WFMH AT 51: LOOKING TO THE NEXT CENTURY
On this final day, of our last Congress of this century, in my final address as Secretary General of this unique organization, I invite you to share my pride in the World Federation for Mental Health.
One year past its golden anniversary, WFMH is the world’s most trusted name in mental health. This trust is a priceless asset, a legacy we dare not squander. It is essential to our special role which cannot be filled by any other organization. . We stand for the voluntary, global, non-governmental, mental health movement, with a global purpose and a global program. We will lose this identity if we become merely a coordinating mechanism for a network of national or regional associations. WFMH must continue with a global agenda expressed through its regional and local components.
Our claim to uniqueness depends even more crucially upon the fact that we carry no obligations to other institutions. We are not obliged to promote or protect the interests of any government, or inter-governmental organization. Nor, are we responsible to any corporate entity. Unlike the international unions of mental health workers, we have no primary concern with the welfare of professionals of any discipline; nor, indeed, of any one element of our diverse membership. We are not an organization only of citizen volunteers, or only of professionals, or only of consumer/users. With our all-inclusive membership we have succeeded in being both truly global and truly ecumenical.
In order to better understand who we are, what we might become, and what challenges we face in using our unique freedom, let us look back to our origins.
We have twin philosophical roots. First, is the high value attached to providing direct help for,and protecting the rights of, persons defined as mentally ill. This value came directly from a survivor of mental illness and hospitalization, Clifford Beers. In 1908, after hospital discharge, he conceived of an international reform movement devoted–in his words–to “the protection of the insane”. This became our predecessor, the International Committee on Mental Hygiene. Its reform goals are alive today in our international agenda, but we are still in the process of forging an effective partnership with Beers’ successors, today’s survivors of mental illness.
Our second root is less specifically concerned with mental illness and more broadly with protecting human rights as a basis for mental health. It implies that mental health cannot be sustained in a context dominated by human rights violations. That root originated in the reaction against the Nazi atrocities which the International Tribunal at Nuremberg deemed crimes against humanity. It was given form in the United Nations Universal Declaration of Human Rights which was drafted between 1946 and 1948, in the same historical moment when a preparatory commission met to plan the founding of our own Federation. The new inter-governmental United Nations, and the non-governmental WFMH, together, became emblematic of the idealism of that moment with its expectation that peoples, countries and cultures could collaborate together in peace and friendship as members of a single human family. That ideal persists in our work today.
Our Preparatory Commissions views were directly influenced by the first agencies of the new United Nations.
UNESCO, emphasizing “the dignity, equality and mutual respect” of humankind, and focusing its first project on the reduction of international tensions, inspired our founding document, Mental Health and World Citizenship, which was proclaimed in August 1948. It called for “an informed, reflective responsible allegiance to mankind as a whole…a world community built on free consent and respect for individual and cultural differences”. It concluded that “the ultimate goal of mental health is to help [people] live with their fellows in one world”. WHO, by defining health broadly as “well-being”, acknowledged its subjective aspects and the importance of social context and personal history. This laid the groundwork for advocacy concern with the socio-economic and cultural circumstances of people’s lives, as as they influenced their health.
Following the inspirations of WHO and UNESCO, the new Federation committed itself specifically to pursue the ideal of mental health “for all of the world’s peoples”. This commitment was historic. By advocating equal treatment and equal rights for all, including women, the young and the aged, refugees and minorities, political dissidents and conformists, as well as the mentally ill, it challenged the values and practices of authoritarian societies.This perspective continues to inform our efforts. However, the challenges which it evokes continue to recur.
This afternoon I draw your attention to three of these challenges.
First, is that of remaining independent in our thinking and our agendas. This is difficult in the face of the competing desires of special interests regarding mental health issues. They concern every aspect of the field including the diagnosis and treatment of illness, the economics of health care, and the interpretation of patients’ rights. Our Assembly and Board have already recognized that we must not compromise our advocacy positions when we accept financial support from corporate entities. This is essential to maintaining the trust of our constituencies. At the same time, we need the private sector of the world’s economy and we seek to broaden our support from it–we cannot exclude it from participating in our work.
