Development of a mental health policy and system in Tanzania: an integrated approach to achieve equity.

OBJECTIVE: Although most donor and development agency attention is focused on communicable diseases in mainland Tanzania, the importance of noncommunicable diseases, including mental illness, is increasingly apparent.
METHODS: This report describes a ten-year collaborative project (1999-2009) to meet these challenges through a sustainable mental health policy introduced across Tanzania. The country used an integrated approach, combining situation appraisal, integrated mental health policy and planning, mechanisms for sustainable implementation with largely local resources integrated into local systems, and monitoring to fine-tune the implementation.
RESULTS: The project led to inclusion of mental health in relevant health policy instruments, treatment at the primary care level, stronger referral and intersectoral coordination, and a focus on rehabilitation and public education.
CONCLUSIONS: Although much remains to be done, Tanzania's commitment to mental health is now sustainedly embedded within its policies, national and local budgets, and training activities.