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From traditional definitions of stigma, we have developed four main components to consider in this report: self-stigma (or internalised stigma), which occurs when people with mental health conditions are aware of the negative stereotypes of others, agree with them, and turn them against themselves; stigma by association, which refers to the attribution of negative stereotypes and discrimination directed against family members (eg, parents, spouses, or siblings) or to mental health staff; public and interpersonal stigma, which refer to the forms of knowledge and stereotypes, negative attitudes (prejudice), and negative behaviour (discrimination) by members of society towards people with mental health conditions; and structural (systemic or institutional) stigma, which refers to policies and practices that work to the disadvantage of the stigmatised group, whether intentionally or unintentionally. Stigma and discrimination contravene basic human rights and have severe, toxic effects on people with mental health conditions that exacerbate marginalisation and social exclusion, for example by reducing access to mental and physical health care and diminishing educational and employment opportunities [...]provisions that support the social inclusion of people with disabilities should be applied equally whether they arise from physical or mental health conditions. [...]health and care provision should be equitable regardless of whether people have a physical or mental health condition.

Inclusion of bovine-derived milk fat globule membrane (bMFGM) or bMFGM components in infant formulas (IFs) may support healthy brain development. This double-blind, prospective trial evaluated growth, tolerance, and iron status in infants receiving added bMFGM and modified protein, iron, and arachidonic acid (ARA) concentrations in IF. Healthy term infants were randomized to: control (marketed, routine cow’s milk-based IF/100 kcal: 2.1 g protein, 1.8 mg iron, 34 mg ARA) or INV-MFGM (investigational cow’s milk-based IF/100 kcal: 1.9 g protein, 1.2 mg iron, 25 mg ARA and whey protein-lipid concentrate, 5 g/L (source of bMFGM)). Anthropometrics, stool characteristics, fussiness, and gassiness through day 365 and blood markers of iron status at day 365 were evaluated. The primary outcome was rate of weight gain from 14–120 days of age. Of 373 infants enrolled (control: 191, INV-MFGM: 182), 275 completed the study (control: 141; INV-MFGM: 134). No group differences in growth rate (g/day) from day 14–120 or study discontinuation were detected. Few group differences in growth or parent-reported fussiness, gassiness, or stool characteristics were detected. No group differences were detected in hemoglobin, hematocrit, or incidence of anemia. In healthy term infants, bMFGM and modified protein, iron, and ARA concentrations in a cow’s milk-based IF were well-tolerated, associated with adequate growth throughout the first year of life, and supported normal iron status at one year of age.

Last year's Lancet Commission on Global Mental Health and Sustainable Development1 reframed mental health as a dimension, emphasising mental health promotion and prevention of mental disorders for the entire population, alongside quality treatment and care for those who have a mental health condition. The Countdown will give particular attention to mental health treatment coverage as an essential component of universal health coverage with commitment from all countries, both as a part of the SDGs and within the General Programme of Work 2019–2023 of WHO.2 Quality of services and satisfaction with care will be an integral part of monitoring. GMB Akash/Panos Pictures As the global community begins to mobilise resources towards addressing the goals of promoting mental health, preventing mental disorders, and providing quality care for people with mental health conditions, there is an urgent imperative for a comprehensive and transparent monitoring mechanism to catalyse global and national action and hold diverse actors accountable.3 Countdown Global Mental Health seeks to realise this aspiration.

Combine economic, social and medical data to forecast need and design services to address the growing crisis. Combine economic, social and medical data to forecast need and design services to address the growing crisis.

Richard Miller Executive director, Action Aid UK, Chris Bain Director, Cafod, Martin Kyndt Associate director, Christian Aid, Rose Caldwell UK executive director, Concern Worldwide, Elisha London UK director, Global Poverty Project, Dame Barbara Stocking Chief executive, Oxfam GB, Tim Aldred Head of policy, Progressio, Justin Forsyth Chief executive, Save the Children UK, Matthew Frost Chief executive, Tearfund, David Bull Executive director, Unicef UK