USAID Mental Health Position Paper | Document | U.S. Agency for International Development

USAID has long supported initiatives that increase access to mental health services. The Agency now elevates this commitment with the USAID Mental Health Position Paper, USAID’s first policy document related to the integration of mental health into Agency programs. The Position Paper signals USAID’s commitment to advancing mental health around the world and achieving USAID’s long-term development goals.

The Policy Paper focuses on four principles that will guide the Agency’s approach:

Promote sustainable enabling environments that support mental health.
Apply contextually-appropriate approaches developed in partnership with local communities.
Actively promote the use of ethics, human rights, and Do No Harm practices.
Address key barriers to effective programming, including mental health stigma and the need to diversify and strengthen partnerships.

The Position Paper is the result of careful work spanning over two years. In January of 2022, USAID launched a policy development process and initiated broad stakeholder consultations. Nearly 200 participants, representing geographic, thematic, professional, and experiential diversity provided input. This information and an extensive literature review, summarized in 11 evidence briefs linked below, informed the development of the position paper and the recommended approaches.

Evidence Briefs

“Proposed Theory of Change for Global Mental Health” summarizes research on determinants of mental health to inform a possible theory of change for global mental health.
“Contextualization of Mental Health Interventions in Global Mental Health” provides a summary of literature on current concepts, terms, and accepted practices for the contextualization of mental health interventions; discusses barriers and limitations when contextualizing interventions, challenges regarding use of the term “cultural adaptation” in global mental health, and promising approaches to consider.
“Trauma-informed Approaches in Global Mental Health” provides an overview of trauma-informed approaches at the organizational and service levels.
“Mental Health Research in Humanitarian and Development Settings” identifies gaps in global mental health research and offers recommendations for how policies and programs may address pressing research needs in international development and humanitarian settings.
“Mental Health Terminology” discusses global terms to describe mental health and contextualizes terminology; provides a list of standard terms with accompanying definitions for mental health.
“Terms and Approaches to Address Mental Health” examines terms and approaches used across professions that work in global mental health; provides suggestions for integration into mental health policy and programming.
“Mental Health Stigma and Discrimination” examines how mental health stigma and discrimination influence policy and implementation efforts in development and humanitarian contexts.
“Conceptualization of Mental Health” provides a review of literature about how mental health is conceptualized across regions and cultures and discusses implications for programming.
“Ethical Principles in Global Mental Health” reviews “do no harm” and safety principles and discusses an appropriate broader set of ethical principles.
“Ethical Principles Across Professions” summarizes the ethical codes used by mental health professional organizations and discusses relevance to development and humanitarian contexts.
“Mental Health Treatment Approaches in the Global South” discusses treatment approaches used in the Global South and acknowledges that many evidence-based approaches were developed in the Global North and that opportunities for evidence generation in relation to promising approaches developed in the Global South may have been limited.

USAID Mental Health Position Paper

Positive mental health allows people to more readily cope with stressors and adapt to change. At scale, mental adaptiveness translates into stronger, more resilient communities. In this way, elevating mental health throughout USAID is another way of putting into practice our Agency's mission of advancing a free, peaceful, and prosperous world.

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