WHO calls for mental health to be central to neglected tropical disease care

A major new World Health Organization publication sets out, for the first time, a practical, evidence-based package of care to address the mental health impacts of neglected tropical diseases (NTDs) and the stigma that can prevent people from seeking care and participating fully in society.

The Essential care package to address mental health and stigma for persons with neglected tropical diseases responds to growing evidence that people living with NTDs experience higher rates of depression, anxiety, distress and suicidal behaviours than the general population, driven not only by the direct effects of illness but by stigma, discrimination and social exclusion.

The Essential Care Package (ECP) provides governments, health leaders, and frontline services with clear guidance on integrating mental health support and stigma reduction into existing NTD programmes and health systems, including prevention, identification, assessment, management, and follow-up.

With more than one billion people affected by NTDs worldwide, the ECP argues that progress towards elimination will be limited unless mental health and stigma are treated as a core part of disease management rather than an add-on.

"NTDs take a far greater toll on mental and social well-being than is often recognised," said Dr Daniel Ngamije Madandi, Director of the WHO Department of Malaria and Neglected Tropical Diseases. "By integrating mental health and tackling stigma head-on, the Essential care package (ECP) equips countries to confront the full reality of NTDs and move closer to WHO's vision of complete well-being."

The ECP sets out clear, practical actions to integrate mental health care and stigma reduction into NTD services, with defined responsibilities across people living with NTDs, communities, health workers and system leaders. It calls for people affected by NTDs to be supported to recognise distress, know where and how to seek help, access peer support, and understand their right to health care, employment and community life. Families and communities are identified as critical to recognising distress early, supporting help-seeking, and challenging attitudes and behaviours that drive stigma and exclusion.

Professor Julian Eaton, Senior Lecturer in Global Mental Health at Liverpool School of Tropical Medicine, said: "Integration does not work when it is treated as an extra checkbox for already stretched services. This package is invaluable because it sets out what good integration looks like in practice, from involving people with lived experience in service design, to routine screening and compassionate care, to referral pathways and peer support that reduce isolation and self-stigma.

"If we want NTD programmes to succeed, we have to take stigma and mental health seriously as part of meeting overall needs, not as a separate issue."

For frontline health workers, the ECP focuses on routine, compassionate, person-centred care. It recommends that mental health assessment and support are embedded within NTD services, including basic psychoeducation, screening and clear referral pathways to peer support, physical health care and specialist mental health services. Training is emphasised not only to build clinical skills, but also to reduce stigmatising attitudes within services and ensure that comorbid mental health needs are recorded.

At a system level, the ECP stresses that integration requires coordinated planning between NTD and mental health programmes rather than parallel delivery. This includes strengthening community-based supports such as peer groups, incorporating mental health indicators into routine NTD data collection, and exploring collaborative care models such as embedding mental health care specialists within NTD services.

Together, these measures aim to make integrated care feasible in resource-constrained settings, improving wellbeing, strengthening treatment adherence and supporting progress towards NTD elimination and universal health coverage.

The ECP was developed by World Health Organization and a broad international partnership spanning NGOs, academia and organisations representing people affected by NTDs.

The ECP was developed by WHO, Liverpool School of Tropical Medicine, Neglected Tropical Disease NGO Network cross-cutting group on Disease Management, Disability and Inclusion, CBM Global Disability Inclusion, The Leprosy Mission, Netherlands Leprosy Mission, Brighton and Sussex Medical School, The Carter Center, Lepra, Effect Hope, the International Federation of Anti Leprosy Associations and its Advisory Panel of Persons Affected by Leprosy, infoNTD, the Anesvad Foundation and others.