WHO Urges Shift From Psychiatric Institutions to Mental Health Care in Communities

WHO Director-General Dr Tedros Adhanom Ghebreyesus said people should not have to surrender their freedom, dignity or place in their community to receive ongoing support.

Receiving mental health care should not mean losing the freedom to make everyday decisions or spending years separated from family and community. The World Health Organization's new publication, Supporting the transition to community-based mental health and social care: Practical guide to the deinstitutionalization of psychiatric hospitals, sets out steps to help countries change that reality. Published on 9 October 2026, it is a WHO practical guide, rather than a research study published in a journal.

Released ahead of World Mental Health Day, the guide calls for care built around people's needs, rights and choices, with the support required to live fulfilling lives beyond psychiatric institutions.

WHO's 2026 campaign information reports that approximately 49% of psychiatric hospital admissions are involuntary. That figure describes admissions; it does not mean that half of all residents have been detained for the same length of time.

Figures highlighted in WHO's announcement show that 28% of people admitted to psychiatric hospitals stayed longer than six months. Only 9% of reporting countries had fully moved to community-based mental health care, and 53% remained at an early stage of reform.

WHO Director-General Dr Tedros Adhanom Ghebreyesus said people should not have to surrender their freedom, dignity or place in their community to receive ongoing support. His call to governments is to redirect investment towards services that protect those rights and make community living possible.

What moving care into the community involves

Deinstitutionalization, often shortened to DI, involves supporting people who have spent extended periods in psychiatric hospitals to return to community life with appropriate care and practical assistance. The announcement describes these long stays as six months or more.

A successful move depends on much more than a discharge date. Someone leaving hospital needs a suitable place to live, access to health care and social support, and opportunities to study, work and rebuild relationships. Families need support of their own to help make the transition sustainable.

These needs place responsibility across housing, health, education, employment and social services. Hospital leaders cannot create a functioning community support system by themselves, and sending someone home without adequate arrangements does not fulfil the guide's vision.

The broader reform requires policies, laws and funding to support community living, alongside changes in how services understand and respond to people's needs.

How psychiatric hospitals can help make the change

The guide gives psychiatric hospital leaders and decision-makers a practical framework organised around three phases: plan, prepare and provide. Its recommendations cover three areas where hospitals can influence change: reducing admissions and lengthy stays, improving care and rights protections inside hospitals, and supporting discharge with continued care and participation in community life.

Changing institutional practices matters for people still receiving hospital care. Respect for their preferences, autonomy and dignity needs to be part of everyday treatment, including the decisions that shape their future.

Preparing for discharge requires coordination between hospital teams and the services people will rely on after leaving. Housing arrangements, continuing health care and social support need to connect so that a person's move out of hospital becomes a supported transition.

Developed with experts from around the world, including people with lived experience, the guide offers approaches that can be adapted to different countries and local circumstances. Governments, hospital leaders, workers, families and community services all have responsibilities in making those changes work.

People with lived experience must shape the services

The 2026 World Mental Health Day theme, "Lived experiences heard: real voices, real change," reflects a central message of the guide: people who use mental health services need a meaningful role in deciding how those services operate.

People who have experienced institutional care can explain barriers that may be missed in policy discussions, from the loss of everyday choice to the practical difficulties of rebuilding life after discharge. Their knowledge can help services understand what supports recovery and what makes participation in community life harder.

Independent lived experience consultant and advocate Grace Gatera stresses that reform must be developed with people who understand institutional care through personal experience. Their expertise belongs alongside other forms of knowledge in decisions about services and support.

Meaningful involvement gives people influence over policy, service design, delivery and evaluation. Inviting someone to share their story without allowing them to shape decisions falls short of that commitment.

WHO is calling on governments and services to accelerate this shift, with investment that connects mental health support to housing, opportunity and community participation. The measure of progress is whether people can receive the care they need and have a real say in where and how they live.