~UN New York- NGO Committee on Mental Health~
On 26 May 1998 WFMH representatives participated in a significant meeting arranged at UN Headquarters by the NGO Committee on Mental Health. Jorge Alberto Costa e Silva, M.D., Director of WHO’s Division of Mental Health and Prevention of Substance Abuse, came to New York from Geneva to present a day-long program on current WHO activities in the mental health field. Andrew Joseph, Director of the WHO Office at the United Nations, also attended the meeting and WFMH President Marten deVries was present for the morning session. The program was moderated by WFMH Main Representative at UN NY, Nancy Wallace. Elena Berger, Anie Kalayjian and Haydee Montenegro also attended on behalf of WFMH.
The meeting opened with remarks by Gillian Sorensen, the Assistant Secretary-General for External Relations in the UN Secretariat, who brought greetings from Secretary General Kofi Annan. She had accompanied him on a visit to a treatment center for refugee victims of torture the previous week. She spoke movingly about the experiences described by the torture survivors to Mr. Annan and about the need to pay special attention to mental health care in services for refugees. Dr. Costa e Silva then discussed the main goals of WHO’s “Nations for Mental Health” program for underserved populations, which are: (1) to strengthen national mental health planning, (2) to promote “best practices,” and (3) to make relevant information widely available.
As examples of efforts to improve mental health planning he referred to the meetings arranged by the Carter Center and WFMH at the Pan American Health Organization Headquarters (Washington, D.C.) in September1996 and in Helsinki in July 1997, both co-sponsored by WHO. These meetings provided a format for co-operation with NGOs to focus government attention on mental health needs. Future efforts to influence government health planning include a three-day meeting in Moscow in November 1998, arranged in conjunction with the World Psychiatric Association; an event in Brussels in March 1999 to review on European perspectives; and a meeting in Beijing, China, in 1999.
“Best practices” are being developed to meet a variety of needs. One strand of the “best practices” approach gives special attention to improving technical capacity to achieve agreed goals. In Bolivia, Bhutan and Zanzibar (Tanzania) the program is supporting the development of national health plans. In some countries the major requirement is mental health reform, and a meeting for Mediterranean countries has been arranged. In Sarajevo (Bosnia) and Guatemala planners are looking at the special issues involved in providing mental health services in countries with a history of division. Dr. Costa e Silva noted that human rights should be a basic component of mental health policy everywhere, but they are particularly important in developing a strategy for formerly divided countries trying to recover from periods of strife.
Other areas of the “best practices” program concentrate on community-based mental health care and on mental health promotion. Model projects for community-based care are being developed in Belize, Ghana, Mongolia and Mozambique. Other projects are being designed in Egypt and Yemen. A variety of mental health promotion plans are being developed in China, the Marshall Islands and South Africa. A mental health promotion project in Argentina involves training and employment for the mentally ill. A project in Bulgaria is using adolescent peer counselors to help young people, and one in Sri Lanka strengthens an existing rehabilitation program.
The planning and “best practices” objectives lead directly to the third goal of Nations for Mental Health, the development and dissemination of materials to provide information to the broadest possible audience. WFMH has collaborated with WHO in this category, producing a mental health information video in Sri Lanka through the new IPSER/Worldview consortium. More information videos are in the planning stage.
Dr. Costa e Silva also spoke about the current reorganization of WHO under the new Director General, Gro Harlem Brundtland, whose transition team was working on a thorough revision of WHO’s structure and objectives. WFMH President Marten deVries reported on his recent meeting with Dr. Brundtland in Oslo, where she had suggested new partnerships among NGOs interested in mental health. DeVries stressed the importance of NGO collaboration, which had already benefitted from Dr. Costa e Silva’s interest. This was endorsed by Juan Mezzich, President of the World Psychiatric Association, and by Nancy Wallace, who pointed out that the NGO Committee on Mental Health at the UN is a useful forum for partnerships. In the afternoon Dr. Costa e Silva met in a more informal setting to answer a prepared list of questions about his WHO Division from the five working groups of the NGO Committee. (The working groups cover gender perspectives and mental health; life span mental health – children/adolescence/families and ageing; mental disfunction/illness – prevention/treatment/attitudes; refugees/migrants/armed conflict and mental health; and substance abuse.) The question list covered issues such as the susceptibility of women to depression, mental health needs by age group from children to the elderly, the provision of mental health services in rural areas, the psychological trauma of catastrophic experiences, the treatment of mentally ill persons in prisons, and the link between mental illness and substance abuse.
In the course of this session Dr. Costa e Silva covered a large number of topics and also provided information about the activities of his Division and of WHO in relation to the health concerns of the UN system as a whole. On gender issues, for example, he noted that it was often very difficult to reach inter-government agreements because of the wide cultural variations among countries. He emphasized that although WHO is the leading UN agency on health matters, other UN agencies also have strong interests in global health care, sometimes operating in collaboration with WHO but on other occasions work independently.
Dr. Costa e Silva expressed his willingness to become personally involved with the work of the NGO Committee at UN NY, saying that it provided a valuable opportunity for his Division to have input from a broad-based group of NGOs. As an initial step he offered further collaboration when he and some of his staff members returned to the UN in June for the Special Session on Drugs. He also offered to participate in the group’s planning for the 1999 meeting of the UN Commission on the Status of Women, which will discuss women’s health.