The World Health Organization (WHO) marked World Mental Health Day on October 10, 2026, with a call for countries to move people out of long-term psychiatric hospital care and into community-based services, backed by a new 146-page practical guide on how to do it. In a news release issued from Geneva on October 9, WHO said nearly half of the people living in psychiatric hospitals and social care institutions are held there involuntarily, for months, years or even decades.

The guide, Supporting the transition to community-based mental health and social care, is aimed at psychiatric hospital leaders and decision-makers. It defines deinstitutionalization as helping people who have spent six months or more in a psychiatric hospital return to life in the community with the care and opportunities they need. It sets out three phases, plan, prepare and provide, and three areas where hospitals can act: reducing admissions and lengths of stay, transforming care inside the hospital, and increasing supported discharge, continuity of care and community participation.

WHO’s figures, drawn from its Mental Health Atlas 2024, show how far most countries are from that goal. Only 9% of reporting countries have fully transitioned from institution-based to community-based mental health care, while 53% remain at an early stage of reform. More than one in four people admitted to psychiatric hospitals (28%) stayed longer than six months, according to the release, and the campaign page reports that 49% of reported psychiatric hospital admissions are involuntary and 23% of hospital stays last longer than a year.

“People should not have to give up their freedom, dignity or place in their community to receive ongoing mental health support,” WHO Director-General Tedros Adhanom Ghebreyesus said in the release, adding that countries must move away from relying on long-term institutional care. According to a Bernama-WAM report carried by The Star, he also called on countries to speed up shifting investment from institutions to rights-based mental health care and community support. WHO’s South-East Asia office said in a separate statement that more than 1 billion people worldwide live with a mental health condition, most commonly anxiety or depression.

Lived experience at the center

This year’s campaign theme, “Lived experiences heard: real voices, real change,” calls for people who have lived with mental health conditions to help shape the policies and services that affect them. According to the campaign page, 80% of countries with a mental health policy or plan say it was developed in consultation with people with lived experience, and 59% say the same of their mental health legislation. But only 45% report ongoing collaboration with lived-experience and family advocacy groups in planning, delivering or monitoring services, and 37% involve them in training primary care workers. “Too often, PWLE are asked to share their stories but excluded from decisions,” the campaign text says, using WHO’s abbreviation for people with lived experience.

The guide was developed with international experts including people with lived experience, and WHO says its approaches can be adapted to local contexts. Grace Gatera, an independent lived experience consultant and advocate quoted in the release, said reform “must be done with people who know what it means to go through institutional care.”

Why it matters

WHO argues that institutional care can consume large shares of mental health resources, separate people from their communities, limit their autonomy and expose them to human rights violations. The guide stresses that hospitals cannot achieve the transition alone: people leaving long stays need access to housing, health care, social support, education and employment, and their families need help too. Reform also depends on changes to policies, laws and funding and on building community mental health services and housing support.

For health systems, the practical content is the point. Earlier WHO policy documents set out the principles; this guide is organized as actions that hospital leaders can take within their own mandate, in partnership with authorities, families, workers and community services, according to the publication page. Progress remains uneven, as WHO’s own atlas data show, and the organization is asking governments to use the day to accelerate the shift.

What to watch

The guide is available free under a Creative Commons license from WHO’s publications site. The atlas figures give a baseline against which countries’ reforms can be tracked. WHO’s South-East Asia region, for example, has set targets of a 50% increase in government service coverage for mental health conditions and a 15% reduction in the suicide rate by 2030, and reports treatment gaps as high as 90% in many of its member states.

This article is for general information and does not replace advice from a qualified clinician. Corrections: email the editor using the address on the Contact page.