Maintaining independence of policy is equally important in relation to governments and the inter-governmental system, the UN. National governments are a frequent source of funds for our member associations. Collaborating with a UN agency gives us prestige, and access to a world-wide health, science and education network. But we must also be able to criticize and find our own way. There have been instances when our views have differed from governmental or UN positions. Some of these differences have concerned human rights. But we have achieved a proud record of human rights collaboration with a range of UN agencies. While maintaining our official relationships we do not compromise our status as an independent, non-governmental source of advocacy. Only thus can we be of maximum help to the UN bodies which want our assistance and are might be responsive to our advocacy efforts.
A second challenge is that of maintaining our position of moral universality–a single global standard of rights– in the face of the particular moralities of many of our constituencies. This is a complex and sensitive matter which touches on traditional practices bearing on mental health . Most obvious are those concerned with sexuality, reproductive behavior, and the status of women. Some WFMH positions do not fit the cultural contexts in which our member associations must operate. In these instances it is the responsibility of our global body to assist our regional and national members in their work. Our record in this respect has been outstanding and we can be proud of it.
Third, and most difficult, are the challenges posed by new forms and frequencies of mental and emotional distress. The increasing and aging world population will continue the trend to greater absolute numbers and proportions of those suffering from mental illness and nervous system disease.
The mental health consequences of collective violence including human rights violations, affect entire communities, hundreds of thousands of whom have become refugees subject to the most traumatic experiences.
The persisting poverty of large segments of the world’s population continues its adverse effect on mental health.
Among its mental health consequences are those associated with HIV infection, substance abuse , child labor, and the commercial sexual exploitation of children.
In the face of this third set of challenges our moral and historical strength as an independent organization, permits us to advocate social change and sponsor education where it might be effective. Some of our WFMH committees and university-based collaborating centers are already deeply involved in such efforts. Our collaborating centers, increasing in number since they were initiated in 1986, are beginning to provide a scientific-technical basis for our advocacy, and to recruit scientists and clinicians as advocates and educators. Since 1992, World Mental Health Day has served an annual educational function.
In March 1998, in Maastricht, our President and now incoming Secretary General Marten de Vries, boldly emphasized the importance of research for achieving our goals. I believe that research is the imaginative form of compassion. The UN Declaration of Human Rights includes a right “to share in scientific advancement and its benefits”. Our own WFMH Declaration of Mental Health and Human Rights states: “High priority shall be given to research on the prevention of mental disease…and ill health”. If WFMH is to continue its impact into the next century it must become an effective advocate for science, and, for understanding the psycho-social and ethical consequences, both of scientific advances and of decisions not to explore the unknown. Yes, we have far to go to become the strong global institution which our founders envisaged. We know that we are imperfect people who have created an imperfect organization. But I believe that we can look to a future which continues active partnerships between professionals and volunteers, including users of mental health services; between the Federation and units of the United Nations ; with strong institutions such as universities; and between WFMH and other NGOs.
We are heirs to a precious legacy, and we have accepted the responsibility to fulfill it. In the words of our founding document, and through periods of governmental abuse of human rights, of inter-ethnic strife and collective violence, we have remained “a world community” of “respect for individual and cultural differences”. More than that, we of this World Federation, constitute a community of commitment, with a shared identity which transcends our individual differences.
The fact that we have stayed together for more than half a century only through dedication to a shared ideal is a source of inspiration. We know that we can accomplish together what we cannot do individually.
I have the greatest confidence in our continuing leadership. Dick Hunter, who joined me in 1981, continues as our Chief Operating Officer. Ahmed El Azayem as President for 1999-2001 will have the support and creative energy of the new Secretary General de Vries. Benjamin Vicente who chairs this World Congress, separated by more than a quarter century from the last in South America, is renewing our important ties with this vast region
Most important is the continuing dedication of our world-wide membership, all of whom are volunteers–users, mental health association members, professionals. It is with faith in thepower of individuals, and the outcome of our collective efforts, that I say goodbye to the past and look forward to the future.
Thankyou, goodbye and godspeed.
Eugene B. Brody MD