both documents as one entity 4. For countries with a federated system, please refer to policies/plans of the majority of states/provinces or the majority of the population in the country 1.1 Do you have a stand-alone policy or plan for mental health? Yes No 1.2 If yes, please state the Year of policy / plan: (latest revision) 1.3 If no, are policies and plans for mental health integrated into those for general health or disability? Yes No 1.4 Please state the current status of your country s policy / plan for mental health (whether stand-alone or integrated) (Select one response only) Not developed / not available Available but not implemented Available and partially implemented Available and fully implemented

6 1.5 Please complete the following checklist in order to assess compliance of policy/plan with international human rights instruments The current policy/plan promotes the transition towards mental health services based in the community (including mental health care integrated into general hospitals and primary care) YES NO The current policy/plan for mental health pays explicit attention to respect for the human rights of people with mental disorders and psychosocial disabilities and vulnerable and marginalized groups The current policy/plan for mental health promotes a full range of services and supports to enable people to live independently and be included in the community (including habilitation and rehabilitation services, social services, educational, vocational, employment opportunities, housing services and supports, etc.) The current policy/plan for mental health promotes a recovery approach* to mental health care, which emphasizes support for individuals to achieve their aspirations and goals, and the involvement of mental health service users in the development of their treatment and recovery plans The current policy/plan for mental health promotes the participation of persons with mental disorders and psychosocial disabilities in decision making processes on issues affecting them (e.g. policy, law, service reform) YES YES YES YES NO NO NO NO Question 2 MENTAL HEALTH LEGISLATION NOTES: 1. Mental health legislation refers to specific legal provisions that are primarily related to mental health, which typically focus on issues such as civil and human rights protection of people with mental disorders, treatment facilities, personnel, professional training and service structure. 2. For countries with a federated system, the indicator will refer to the laws of the majority of states/provinces within the country. 3. Laws for mental health may be stand-alone or integrated into other general health or disability laws. 2.1 Do you have a stand-alone law for mental health? Yes No 2.2 If yes, please state the Year of law: (latest revision) 2.3 If no, is mental health legislation integrated into general health or disability laws? Yes No 2.4 Please state the current status of your country s law covering mental health (Please tick one box only) Not developed / not available Available but not implemented

7 Available and partially implemented Available and fully implemented

8 2.5 Please complete the following checklist in order to assess compliance of legislation with international human rights instruments Current legislation promotes the transition towards mental health services based in the community YES NO Current legislation promotes the right of persons with mental disorders to exercise their legal capacity*, and to nominate a trusted person or network of people to support them in discussing issues and making decisions Current legislation promotes alternatives to coercive practice; these alternatives include voluntary admission, informed consent to treatment and substitutes for seclusion and restraints* Current legislation provides for procedures to enable people with mental disorders and psychosocial disabilities to protect their rights and file appeals and complaints to an independent legal body Current legislation provides for regular inspections of human rights conditions in mental health facilities by an independent body YES YES YES YES NO NO NO NO Question 3 STAKEHOLDER INVOLVEMENT 3.1 Please complete the following checklist in order to assess the level of involvement of associations of persons with mental disorders and family members in the formulation and implementation of mental health policies, laws and services at national level in the last two years Domain Measure Not implemented Partially implemented Fully implemented Information Policy Early involvement Participation Ministry of Health gathers and disseminates information about organizations of persons with mental and psychosocial disabilities, and of families and carers Ministry of Health has developed and published a formal policy on the participation of persons with mental and psychosocial disabilities in the formulation and implementation of mental health policies, plans, legislation and services. Persons with mental and psychosocial disabilities, as well as families and carers, are involved from the beginning of the formulation and implementation of mental health policies and laws, and given adequate notice. Ministry of Health systematically involves persons with mental and psychosocial disabilities in planning, policy, service development and evaluation: the majority of committees and subcommittees developing the above areas have representation of an organization of persons with mental and psychosocial disabilities or at least one person with a mental and psychosocial disability

