Keep up with what is happening at the United Nations through the blog reports of our representatives. Together we are working to make mental health a global priority!

Dr. Shekhar Saxena, Director of the Department of Mental Health and Substance Abuse of the WHO (World Health Organization) in Geneva Switzerland, invited me as Board Member of the WFMH (World Federation for Mental Health) to take part at the MH GAP Forum 2017 which was held on 9-10 October 2017. This year's forum coincided with WHO celebration of WMHD - World Mental Health Day and dealt with the implementation of WHO's Mental Health Action Plan.

The WHO recognizes the initiative of WFMH to commemorate the WMHD on 10 October every year. The WFMH founded the awareness day 25 years ago, in 1992. The day provides an opportunity for all stakeholders working on MH (mental health) issues in the world to talk about their work, and what more needs to be done to make MH care a reality for people worldwide. People all over the world are holding events, making announcements and celebrating the day. This year's theme, which was set by the WFMH, is: "Mental Health in the Workplace".

The 2 days forum provided an opportunity for a diverse group of stakeholders to discuss a variety of themes on the implementation of the WHO's mental health action plan 2013-2020 and related topics. The objectives were:

1. To strengthen effective leadership and governance for MH
2. To provide comprehensive, integrated and responsive MH and social care services in community-based settings.
3. To implement strategies for promotion and prevention in MH
4. To strengthen information systems, evidence and research for MH.

Highlights in this year's program, with the theme of "Mental Health Capacity building within countries", included:  Launch of Mobile App which will make it much easier for care providers to access the plan, Operations Manual to assist program managers to plan, Training Package, MH in the workplace, a review of outcomes of the year-long campaign on Depression – Let's Talk, MH campaigns – where do we go from here? And group discussions.

The topics of the group discussions were: Workforce development in psychological intervention delivery, Public health response to dementia, Human rights in MH, Community engagement in suicide prevention, Self-help interventions, helping adolescents thrive, helping people with severe mental disorders live longer and healthier lives and MH GAP implementation.

The MH Action Plan 2013-2020 was adapted by WHO Members States in May 2013 which aims to strengthening the response from health and social sectors in countries:

Challenge – The global burden of mental disorders is large and continues to grow. Health systems throughout the world are struggling to respond adequately to the needs of people with MH problems:

• 1 in 4 people are affected by a mental disorder at some point in their lives.
• By 2030 depression will be the leading cause of disease burden globally.
• 900,000 persons commit suicide each year. Suicide is the second most common cause of death among young people.
• 3 out of 4 with severe mental disorders receive no treatment.
• People with MH disorders are exposed to a wide range of human rights violations.

Vision – A world in which MH is valued, promoted, and protected, mental disorders are prevented and persons affected by these disorders are able to exercise the full range of human rights and to access high-quality, culturally appropriate health and social care in a timely way to promote recovery, all in order to attain the highest possible level of health and participate fully in society and at work free from stigmatization and discrimination.

Cross-cutting Principles – Universal health coverage, Human rights and Evidence-based practice.

Objectives and Targets –

• To strengthen effective leadership and governance for MH
• To provide comprehensive, integrated and responsive MH and social care services in community0based settings.

GOAL – To promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability for persons with mental disorders.

The 2 days MH GAP Forum which was held in the central hall of the WHO Geneva was chaired by Dr. Shekahar Saxena, Director of the Department of Mental Health and Substance Abuse of the WHO, with the participation of hundreds of representatives from 34 Member States, 6 United Nations Agencies: UNESCO, UNHCR, UNICEF, UNITAR, UNIRISD and UNRWA, 113 organizations, 13 WHO Collaborating Centers, observers and WHO Secretariat.

The Intergenerational Dialogues on the SDGs (Sustainable Development Issues) was a full-day conference sponsored by the Department of Public Information at the United Nations on 1 August 2017. The Opening Plenary set the stage for the agenda. Speakers represented the UN, Government and Civil Society, focusing on the importance of full partnerships and reciprocal mentoring between young people and older adults. Maher Nasser, the Acting Under-Secretary General for Global Communications, noted that the world has1.8 billion youth (more than half under 60), with the global south now experiencing a youth bulge. The global north has an aging bulge and a youth deficit. Clearly, the youth in the south will become another bulging aging population in the future. It is essential that both populations work together on issues that affect them both. Climate change is an example.

            Bruce Knotts, Director of the Unitarian Universalist United Nations Office and Chair of the NGO/DPI Executive Committee, addressed gay and transgender marginalized UN issues. He noted that youth and age discrimination at the UN are also issues that must be addressed.

