"Public policy consists of a plan of action or program and a statement of objectives." (1) "An explicit health policy achieves several things: it defines a vision for the future which in turn helps establish benchmarks for the short and medium term. It outlines priorities and the expected roles of different groups. It builds consensus and informs people, and in doing so fulfils an important role of governance." (2)

A mental health policy is a concise statement by government intended to set clear directions to improve the mental health of the community, for the future development of mental health services "and other aspects of care provided by the family, community and other relevant agencies." (3) Some countries include within their national mental health policy a Mission Statement or Vision that captures the thrust or direction of the policy. "Mental health policy is concerned with a diverse agenda that aims to improve the mental health status of populations by providing clinical services and treatment, preventing mental illness or minimizing progression of emotional distress to mental disorder and promoting mental health." (4) Mental health plans, programmes and strategies are developed from the mental health policy and outline the way in which mental health policy objectives will be achieved. Mental health policies "coordinate through a common vision and plan, all programmes and services related to these objectives. Without this type of organization, programmes and services are likely to be inefficient and fragmented." (5) "It is widely recognized that national policy, programme and legislation on mental health are basic requirements for the mental health care in any country." (6)

Despite wide recognition of the importance of national mental health policies, data collected by the World Health Organization (WHO) reveals that of the 181 countries of the world, covering 98.7% of the world's population, 43% (78) have no mental health policy and 23% (37) have no mental health legislation. (7) For example, about half of the WHO African and Western Pacific region countries do not have a mental health policy. (8) As a result while there are increasingly effective interventions available to reduce the burden of mental illness, many countries do not have the policy and planning frameworks in place to identify and deliver mental health interventions, even when resources are available. As a result, people with serious and chronic mental illness, such as schizophrenia, and their families, suffer extreme personal, social and economic hardship and disempowerment, often on a life-long basis.

Experience in many countries and that of organizations such as WHO and the World Bank has shown that sector wide reform, in both health and mental health, has been more successful when undertaken within a clear, long term policy framework, supported by government and major stakeholders. Both WHO and the World Bank have emphasized the need for ready access to the basic tools for mental health policy formulation, implementation and sustained development. At present such tools are extremely limited. (9)

The Mental Health Policy Template aims to provide the user with a basic tool or framework upon which to base the formulation of a mental health policy. It is intended to be generalizable across countries and regions and to include what is common to all countries. The Template is not prescriptive in terms of measures to be used or actions to be taken in relation to policy development or implementation.

The Template identifies the essential domains and elements that need to be considered when formulating mental health policy. It consists of four major domains. Within each domain are elements that form part of the overall domain. The title given to each domain and element aims to be generic enough to be applicable for all countries. The Template is a non-recursive as opposed to linear model. The information collected in the Outcomes Domain serves to inform the action undertaken in the Context, Resources and Provision Domains.

The Template uses language, concepts and terminology consistent as possible with mainstream health sector reform and aims to be consistent with the World Health Report 2000-Health Template. (10) For all terminology the Regional Meeting should consider the appropriateness of the terms and wording used. While countries may wish to use terminology that is country specific, the generic terminology, consistent with the World Health Organization, will provide a common language that may facilitate communication between countries, regions, and organizations associated with mental health policy and servicing. Mental health stakeholders at meetings convened by the International Consortium for Mental Health Policy and Services and held in Eastern Europe, Africa, Latin America, the Eastern Mediterranean, South East Asian and Western Pacific Regions of the world during 2000/2001 have considered all terminology.

Explanatory notes have been developed for each domain and element. The title we have given each element must be generic enough to cover the domain and element for all countries. The explanatory notes define indicate the way the term is used within the Template and the scope that the term is meant to cover. The explanatory notes also discuss the importance of each domain and element in relation to mental health and suggest why mental health policy makers may wish to consider a domain or element when formulating mental health policy.

Country specific examples are provided for a number of the elements. In addition, extracts from existing mental health policies are provided for a number of elements. These extracts provide examples of how countries have formulated policy for specific domains and elements.