Indicator 28. Proportion of persons with a severe mental disorder (psychosis, bipolar affective disorder, or moderate-severe depression) who are using services

Rationale and definition:

There is growing recognition of the need for comprehensive mental health services to be offered as part of a universal health care (UHC) package. The World Health Organization’s Mental Health Action Plan proposes a number of indicators on mental health, including this indicator, which measures service coverage for a selected set of severe mental disorders.1 This indicator is calculated by dividing the number of cases of severe mental disorders (psychoses, bipolar affective disorder, or moderate-severe depression) receiving services by the total number of cases of severe mental disorder in the sampled population.2


By sex and geographical location like rural and urban (to support targeting of healthcare systems). Other opportunities for disaggregation to be reviewed.

Comments and limitations:

There have been a number of conferences and meetings discussing mental health in the post-2015 development agenda;3 these groups should aim to build consensus around an appropriate target range for this indicator, which has yet to be determined. In addition, stigma against people suffering from severe mental disorders may lead to under-counting. Data collected from surveys and hospital administrative records should be compared against prevalence estimates to reduce under- counting.

Preliminary assessment of current data availability by Friends of the Chair:


Primary data source:

One option is to collect data on both the numerator and the denominator as part of routine population surveys, such as DHS surveys.4 Alternatively, data for the numerator can be collected from hospital and clinic administrative records, while data for the denominator can be based on national or sub-national prevalence rates. National prevalence rates of psychosis, bipolar affective disorder, and moderate-severe depression are estimated annually as part of the global burden of disease study for all countries.5

Potential lead agency or agencies:


  1. WHO (2013d).

  2. See WHO. Mental Action Plan 2013-2020. (2013)

  3. See for example the Movement for Global Mental Health Post-2015 article.

  4. WHO, Mental Action Plan 2013-2020.

  5. See i) Whiteford, Harvey A et al (2013). Global burden of disease attributable to mental and substance abuse disorders: findings from the Global Burden of Disease Study 2010. Lancet 382, 1575-86. And ii) Ferrari, Alize J et al (2013). Burden of Depressive Disorders by Country, Sex, Age, and Year: Findings form the Global Burden of Deisase Study 2010. PLoS Med 10:11.