            H.E. Mr. Peter Thomson, President of the 71^st session of the UN General Assembly, underscored the SDG charge: “Humanity has been on a course of unsustainability. We must reverse that to ensure the future of generations.”  

            Barbara Crossette, Senior UN Correspondent for the United Nations, focused on the International Conference on Population and Development held in Cairo in 1994. Among the outcomes was the groundbreaking commitment to the centrality of girls and women. Since then, she noted, there has been a steady campaign against the rights of women, most recently in the U.S. She credited the World Bank as one of the few organizations that have noted that the Cairo committed had been breached. She also noted that the SDGs don’t recognize non-traditional family structures, mostly important to women. Nor do they address LGBT people.

            From there, speakers addressed the changing perceptions of “book-ended generations,” indigenous rights issues, transgendered youth, and mental health.

            Before and after a working lunch break, participants divided into dialogue groups to discuss 1) breaking the intergenerational cycle of poverty, 2) gender equality and full inclusion, 3) access to full employment throughout the life cycle,  4) sharing responsibility for the planet, 5) intergenerational innovation, and 6) healthy living, and physical and mental illness. I attended groups 1 and 5, representing WFMH, and spoke from the floor during the latter dialogue about the fact that the World Health Organization (WHO) has reported that depression is the number one health burden in the developed world. By 2020, WHO forecasts that it will be the developing world’s number two health burden, second only to heart disease, and by 2030 it will be number one. I said that women’s at risk status should be addressed, given that they are twice as likely to be affected in all instances.

            The Closing Plenary provided remarks from all UN constituencies, including rapporteurs’ reports.  

Janice Wood Wetzel

WFMH NGO Representative, New York

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Submitted by Caroline Morton-Gallagher, WFMH UN Rep

June 6 the UN Special Rapporteur on the Right to Health presents his visionary report on mental health to countries at the Human Rights Council (report available in several languages here).

The report provides an important framework and road map for mental health that responds to people’s needs, respects their rights and ensures that the dignity of every person is respected.

The World Health Organization is committed to responding to the report’s call for Member States to seek technical assistance from the WHO QualityRights initiative in order to promote access to good quality mental health and related services and respect for the rights of persons with psychosocial, intellectual and cognitive disabilities.

The World Health Organization’s recent shift in approach to the health care of refugees and migrants from humanitarian-based care to an approach based on broader health systems offers an opportunity to integrate mental health care into services.

 Given the magnitude of the crisis caused by forced displacement, emergency care and health systems-based care will both be needed.  The World Federation for Mental Health supports efforts to integrate mental health care in overall health care wherever possible.  

 Special attention should be paid to those vulnerable people who had a serious mental illness before a regional crisis took place.  Their special needs are often neglected if they become refugees or displaced persons—but given the proportion of people with mental health conditions in general populations, the proportion must also be high among refugees and displaced persons.   The numbers will be made higher by the displacement experience.

 The situation of migrants in the Middle East, in southern Europe and in Africa presents an enormous challenge.  Despite the many priorities in providing care, and the constraints required by budgets, mental health care should be included in assistance.

 Planning should take account of the health of women, adolescents, children and the elderly. Many of them have experienced violence in crisis situations.  Children in particular may be exposed to a lifetime of mental health consequences.  

The Report of the High-Level Working Group on the Health and Human Rights of Women, Children and Adolescents, newly released by the World Health Organization and the Office of the High Commissioner for Human Rights, emphasizes a goal of achieving the highest attainable standard of physical and mental health for marginalized people such as migrants and refugees.

“Artificial Intelligence & Technology Tools for Mental Health, Well-Being and Resilience: Bridging the Treatment Gap” – STI side event – UN - 16 May 2017

The conference focused much of its discussion on Artificial Intelligence (AI), its importance in bridging the service gaps in the world, what is now being done, what is projected for the near future, and ethical and practical issues that must be addressed.

Five excellent speakers included:

Ralph El Chamnay, MD: psychiatrist serving as head of NIMH Programme at the Ministry of Public Health in Lebanon. He reported on the Substance Abuse Use Strategy 2015-2020 that he leads. They have reformed the mental health system in Lebanon toward a community-based mental health services model.

Julie Edgcomb, MA who is currently the Ambulatory Services Administrator for Natividad Medical Center and the Monterey County Health Department, providing services to over 61,000 ethnically diverse people from 12 clinics. She has used innovative AI technology to bridge the gap in service personnel.

Thomas Gass, PhD, MSc, Secretary General for Policy Coordination and Interagency Affairs in ECOSOC, Switzerland, among many titles and responsibilities worldwide. He spoke of the importance of interfacing between the UN and people and policies. 

