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World Federation
Activities
at United Nations Agencies in 2010-2011
The World Federation for Mental
Health has had Special Consultative Status to the United Nations
Economic and Social Council (ECOSOC) since 1963. It has had much
earlier contacts with some United Nations agencies, having been
founded in 1948, the same year as the United Nations itself. A
close connection has been maintained since those early
beginnings with the World Health Organization (WHO), a UN agency
with headquarters in Geneva. WFMH also has formal relationships
with the UN Department of Public Information, UNICEF and UNESCO.
Ongoing informal relationships have been maintained with the UN
Department of Economic and Social Affairs (DESA), the UN
Population Fund (UNFPA), the UN Entity for Gender Equality and
the Empowerment of Women (UN Women), the UN Office for the
Coordination of Humanitarian Affairs (OCHA), and the
International Strategy for Disaster Reduction (ISDR). WFMH
volunteer UN Representatives participate in events in both New
York and Geneva.
In New York the Federation’s UN
Representatives participate in civil society activities
including those at the UN Commission on the Status of Women
(since 1993) and the UN Commission on Social Development (since
1998). They are members of the NGO Committee on Mental Health,
which the WFMH Main Representative helped to found in 1996. They
help to organize World Mental Health Day programs for the UN
community.
Advocacy on Non-Communicable
Diseases
In 2011 WFMH focused its
advocacy on pressing for the inclusion of mental illnesses among
the major non-communicable diseases (NCDs) to be included at the
General Assembly’s High-Level Meeting on the prevention and
control of NCDs, to be held at UN Headquarters on 19-20
September 2011. This is part of a broader WFMH campaign called
“The Great Push for Mental Health” to urge governments to
provide an adequate budget for mental illnesses in their health
planning, and to encourage grassroots organizations to
participate in advocacy.
Cardiovascular diseases,
cancers, chronic respiratory diseases and diabetes are the
priority illnesses on the agenda of the September UN High-Level
Meeting. Mental illnesses were given the briefest of mentions
despite their widespread prevalence. WFMH presented a statement
to the meeting of the World Health Organization’s Executive
Board in January asking for more attention to mental illnesses.
A second statement was submitted to the WHO’s World Health
Assembly in May, where WFMH’s Senior Representative in Geneva,
Myrna Lachenal, read the following paragraphs into the record on
behalf of three organizations:
Joint Statement of the
World Federation for Mental Health and the NGO Forum for Health
and the Alliance for Health Promotion at the 64th World Health
Assembly, Geneva, 16-24 May 2011 : Agenda item 13.12 Prevention
and control of noncommunicable diseases
Mental illnesses are not
only a risk factor for other NCDs, but are often a consequence
of having diabetes, cancers, cardiovascular diseases and
respiratory diseases. Without addressing mental illnesses
explicitly outcomes related to NCD initiatives will not only be
less effective—but also, as the research shows—will cost more.
For example, we know that diabetics have twice the risk of being
depressed as non-diabetics; and treating both diabetes and
depression results in improved medication adherence and lower
healthcare costs. If depression is addressed, outcomes improve
and medical expenditures are reduced.
We understand the concern
that the inclusion of all mental illnesses may not be possible
at this stage. However, as the WHO mhGAP Programme shows, there
are cost-effective, evidence- based interventions for a limited
set of diagnoses. We are advocating that these be included as
part of the NCD armamentarium. The bottom line is that we need
to ensure that mental illnesses are included in some form as
part of the action plan, recognizing both the linkages with
other NCDs as well as the state-of-the-science. Let us not
undermine the NCD effort right from the start by excluding
mental illnesses and substance abuse.
WFMH Secretary General Dr.
Vijay Ganju attended WHO’s Global Forum for NGOs, held in Moscow
on 27 April 2011 prior to a meeting of Health Ministers to
prepare for the September High-Level Meeting at the United
Nations. He also attended the Informal Interactive Hearing on
Non-Communicable Diseases at the United Nations on 16 June 2011,
and submitted a Civil Society Statement on Non-Communicable
Diseases and Mental and Substance Abuse Disorders which was
supported by 46 other international and national organizations.
