A National Program to scale up investment and reducing the gap in mental health in Somaliland: first year achievements

In Somaliland, mental health has been a neglected sector since the inception of the country almost 30 years ago. Only two years ago, there was no office, no staff, and no funding for mental health. Public mental health services were confined to five public in-patient facilities within the regional general hospitals, with a total bed capacity of 216 beds for a population of 4 million people. All the facilities experienced severe shortages of human and material resources, and proper supervision or control by the ministry did not exist. Lack of adequate and good quality-public mental health services has encouraged the opening of a plethora of unregulated private mental health facilities with poor records of human rights and services. One of the major impediments to improving mental health in the country was a lack of financial resources. In recognition of the deteriorating situation of mental health in the country and public pressure to do something about the problem. In late 2020, the government decided to scale up mental health services through khat taxation. Tax collection started in January 2021, and the first funds were released for use in July 2021. A five-year national program on mental health was then launched on August 1, 2021 underpinned by four main objectives: 1) establishment of leadership and governance in mental health; 2) strengthening existing mental health services and their integration into primary health care; 3) development of human resources in mental health; and finally 4) setting up a mental health information and research system. In this paper, we present early program achievements and their relevance to public health for other countries with similar settings looking to improve their mental health through effective mobilization of local resources.