9 Resources Ministry of Health reimburses costs of participation of persons with mental and psychosocial disabilities and provides resources to allow participation (physical location, transport, remuneration or reimbursement of expenses, interpreters, attendant carers and meeting support personnel) Question 4 GOVERNMENT MENTAL HEALTH SPENDING NOTES: 1. Since there is no globally implemented system of health accounting for mental health care spending, each country needs to determine and define the scope and content of its mental health spending. 2. Mental health spending can include activities delivered in primary care (e.g. psychosocial treatment for mental disorders or spending on psychotropic drugs) and in social care (e.g. admissions for mental disorders in social institutions) 3. Mental health spending also includes programmatic costs incurred above the level of health care facilities, including administration / management, training and supervision, and mental health promotion activities. 4. Total reported mental health spending can be divided by known total health expenditure in the country (available from WHO s National Health Accounts database) to derive the proportion of total health spending allocated to mental health. 4.1 Please rank who is the main overall source of funds for care and treatment of severe mental disorders (e.g. psychosis, bipolar disorder) in your country? Government (e.g. national health insurance / reimbursement schemes) Non-governmental Organisations (profit and non-profit) Employers (e.g. social health insurance schemes) Households (e.g. direct out-of-pocket payments and private insurance) 4.2 Please answer the following questions before completing the table 4.3 below: Please indicate the 12 month period that is used to complete the table below: Start: / (e.g. 01 / / 2013) Finish: / Name of the local currency units used in completing this table:

10 4.3 Please complete the table below in order to show the total government annual mental health expenditure in your country. CARE SETTING TOTAL GOVERNMENT MENTAL HEALTH EXPENDITURE IN THE LAST YEAR Inpatient and day care services Mental hospital* Psychiatric wards in general hospitals* Mental health community residential facilities* Mental health day treatment facilities* Other residential facilities* Outpatient and primary health care services Mental health outpatient facilities* Primary care facilities / clinics* Other outpatient health facilities or services (e.g. outreach, private practices) Social care services Community care or rehabilitation facilities Other programmatic costs not included above (e.g. programme management, training, media) TOTAL GOVERNMENT SPENDING IN THE LAST YEAR (local currency units) Note: UN = Unknown TOTAL Question 5 MENTAL HEALTH WORKFORCE 5: Mental health workforce NOTES: 1. Exclude non-specialized health professionals working in general health care facilities or services (i.e. staff working in primary care and in general hospitals) 2. Include specialized mental health professionals working partly or fully in general as well as specialist health care settings 3. Include mental health staff (both full-time or part-time) working in government, voluntary / NGO and private (forprofit) mental health facilities and services. 4. To avoid double-counting, if staff work in more than one setting, please allocate the staff to the care setting where the professional spends most of their time, or split their time accordingly.

11 5.1 Please complete the table below showing the total number of mental health workers in your country CARE SETTING Inpatient and day care services Mental hospitals* Psychiatric ward in a general hospitals* Mental health community residential facilities* Mental health day treatment facilities* MENTAL HEALTH WORKFORCE (NUMBER OF MENTAL HEALTH PROFESSIONALS, BY CARE SETTING) Total number of professionals working in mental health Psychiatrists working in mental health Other medical doctors working in mental health Nurses working in mental health Psychologists working in mental health Social workers working in mental health* Occupational therapists working in mental health* Other paid workers working in mental health* Outpatient care services Mental health outpatient facilities Other outpatient health facility or service (e.g. outreach, private practice) TOTAL [UN=unknown]

12 Question 6 MENTAL HEALTH TRAINING IN PRIMARY CARE NOTES: 1. One day of training is equivalent to at least 6 hours 2. New / initial in-service training covers general principles of care, core competencies needed, introduction to priority disorder and their appropriate assessment and management (e.g. mhgap base course or standard course); it is expected to last at least 4-6 days, but for certain types of health worker and settings (e.g. community health workers focusing on a sub-set of disorders) could be 2-3 days. 3. Refresher / specific in-service training summarizes general principles, practices and competencies from initial training sessions, and/or focuses on the assessment and management of one or more specific disorders (e.g. from the mhgap standard course) 6.1 Please complete the table below showing the number (and proportion) of primary care staff trained in mental health at least two days in the last two years PRIMARY CARE STAFF TRAINED IN MENTAL HEALTH AT LEAST TWO DAYS IN THE LAST TWO YEARS (BY TYPE OF PROFESSIONAL) Number of staff working in primary care Number of primary care staff trained in mental health at least two days in the last two years % trained New / initial inservice training Refresher / specific in-service training Physicians / Doctors % Nurses % Midwives % Community health workers % Other health care workers % [UN=unknown]