A follow-up letter was also sent to WHO.
Activities at United Nations
Headquarter in New York in 2010-2011:
WFMH participates in the
activities of the NGO Committee on Mental Health, a coalition of
mental health organizations with consultative status at the
United Nations. WFMH’s Representatives attend the monthly
meetings of the NGO Committee and help to organize various
programs for its Working Groups. Nancy Wallace, WFMH’s Main
Representative, is a former chair of the NGO Committee and is
Co-Convenor of its Working Group on Trauma and Mental Health.
Linda Conte is Vice-Chair of the NGO Committee and a Co-Convenor
of the Committee’s Working Group on Children, Youth and Mental
Health. Ricki Kantrowitz is a member of the NGO Committee on the
Status of Women, and has given many years of volunteer service
to events at the annual session of the UN Commission on the
Status of Women.
Nancy Wallace and Linda Conte
are WFMH’s Representatives to the UN Department of Public
Information/NGO Relations. They attend the DPI Briefings for
NGOs and forward information about UN activities to WFMH.
At the 54th Session of the UN
Commission on the Status of Women, 1-12 March 2010, WFMH
sponsored a workshop on “Natural Disasters and Mental Health:
Consequences for Recovery and Resilience in Women and Children
(9 March 2010). Just before the Commission’s session, a special
meeting was held in New York to mark the fifteenth anniversary
of the UN Conference on Women which took place in Beijing in
1995. Two of WFMH’s UN Representatives attended the “Global NGO
Forum for Women: Beijing + 15.” They had been part of a WFMH
delegation that attended the UN Conference in Beijing.
At the 55th Session of the
Commission on the Status of Women in 2011, WFMH sponsored a side
event on “Promoting Women’s Mental Health and Well Being in the
Workplace (2 March 2011). The Federation also sponsored a side
event on “The Impart of HIV/AIDS and Mental Health for Asian
Women (3 March).
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DECLARATION OF THE CONSORTIUM FOR
GLOBAL INFANT, CHILD AND ADOLESCENT MENTAL HEALTH
The social, emotional and
mental health of infants, children and adolescents is essential
for effective learning and for sustaining healthy and productive
societies. Beginning early in life, a broad range of programs
from mental health promotion to early intervention, treatment
and care can provide resiliency and protection. Threats to the
mental health of children are recognized worldwide in the form
of exposure to violence, malnutrition, poverty, school failure,
disrupted families, lack of opportunities for self-sufficiency
and mental illness. Despite an increasing body of evidence
documenting the objective costs to society of mental ill health
in children and adolescents, influential policies and meaningful
financial support are lacking*. In fact, in some nations, child
mental health is suffering due to cutbacks in and a lack of
access to services previously available. This is a critical
period in world history when there is a need to redress past
failures and focus with a heightened sense of urgency on a few
steps that can be undertaken globally to improve the mental
health status of children and adolescents.
The World Health Organization
has documented the absence of programs for social emotional
learning and mental health promotion, as well as services for
children with or at risk for mental disorders worldwide (Atlas,
2005). The gaps are universal, but there are obvious differences
in countries by economic development, historical precedent and
impact of current events. Where the number of children is
greatest, the resources are the least! The WHO Atlas
demonstrated that long held beliefs that the United Nations
Convention on the Rights of the Child ensured a level of access
to preventive programs and care and the fulfillment of a
mentally healthy life, and that the training of primary care
clinicians alleviated the need for other service initiatives,
were not true. The absence of infant, child and adolescent
focused mental health policy appears to be a significant
limiting factor to the support for promotion, prevention and
care.
Lack of a skilled education,
counseling and health care workforce hampers the delivery of
needed programs and services. This deficit, coupled with a lag
in the ability of primary health care services to incorporate
mental health interventions, and a failure of public health and
education initiatives to highlight mental health issues, has led
to continuing gaps in care over decades despite the clarion call
for change to meet needs. In spite of the overwhelming evidence
of cost effectiveness for interventions, such as those for
infants at the beginning of life, including home visiting to
benefit both the mother and child and their attachment
relationships and to recognize difficulties in parent-child
interaction, policy makers have failed to invest in and provide
support for their implementation at the needed scale. Much more
must be done to increase the awareness of educators concerning
the interdependent link between mental health, learning and
school success and the many evaluated programs to address mental
health along the continuum.