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“Families, Education and Well-Being: In Observance of International Day of Families” – DPINGO – UN - 18 May 2017

            This session focused on the primary importance of families for the advancement of mental health, the need for mental health education, research, and the ending of stigma. Speakers came from Australia, Spain, Argentina and the U.S. The event largely consisted of common sense reporting ranging from global home studies, the importance of case studies, and community mental health educational outreach efforts.

12 April 2017

Brussels, Belgium

 I attended this meeting on behalf of the WFMH.  It was a full-day programme about the status of Mental Health in Europe. There were about 20 participants from Germany, Malta, Romania, Belgium, Ireland, Luxembourg, Austria, Denmark, UK, the Netherlands, Portugal and Lithuania, and 10 speakers. 

 The following topics were addressed:

 -          The EU strategy on Mental Health: understanding the current framework

-          Early prevention, detection, and treatment of mental ill-health: promoting a cross-sectoral approach

-          Promoting equal opportunities for people with mental health problems

-          Improving mental health in the workplace: challenges and solutions

 It was an interesting day with good networking opportunities due to the small group of attendees. I connected with a representative from the National Institute of Public Health in Denmark as well as the Mental Health Commissioner in Malta. We had a common interest in epilepsy and mental health, which broke the ice. The National Institute of Public Health in Denmark is rolling out a new programme on mental health and reaching out to various communities. I put its representative in touch with the Danish Epilepsy Association (as we know there is an overlap in stigma and discrimination experienced by people with epilepsy and those with mental health issues). The Mental Health Commissioner has invited me to pay him a visit whenever I am in Malta.

 Global Anti-Stigma Alliance:

The Global Anti-Stigma Alliance (GASA) is an international network of different national campaigns against stigma. The aim of the network is for the members to share knowledge, evidence, materials and best practices.  The key principles of the network are empowerment, equality and dignity, with emphasis on recovery and effective evidence-based approach. It operates with a duel focus: To create understanding within the wider public to promote inclusion and to reach people with lived experience, enabling them and preventing self-stigma.

 They are organising an international conference in Copenhagen in September 2017.http://www.againststigma2017.com/index.php/conference-info/global-anti-stigma-alliance

  Mental Health Europe:

This is a European umbrella organisation, mostly funded by the EU. It has prepared a Joint Statement on Mental Health: http://www.mhe-sme.org/fileadmin/Position_papers/Joint-statement_on_mental_health-final_with_endorsements.pdf

 Caroline Morton-Gallagher

International Relations Officer

Stichting Epilepsie Instellingen Nederland (SEIN)

Note: This is a partial list. Contact us to update it: MCAresources@gmail.com

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20 April. Psychology Day at the United Nations; Promoting Well-Being in the 21st Century: Psychological Contributions; Psychology Coalition at the United Nations; UN New York.

8-9 May. GMH Workshop; Transformative Opportunities for Solving the Grand Challenges in GMH; National Institute of Mental Health and Grand Challenges Canada; Bethesda, MD USA

5-6 June. GMH and Psychosocial Support; King’s College London, London UK

13-15 June. Conference of State Parties to the Convention on the Rights of Persons with Disabilities; UN New York

24 June-1 July. GMH Conference and Summer School; Psychotherapy and Psychosocial Interventions in Low- Middle Income Settings; Center for Mental Health–University of Rwanda, Institute of Health and Wellbeing–University of Glasgow, and Global Engagement Institute; Rwanda

5-10 July. Summer Institute in GMH; Group Interpersonal Psychotherapy, WHO Humanitarian Intervention Guide; Teachers College, Columbia University; New York

28-30 July. 75th Annual ICP Conference; Psychology’s Contributions to People, Planet, and the World; International Council of Psychologists; Pace University New York

3-6 August. 125th Annual APA Convention (see International program, contact Office of International Affairs). American Psychological Association, Washington DC

10 October. World Mental Health Day; Mental Health in the Workplace; World Federation for Mental Health

9-10 October. mhGAP Forum (contact pillardp@who.int); World Health Organization; Geneva, Switzerland

2-5 November. World Congress of Mental Health; Partnerships for Mental Health; World Federation for Mental Health; New Delhi, India

5-17 November. GMH: Trauma and Recovery Certificate Program; Harvard Program in Refugee Trauma; Orvieto/Porano, Italy (online training Nov. 2017-May 2018)

5-6 February 2018. 5th Annual GMH Summit; Leaving No One Behind; Movement for Global Mental Health; Johannesburg, RSA

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Prepared by Kelly O’Donnell, PsyD