13 Question 7 SERVICE AVAILABILITY 7.1 Please complete the following table in order to assess the level mental health service availability in your country MENTAL HEALTH SERVICE AVAILABILITY IN THE COUNTRY CARE SETTING Total number of facilities/beds/visits Mental hospitals* (including forensic units*) Psychiatric units / beds in general hospitals* Mental health community residential facilities* Mental health day care or treatment facilities* Mental health outpatient facilities* Other outpatient facilities (specify: ) facilities facilities facilities facilities facilities facilities beds beds beds places N/A N/A admissions in last year admissions in last year admissions in last year sessions in last year visits in last year visits in last year [UN= data are unknown] Question 8 SERVICE COVERAGE FOR SEVERE MENTAL DISORDERS NOTES: 1. For the purpose of this indicator, severe mental disorders include: non affective psychosis (ICD-10 F2); bipolar affective disorder (ICD-10 F30-31); moderate-severe depression (ICD-10 F F33.1-3); moderate depression is included due to its prevalence, its significant adverse impact on functioning and its influence on suicidal ideation. Many other mental disorders can be severe (e.g. substance use disorders, obsessive-compulsive disorders, personality disorders); these are not included for the purpose of this indicator to limit measurement effort. 2. For measuring coverage, it is the number of persons in need who receive care (rather than number of services provided) that has to be counted 3. Outpatient care is composed of hospital outpatient departments, primary health care and community-based health care facilities, including day-care centers; inpatient care is composed of mental hospitals, psychiatric wards in general hospitals, community residential facilities 4. Health care facilities cover those run both by government and non-governmental (profit or not-for-profit) providers 5. The sum of persons with severe mental disorder who received care in the previous one year from the various inpatient and outpatient health facilities can be considered a reasonable approximation of treated prevalence.

14 However, without unique personal identifiers, this sum may include some patients treated in more than one setting and therefore count these persons more than once. 6. In order to derive a measure of service coverage, reported values for this indicator can be related to the expected number of cases of severe mental disorder in the population (based on local epidemiological surveys or estimates from global and regional disease burden studies) 7. If MHIS is unavailable or insufficient, a baseline and repeat survey of facilities providing mental health services to persons with severe mental disorders in one or more defined geographical areas of a country can be carried out; the survey should be repeated at least once before 2020 (preferably every 2-3 years) in order to assess the target of increased service coverage by 20% 8. If data by diagnostic group is incomplete or reported differently in your country, please contact the WHO secretariat in the Department of Mental Health and Substance Abuse to discuss the completion of this exercise 9. If service utilization data are available by age and sex, please also provide this information to WHO. 8.1 Please answer the following questions before completing the table below (8.2) Indicate if the population used for completing the table below refers to: National level (the total population of the country) Regional / provincial level (the total population of one or more regions/provinces) Specific sites / localities (local areas where the data are available or have been collected) Name of the population used for completing the table below: (e.g. country, region, or other administrative area) What is the size of this population (number of persons)? Year to which this data table refers: Are the data derived from: Routine health information systems Periodic or occasional survey 8.2 Please complete the table below in order to show the number of persons with mental disorder who received mental health care in the last year. NUMBER OF PERSONS WITH MENTAL DISORDER WHO RECEIVED MENTAL HEALTH CARE IN THE LAST YEAR All mental Severe mental disorders disorders CARE SETTING Nonaffectivsevere Moderate- Bipolar (common and severe) disorder psychosis depression Inpatient and day care services Mental hospital* Psychiatric ward in a general hospital* Mental health community residential facility* Mental health day treatment facility* Other residential facility* Outpatient and primary health care services Mental health outpatient facility* Primary care facility / clinic* Other outpatient health facility or service (e.g. outreach service)

