Ahead of World Mental Health Day, the World Health Organization (WHO) has released a new guide to support countries in shifting away from institutionalized mental health care models focused on long-term stays in psychiatric hospitals towards person-centred care in the community that respect people’s rights and choices.
Many people with mental health conditions are currently living in large psychiatric hospitals and social care institutions. Nearly half are kept in these facilities involuntarily for months, years, or even decades, isolating them from the outside world.
Known as deinstitutionalization (DI), this process involves helping people who have spent long periods (six months or more) in psychiatric hospitals to return and live in their communities, with the care, support and opportunities they need to lead fulfilling lives.
“People should not have to give up their freedom, dignity or place in their community to receive ongoing mental health support,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “Countries must move away from relying on long-term institutional care and accelerate the shift of investments from institutions to rights-based mental health care and support in communities.”
The new guide sets out practical actions for psychiatric hospital leaders to implement DI. It focuses on reducing psychiatric hospital admissions and long stays, changing institutional practices to better protect people’s rights, and helping people leave hospital and return to community life with the support they need.
It also makes clear that DI cannot be achieved by hospitals alone. Access to housing, health care, social support, education, employment opportunities and support for families are essential to helping people live well in their communities.
Many countries are working to strengthen community-based mental health services, but progress remains uneven. WHO’s Mental Health Atlas found that only 9% of reporting countries had fully shifted to community-based mental health care, while more than half (53%) were still at an early stage of reform. More than one in four (28%) people admitted to psychiatric hospitals stayed longer than six months.
Putting lived experience at the centre
The new DI guide aligns with this year’s World Mental Health Day theme, “Lived experiences heard: real voices, real change,” and highlights the importance of ensuring that people with lived experience are active partners in shaping the policies, services and decisions that affect their lives.
Too often, people who have experienced institutional care are left out of decisions about how mental health systems are designed and reformed – decisions that directly shape the care, treatment and support they receive. Yet their knowledge and experience are vital to understanding what helps people recover, take part in community life, and access the services and support they need.
“Shifting towards community-based mental health care must be done with people who know what it means to go through institutional care, not for them,” said Grace Gatera, independent lived experience consultant and advocate. “Their expertise, alongside that of others, is essential to building services that support choice, recovery and participation in community life.”
The guide was developed with experts from around the world, including people with lived experience. Its practical approaches can be adapted to different countries and local contexts.
On World Mental Health Day, WHO is calling on governments and services to accelerate the shift from institutional to community-based mental health care and build mental health systems together with people with lived experience, not simply for them.
About WHO
Dedicated to the well-being of all people and guided by science, WHO leads and champions global efforts to give everyone, everywhere, an equal chance at a safe and healthy life. We are the United Nations’ agency for health that connects nations, partners and people in more than 150 locations – leading the world’s response to health emergencies, preventing disease, addressing the root causes of health issues and expanding access to medicines and health care. Our mission is to support all countries to promote, provide and protect health. “Together for health. Stand with science”, the theme of World Health Day 2026, marks a year-long campaign to highlight science as the foundation for protecting health and well-being worldwide.