GMH-Map, Member Care Associates

MCAresources@gmail.com

Please click on the link here to see the analysis and agreed conclusions of the 61st session of the UN Commission on the Status of Women (CSW).  The annual session of the CSW is the UN’s major meeting on women’s issues, and consists of a government-level meeting accompanied by a large parallel meeting for NGOs. A number of  WFMH delegates attend each year. 

https://gallery.mailchimp.com/ff9f2a2de058fd0d00c70a2ba/files/8a14c2d7-298b-4ddf-8d90-306a362f20fb/CSW61_Analysis_Final_12_Apr….pdf

61st Session, 13-24 March 2017

Participation in CSW61

I attended the 61st Session of the Commission on the Status of Women (CSW) in NY from 13-16 March, as part of a WFMH delegation - my first time!

To start with, you would think the UN would think of a different queuing system for security for delegates to enter the building?! (it’s not like they’ve not done this before). Standing in line in sub-zero temperatures wasn’t appealing.

Despite the weather conditions (brrr…), I attended the following sessions:

Monday, 13 March

Opening session (overflow room)

Soundbites from this session:

• “Women’s rights are human rights & attacks on women are attacks on all of us” (Secretary-General)
• “We need all men to stand up for women’s empowerment”(Secretary-General)
• “$ 28 trillion would be added to the annual GDP if women and men are treated equally at work”(President of General Assembly)
• “With 8.600 pre-registrations this is potentially the largest number ever of civil society representatives at this meeting” (UN Women)
• “If you are a woman…you are a worker. Period” (UN Women)
• “Women represent ca. 70% of 1.2 billion people living in poverty worldwide” (UN Women).

I wanted to attend the session ‘Intersectionality: an inclusive approach to gender quality’ but the room was full and I (along with many others) was unfortunately denied access.

In the afternoon I met with some fellow WFMH representatives: Nancy Wallace, Chueh Chang and Ricky Kantrowicz. It was a great opportunity to meet each other and for the more experienced WFMH representatives to share their experiences with me for participating at CSW.

Tuesday, 14 March

Due to the blizzard the UN was closed and all events were cancelled. Unfortunately, the WFMH panel was due to be held today. I was going to present on ‘good practices in addressing mental health issues in women’ in relation to work.  Below are the panel details:

Date: Tuesday, 14 March

Time: 12:30pm – 2:00pm

Venue: Church Center for the United Nations

Room: Boss Room

Title:  Women’s Mental Health and Work: Impact, Issues and Good Practices

Description:

Mental health is often neglected in the dialogue on economic empowerment.  Women in every country face inequalities, fewer opportunities in education, employment, and decision making.  Women are more likely to live in poverty and experience greater exposure to violence.  Women often face pressure created by their multiple roles in the family and work. Women’s mental health and well-being are strongly impacted by these factors.  When denied access to economic development, women become more vulnerable to violence, psychiatric disorders and psychological distress. There are strong correlations between depression and poverty.  This panel will address the promotion of mental health as a means of empowering women’s economic capacity and development that enables them to contribute fully to their communities, increases self-esteem, encourages independence and recognizes women’s value and economic contribution to society.  We will explore strategies for integrating mental health into policies and programs through case examples from around the world. Open discussion from participants will be encouraged.

NGO Work with topic:

The World Federation for Mental Health (WFMH) was founded in 1948 and has had Consultative Status with ECOSOC and association with DPI since 1963.  The mission of our international organization includes: the prevention of mental and emotional disorders; proper treatment and care of those with such disorders; and the promotion of mental health.  The Federation, through its members and contacts in many countries, has responded to international mental health crises through its role as the only worldwide grassroots advocacy and public education organization in the mental health field.  WFMH has had a long time commitment to women’s rights and issues, participating in the UN CSW annually since 1992, presenting panels on the various themes and advocating for the inclusion of mental health on the agenda of the UN.  WFMH has also been a longstanding member of the NGO Committee on the Status of Women since 1992, with WFMH’s Main Representative chairing in the past a Sub-Committee on Economic Empowerment for Women.

World Mental Health Day is an important initiative of WFMH that is celebrated around the world annually on Oct 10thand is recognized by the United Nations and World Health Organization (WHO) as a global observance.  WFMH’s commitment to economic empowerment, particularly for women, is demonstrated in the upcoming theme for 2017 World Mental Health Day: “Mental Health and Work.”  WFMH has a long history and accreditation with the International Labour Organisation (ILO) and in 2000, ILO and WFMH collaborated on a Congress on Mental Health in the Workplace.  WFMH members participated in the promotion of the ILO and WHO’s important publication Nations for Mental Health in 2000: “Mental Health and Work.”  WFMH’s UN team in New York presented a panel on Mental Health and Economic Empowerment of Women at the UN CSW meetings in 2012.