15 Social care services Community care or rehabilitation facility (e.g. day care centres) TOTAL UN = Unknown Question 9 INPATIENT CARE NOTES: 1. Length of stay of people staying in mental hospitals on December 31 st of the year on which data are based (leave without discharge such as visits home for the holidays is not considered as an interruption of the stay). 2. Treatment without consent (involuntary treatment) should be permitted only under exceptional circumstances (which must be outlined in the country s mental health legislation). 3. Mental health legislation should incorporate adequate procedural mechanisms that protect the rights of persons with mental disorders who are being treated involuntarily 4. Total admissions can / will be divided by the population of the country to derive a rate per 100,000 population 5. If admission data are available by age and sex, please also provide this information to WHO. 9.1 Please complete the table below showing the total number of patients in mental hospitals (by length of stay) PATIENTS IN MENTAL HOSPITALS BY LENGTH OF STAY (number) Total number Total number of inpatients staying in mental hospitals on December 31 st Number of inpatients staying less than 1 year Number of inpatients staying more than 1 and less than 5 years Number of inpatients staying more than 5 years Males Females 9.2 Please complete the table below showing involuntary and total admissions to inpatient mental health facilities INVOLUNTARY AND TOTAL ADMISSIONS TO INPATIENT MENTAL HEALTH FACILITIES (number and percentage) Total admissions Involuntary admissions % of total admissions that are involuntary Mental Hospitals* % Psychiatric wards in General Hospitals* % Mental Health Community Residential Facilities* % TOTAL % [UN= data are unknown; NA=not applicable]

16 Question 10 CONTINUITY OF CARE AFTER DISCHARGE NOTES: 1. Reported values below can be divided by population size to derive a rate per 100,000 population. 2. If discharge / follow-up data are available by sex, please also provide this information to WHO Please answer the following questions before completing the table below (10.2) Indicate if the population used for completing the table below refers to: National level (the total population of the country) Regional / provincial level (the total population of one or more regions/provinces) Specific sites / localities (local areas where the data are available or have been collected) Name of the population used for completing the table below: (e.g. country, region, or other administrative area) What is the size of this population (number of persons)? Year to which this data table refers: Are the data derived from: Routine health information systems Periodic or occasional survey 10.2 Please complete the table below in order to show the number of severe mental disorder discharged from hospital in the last year who had a follow-up visit within one month NUMBER OF PERSONS WITH A SEVERE MENTAL DISORDER DISCHARGED FROM HOSPITAL IN THE LAST YEAR WHO HAD A FOLLOW-UP VISIT WITHIN ONE MONTH (number and percentage) Total number of persons discharged in the last year Total number of persons discharged in the last year who had a follow-up visit within one month % of discharged inpatients followedup within one month Mental Hospitals* % Psychiatric wards in % general hospitals* TOTAL % [UN= data are unknown; NA=not applicable]

17 Question 11 SOCIAL SUPPORT NOTES: 1. Include persons with a mental disorder who are officially recorded / recognized as being in receipt of government support 2. Exclude persons with a mental disorder who are in receipt of monetary / non-monetary support from family members, local charities and other non-governmental organizations 3. If social support data are available by sex, please also provide this information to WHO Please complete the table below showing the total number of persons with mental disorders who received social support in the last year NUMBER OF PERSONS WITH MENTAL DISORDERS WHO RECEIVED SOCIAL SUPPORT IN THE LAST YEAR, BY SEVERITY OF DISORDER Total Persons with severe Persons with other mental disorder mental disorder MONETARY SUPPORT (e.g. disability payments or income support) NON-MONETARY SUPPORT (e.g. housing support, access to employment, educational assistance) TOTAL [UN= data are unknown; NA=not applicable]

18 Question 12 MENTAL HEALTH PROMOTION AND PREVENTION NOTES: 1. Target populations include specific conditions (e.g. self-harm and suicide), age groups (e.g. children and adolescents) and other population groups (e.g. survivors of disasters) 2. Definition of functioning programme: a. Dedicated financial and human resources [Yes/No] b. Defined implementation plan with timelines [Yes/No] c. Documented evidence /evaluation of progress or impact [Yes/No ] 3. Definition of programme types: a. Universal prevention is defined as those interventions targeted at the general public or to a whole population group (that has not been identified on the basis of an increased mental health risk). b. Selective prevention targets individuals or subgroups of the population whose risk of developing a mental disorder is significantly higher than average, as evidenced by biological, psychological or social risk factors. c. Indicated prevention targets high-risk people who are identified as having detectable signs or symptoms foreshadowing mental disorder

