Nearly half of people living in large psychiatric hospitals and social care institutions are held against their will for months or even decades, the World Health Organisation (WHO) has said.
The global health body is calling for a shift towards community-based mental healthcare that protects patients’ rights and dignity.
It also disclosed that only nine per cent of countries reporting data had fully transitioned to community-based mental health services, while more than one in four people admitted to psychiatric hospitals stayed for longer than six months.
WHO made the disclosures in a new guide released ahead of World Mental Health Day on October 10, 2026, according to a statement posted on its X handle on Friday.
The guide urges governments to reduce reliance on long-term institutional care and expand community-based services that allow people with mental health conditions to receive support while retaining their freedom, choices and place in society.
WHO said more than half of the countries reporting data remained at an early stage of reform, with progress towards community-based care varying across regions.
The guide promotes deinstitutionalisation, which involves supporting people who have spent six months or longer in psychiatric hospitals to return to their communities with access to appropriate care and other forms of support.
WHO Director-General, Dr Tedros Ghebreyesus, said people should not have to sacrifice their freedom or dignity to receive mental healthcare.
“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,” he said.
The guide outlines measures psychiatric hospital managers can take to reduce admissions and prolonged stays, improve practices to protect patients’ rights, and support people moving from hospital care to independent living in their communities.
However, WHO said the transition required more than changes within psychiatric hospitals, stressing that access to housing, healthcare, social support, education, employment and family assistance was essential to successful reintegration.
The organisation also called for people with lived experience of mental health conditions to participate in decisions on the design, delivery and reform of mental health services.
An independent lived-experience consultant and advocate, Grace Gatera, said reforms should be developed with people who had experienced institutional care.
“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,” she said.
Gatera added that their experiences were essential to developing services that support personal choice, recovery and participation in community life.
WHO said the guide was developed with experts from different parts of the world, including people with lived experience of mental health conditions, and could be adapted to national and local settings.
Its release comes ahead of World Mental Health Day 2026, which has the theme, “Lived experiences heard: real voices, real change.”
The organisation urged governments and mental health service providers to speed up the shift towards community-based care and give people with lived experience an active role in shaping the policies and services that affect them.
