Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community.

Mental health and well-being are fundamental to our collective and individual ability as humans to think, emote, interact with each other, earn a living and enjoy life. On this basis, the promotion, protection and restoration of mental health can be regarded as a vital concern of individuals, communities and societies throughout the world.

Mental disorders include: depression, bipolar affective disorder, schizophrenia and other psychosis, dementia, intellectual disability and developmental disorders, including autism.


Determinants of mental health

Multiple social, psychological, and biological factors determine the level of mental health of a person at any point of time. For example, persistent socio-economic pressures are recognized risks to mental health for individuals and communities. The clearest evidence is associated with indicators of poverty, including low levels of education.

Poor mental health is also associated with rapid social change, stressful work conditions, gender discrimination, social exclusion, unhealthy lifestyle, risks of violence, physical ill-health and human rights violations.


Mental health promotion and protection

Mental health promotion involves actions to create living conditions and environments that support mental health and allow people to adopt and maintain healthy lifestyles. These include a range of actions to increase the chances of more people experiencing better mental health.

An environment that respects and protects basic civil, political, socio-economic and cultural rights is fundamental to mental health promotion. Without the security and freedom provided by these rights, it is very difficult to maintain a high level of mental health.

National mental health policies should not be solely concerned with mental disorders, but should also recognize and address the broader issues which promote mental health. These include mainstreaming mental health promotion into policies and programmes in governmental and nongovernmental sectors.

In addition to the health sector, it is essential to involve the education, labour, justice, transport, environment, housing, and welfare sectors as well. Promoting mental health depends largely on intersectoral strategies.

In low- and middle-income countries, between 76% and 85% of people with mental disorders do not receive treatment for their disorder. In high-income countries, between 35% and 50% of people with mental disorders are in the same situation

In 2016, the Republic of Macedonia has 1377 hospital beds for treating mental and neurological diseases distributed in psychiatric and neuropsychiatric departments in general and clinical hospitals, special psychiatric hospitals (Psychiatric hospital “Skopje”, Neuropsychiatric hospital “Negorci” and Hospital for mental illness “Demir Hisar”) and the University Psychiatry Clinic. In the same year,  7772 treated patients of mental and neurological diseases are registered with 383910 hospital days.

In addition, from organic, including symptomatic mental disorders, 249 patients were treated, of which 118 men and 131 women. From schizophrenia, schizotypes and nutrition disorders, 974 men and 607 women were treated, or 1581 patients were treated in total. From the mood disorders (affective) – 1163 patients, ie 368 men and 795 women, were treated with depression. The number of treated patients affected by stress and somatoform disorders associated with stress and somatoform disorders is 887, of which 262 are males, and 625 women, 71 men and 45 women, from personality disorders and adolescents, received treatment for 116 patients.


WHO response

WHO supports governments in the goal of strengthening and promoting mental health. In 2013, the World Health Assembly approved a “Comprehensive Mental Health Action Plan for 2013-2020″.

The Action Plan’s overall goal is to promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability for persons with mental disorders.

It focuses on 4 key objectives to:

strengthen effective leadership and governance for mental health;

provide comprehensive, integrated and responsive mental health and social care services in community-based settings;

implement strategies for promotion and prevention in mental health; and

strengthen information systems, evidence and research for mental health.