19 12.1 Please complete the table below describing mental health promotion and prevention programmes in your country Please list up to 10 leading programmes in your country (provide brief description on the first column and a website address, if available, on the second column). Please tick all the functionalities applicable for each programme. List up to 10 leading programmes in your country Functionality of the programme (yes or no) Brief description of the programme Web address (if available) Dedicated financial and human resources A defined plan of implementation Evidence of progress and/or impact 1) 2) 3) 4) 5) 6) 7) 8) 9) 10)

20 12.2 Please complete the table below referring to the Programme numbers as per table Name / description of programme 1) As per table 12.1 Scope of programme Key: 1 = National level 2 = Regional level 3 = District level 4 = Local level Management of programme Key: 1 = Government 2 = NGO 3 = Private 4 = Jointly managed Type of programme Key: 1 = Not sure 2 = Universal 3 = Selective 4 = Indicated Targeted condition Key: 0 = Not applicable 1 = Self-harm / suicide 2 = Alcohol use 3 = Other drug use 4 = Childhood disorders 5 = Depression / anxiety 6 = Psychosis 7 = Other condition / disorder (specify) Targeted age groups Key: 1 = Children 2 = Adolescents / young people 3 = Adults 4 = Elderly 5 = All ages Targeted population groups Key: 0 = Not applicable 1 = Women of child-bearing age 2 = Survivors of personal violence 3 = Survivors of disasters 4 = Indigenous communities 5 = Rural communities 6 = Other population group (specify) 2) 3) 4) 5) 6) 7) 8) 9) 10)

21 Question 13 SUICIDE RATE NOTES: 1. In order to derive the rate of suicide, numbers of suicides reported here can / will be divided by the size of the ageand sex-specific population. 2. If different age groups are used in your country, please contact the WHO secretariat in the Department of Mental Health and Substance Abuse to discuss the completion of this exercise 13.1 Has your country developed a national suicide prevention strategy? Yes No [i.e. a comprehensive strategy or action plan adopted by government] 13.2 Please answer the following questions before completing the table below (13.3) Indicate if the population used for completing the table below refers to: National level (the total population of the country) Regional / provincial level (the total population of one or more regions/provinces) Specific sites / localities (local areas where the data are available or have been collected) Name of the population used for completing the table below: (e.g. country, region, or other administrative area) What is the size of this population (number of persons)? Year to which this data table refers: Are the data derived from: Routine health information systems Periodic or occasional survey 13.3 Please complete the table below in order to show the number of suicide deaths, by age and sex NUMBER OF SUICIDE DEATHS, BY AGE AND SEX Age group (years) Total Male Female Total UN = Unknown.

22 Question 14 CORE MENTAL HEALTH INDICATOR SET 14.1 Please select one response only from the following checklist concerning the availability / status of mental health reporting in your country: No mental health data have been compiled in a report for policy, planning or management purposes in the last two years Mental health data (either in the public system, private system or both) have been compiled for general health statistics in the last two years, but not in a specific mental health report A specific report focusing on mental health activities in the public sector only has been published by the Health Department or any other responsible government unit in the last two years A specific report focusing mental health activities in both the public and private sector has been published by the Health Department or any other responsible government unit in the last two years Thank you for completing the Mental Health Atlas questionnaire 2014 We will acknowledge your contribution according to WHO rules and procedures.

