A new Essential Care Package to address mental health and stigma for people with neglected tropical diseases
Over the past decade, evidence for the burden of mental health conditions among people with Neglected Tropical Diseases has been growing, with a recognition that this has been an overlooked dimension of the person-centred care that the World Health Organization (WHO) NTD Roadmap calls for. This growing realisation led to a commitment among the NTD community to generate evidence for what works to reduce stigma and emotional suffering. In turn, this work led to the publication of new WHO guidance that sets out, for the first time, a practical, evidence-based package of care to address the mental health impacts of 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.
“NTDs take a far greater toll on mental and social well‑being than is often recognised. By integrating mental health and tackling stigma head‑on, the Essential Care Package equips countries to confront the full reality of NTDs and move closer to WHO’s vision of complete well‑being.” Dr Daniel Ngamije Madandi, Director of the WHO Department of Malaria and Neglected Tropical Diseases.
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, 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.
For frontline health workers, the ECP focuses on routine, compassionate, person-centred care. It recommends that mental health screening, assessment and support are embedded within NTD services, with clear referral pathways to specialist mental health services where needed. 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 guidance 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. In time, this will help countries to demonstrate fulfilment of commitments necessary to be certified as having achieved elimination as a public health problem for diseases like lymphatic filariasis.
Together, these measures aim to make integrated care feasible in resource-constrained settings, improving wellbeing, and social integration. There is early evidence that such holistic care can strengthen treatment adherence and support progress towards NTD elimination targets 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. Now it is time for the wider sector to put these tools to good use and scale up access to these models of comprehensive care.
About the Author
Julian Eaton is a public health psychiatrist, and Professor in Global Mental Health in the Department of International Public Health at Liverpool School of Tropical Medicine. For further information, you can contact him via julian.eaton@lstmed.ac.uk.