Wednesday, 15 March

Morning: town hall – informal NGO briefing

Notes from this:

• Issues of social protection are very important for female refugees. Migrant women have degrees/diploma’s in their home country and when they migrate they have to take up jobs others don’t want to do.
• UN women agreed that the issue of recognition of degrees/diploma’s needs to be addressed.
• UN women is pushing for women to be given ID’s in all countries to help facilitate them into employment. This will also help to reduce women trafficking and prove the age of the women and help prevent child marriages.

Lunch briefing

I had lunch with Nancy Wallace and she provided me with more background information on the CSW and WFMH’s involvement over the years, as well as giving me some hands-on advocacy training J. 

Afternoon: NCD Alliance session “Health Women, Healthy Livelihoods”

Interesting session addressing the health of women and it was nice to hear the issue of mental health also being addressed (only in one speaker’s presentation). It was mentioned that the issue of mental health is still a big taboo for young people. 

I posed a question:  asking for substitute language when referring to health – to specify health and mental health so as to increase integration & awareness and in turn help to reduce stigma & taboo. Many people in the audience responded positively to this question.

Afternoon: Putting advocacy for women’s rights at the center of sustainable development  organised by the International Women’s Health Coalition

The title of this session was somewhat misleading. There was no discussion on health at all, but more on working with donors to help build on investment.  

Afternoon: regional caucus Europe/North America

Notes from this:

• Worries that the US was trying to weaken the language of the final report. It was queried whether this was a result of the Trump administration?
• UN to make a statement on the Trump travel ban – restrictions on travelling affected people wanting to attend this meeting.
• Some delegations are using the SDG wording to weaken the wording in the agreed conclusions.
• Difficult for US NGO’s to connect with the US mission.
• There was criticism of UN Women’s role. Their role is to monitor inside the UN and act as guardians of the text of the agreed conclusions. It was said that UN Women might not be using their power properly or disempowering NGO’s(!) and UN Women is also being side-tracked within the UN.
• NGO’s have less and less access to negotiations. The space for advocacy has shrunk and the opportunity to listen to member states and meet delegations is not there.

I had also wanted to attend the session ‘Economic empowerment of displace women’ but the session was not in the allocated room and the location was unknown.

Thursday, 16 March

Morning

I read through the draft agreed conclusions & other CSW-related documentation.

Afternoon: Ending violence against women: prevention & response in the world of work

Notes from this meeting:

• Harassment & violence is a threat to health & wellbeing.
• Violence against women also impacts on their families & communities.
• Minister from Rwanda: 

o   Comprehensive support services available for victims of gender-based violence.

o   Psychosocial counselling part of these services.

• Mexico: mentioned ‘psychological’ as a form of violence.
• Ex. Director UN Women: 

o   Data has been collected from various physicians including from mental health workers.

o   A tool-kit has been developed to address various issues regarding violence in women.

• US restaurant workers are mostly female. Premise is that customers in fact pay their wages through tips, so work at a very low hourly rate (€ 2,13 per hour).  Therefore women often put up with sexual harassment and violence from customers. Research shows that sexual violence can be cut in half when  employers pay workers a minimum income.

Afternoon: Violence, Crises, Adversity & NCD’s organised by the Communications Coordination Committee for the UN (CCCUN) and UN NGO Committee on Mental Health.

I had pre-registered for this session, which was just as well. Everyone who had not was in the first instance asked to leave the room (although just before the session started any stragglers were allowed to stay). The session ran over, so unfortunately there was no time to ask questions.

Notes from this session:

• Advocating since 2011 to integrate mental health into the SDG’s.
• Need to strengthen mental health care systems at primary care level & integrate mental health into the primary care network.
• The Caribbean has high rates of NCD’s. 18-25% of the population suffer from mental health disorders.
• Jamaica has developed a ‘mental health disaster preparedness plan’ (mental health disaster programme).
• Thailand includes mental health in the universal health coverage. The budget for mental health care is 3.5% of the total health budget.
• Mental health & physical health are closely related. Sleep and sleep quality is very important for both.

My impression of my time at CSW is that it is difficult to impossible to connect with country delegates (separate entrances), although I did manage to do some networking with fellow NGO delegates. There are also so many sessions & parallel events it can be quite overwhelming to decide which sessions to choose.  All in all though it was very interesting to participate in CSW61 on behalf of WFMH.

Kind regards,

Caroline Morton-Gallagher

International Relations Officer

Stichting Epilepsie Instellingen Nederland (SEIN)

cmorton@sein.nl