23 GLOSSARY TYPES OF FACILITY Forensic inpatient unit: An inpatient unit that is exclusively maintained for the evaluation or treatment of people with mental disorders who are involved with the criminal justice system. These units can be located in mental hospitals, general hospitals, or elsewhere. Mental hospital: A specialized hospital-based facility that provides inpatient care and long-stay residential services for people with mental disorders. Includes: Public and private non-profit and for-profit facilities; mental hospitals for children and adolescents and other specific groups (e.g., elderly). Excludes: Community-based psychiatric inpatient units; forensic inpatient units / hospitals; facilities that treat only people with alcohol and substance abuse disorder or intellectual disability. Psychiatric ward in a general hospital: A psychiatric unit that provides inpatient care within a communitybased hospital facility (e.g. general hospital); period of stay is usually short (weeks to months). Includes: Public and private non-profit and for-profit facilities; psychiatric ward or unit in general hospital, including those for children and adolescents or other specific groups (e.g. elderly). Excludes: Mental hospitals; community residential facilities; facilities for alcohol and substance abuse disorder or intellectual disability only. Mental health community residential facility: A non-hospital, community-based mental health facility providing overnight residence for people with mental disorders. Both public and private nonprofit and forprofit facilities are included. Includes: Staffed or un-staffed group homes or hostels for people with mental disorders; halfway houses; therapeutic communities; Excludes: mental hospitals; facilities for alcohol and substance abuse disorder or intellectual disability only; residential facilities for elderly people; institutions treating neurological disorders, or physical disability problems. Mental health day treatment facility: A facility providing care and activities for groups of users during the day that lasts half or one full day (including those for children and adolescents only or other specifics groups; e.g. elderly). Includes: day or day care centres; sheltered workshops; club houses; drop-in centres. Both public and private non-profit and for-profit facilities are included. Excludes: Day treatment facilities for inpatients; facilities for alcohol and substance abuse disorder or intellectual disability only. Mental health outpatient facility: An outpatient facility that manages mental disorders and related clinical and social problems. Includes: Community mental health centres; mental health outpatient clinics or departments in general or mental hospitals (including those for specific mental disorders, treatments or user groups, e.g. elderly). Both public and private non-profit and for-profit facilities are included. Excludes: Private practice; facilities for alcohol and substance abuse disorder or intellectual disability only. Other residential facility: A residential facility that houses people with mental disorders but does not meet the definition for community residential facility or any other defined mental health facility. Includes: Residential facilities specifically for people with intellectual disability, for people with substance abuse problems, or for people with dementia; residential facilities that formally are not mental health facilities but where the majority of residents have diagnosable mental disorders.

24 Primary health care clinic: A clinic that often offers the first point of entry into the health care system. Primary health care clinics usually provide the initial assessment and treatment for common health conditions and refer those requiring more specialized diagnosis and treatment to facilities with staff with a higher level of training. TYPES OF WORKER Nurse: A health professional having completed a formal training in nursing at a recognized, university-level school for a diploma or degree in nursing. Occupational therapist: A health professional having completed a formal training in occupational therapy at a recognized, university-level school for a diploma or degree in occupational therapy. Other health or mental health worker: A health or mental health worker that possesses some training in health care or mental health care but does not fit into any of the defined professional categories (e.g. medical doctors, nurses, psychologists, social workers, occupational therapists). Includes: Non-doctor/nonnurse primary care workers, psychosocial counsellors, auxiliary staff. Excludes: General staff for support services within health or mental health care settings (e.g. cooking, cleaning, security). Primary health care doctor: A general practitioner, family doctor, or other non-specialized medical doctor working in a primary health care clinic. Primary health care nurse: A nurse working in a primary health care clinic. Psychiatrist: A medical doctor who has had at least two years of post-graduate training in psychiatry at a recognized teaching institution. This period may include training in any sub-specialty of psychiatry. Psychologist: A professional having completed a formal training in psychology at a recognized, university-level school for a diploma or degree in psychology. WHO-AIMS asks for information only on psychologists working in mental health care. Social worker: A professional having completed a formal training in social work at a recognized, university-level school for a diploma or degree in social work. WHO-AIMS asks for information only on social workers working in mental health care. OTHER TERMS USED Legal capacity: The UN Convention on the Rights of Persons with Disabilities recognizes that people with disabilities, including mental disabilities, have the right to exercise their legal capacity and make decisions and choices on all aspects of their lives, on an equal basis with others. The Convention promotes a supported decision-making model, which enables people with mental disabilities to nominate a trusted person or a network of people with whom they can consult and discuss issues affecting them. Recovery approach: From the perspective of the individual with mental illness, recovery means gaining and retaining hope, understanding one s abilities and disabilities, engaging in an active life, and having personal autonomy, social identity, meaning and purpose in life, and a positive sense of self. Recovery is not synonymous with cure.

25 Seclusion and restraints: Seclusion means the voluntary placement of an individual alone in a locked room or secured area from which he or she is physically prevented from leaving. Restraint means the use of a mechanical device or medication to prevent a person from moving his or her body. Alternatives to seclusion include prompt assessment and rapid intervention in potential crises; using problem-solving methods and/or stress management techniques such as breathing exercises.

Turkey. Note: A Mental Health Action plan is prepared but has not been published yet.

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