Imperfections in current
diagnostic schema are recognized. A better understanding of the
place of culture in both recognizing and ameliorating pathology
is needed. Likewise, recognizing the singular importance of
schools and the multiple tragedies that result from school
dropout must become part of the public debate. There is a
growing concern that a focus on pharmacological approaches to
the care of infants, children and adolescents in the absence of
adequate diagnostic procedures may distort the development of
services.
For the purpose of gaining a
consensus on the needed steps, many international organizations
have come together, forming a coalition to advocate for
necessary changes in policies and programs. The Consortium for
Global, Infant, Child and Adolescent Mental Health*** represents
consumers, professionals across disciplines and a broad range of
institutional supporters.
The Consortium endorses the
following recommendations:
--- Recognize a place for the
consideration and utilization of infant, child and adolescent
mental health interventions in international bodies, such as,
the World Health Organization, UNICEF, UNESCO, World Bank,
International Organization for Migration, United Nations High
Commissioner for Refugees, International Red Cross and Red
Crescent, and others which care for children and adolescents in
their daily lives and during the aftermath of war, natural
disaster, and other upheavals. Currently, there is no focal
point designated for infant, child, or adolescent mental health
in these organizations.
--- Foster the development of
infant, child and adolescent mental health policy as an integral
part of education, social welfare, health policy and health
reform. Many guides to policy development exist with a most
useful one being the WHO publication, Manual on Child and
Adolescent Mental Health Policy Guidance.
--- Recognize and support
inter-sectoral responses to child and adolescent mental health
that help address the social, economic and political
determinants of mental health and mental illness in children and
adolescents. Utilize childcare, educational resources, community
education resources, health care promotion initiatives to focus
on mental health as an essential component of health and
education awareness.
--- Recognize and intervene at
the earliest possible developmental stage to promote positive
mental health and to avert the consequences of growing up with
conditions, which interfere with healthy mental development. The
field of infant mental health provides sophisticated guidance
for promoting mental health. Likewise, it is now recognized that
over 50% of all adult mental disorders begin before the age of
14, and many can be prevented through promotion and
intervention, especially through schools.
- It is the intention of the
Consortium to initiate a Global Infant, Child and Adolescent
Mental Health Report Card. Data will identify continuing
gaps in policy, services, educational activities, economic
support and report on examples of distortions and crises in
care. Core data for the Report Card will be derived through
the resources of Consortium members, but others are invited
to participate in this global initiative.
- Further, the Consortium
will initiate the free distribution of an annual yearbook
containing articles on best practices, newer scientific
findings, and systems development. The Yearbook will be
specifically aimed to enhance the resources of low income
countries.
In the final analysis, the
Consortium aims to support promotion and prevention and to
alleviate the suffering of vulnerable infants, children and
adolescents so that a variety of sectors and agencies can become
more actively involved in supporting a trajectory for healthy
development., saving untold suffering and costs to individuals,
families and societies..
The Consortium seeks to gain a
better understanding of the clinical and policy issues that
either impede or support the ability to deliver culturally
relevant, responsible and responsive services to infants,
children and adolescent.
Mentally healthy children
and adolescents are essential for the future well-being of our
societies.
NOTES:
* Mental health cost fact
sheet.
** Rational care defines care for children and adolescents that
includes an appropriate diagnostic process, involvement of the
family, recognition of the child’s environment, the treatment of
any disorder in a manner that is based on efficacy and
effectiveness, and the utilization of interventions that do not
inappropriately utilize medications.
*** Consortium members: World
Association for Infant Mental Health; International Society for
Adolescent Psychiatry & Psychology; World Federation for Mental
Health; International Association for Child & Adolescent
Psychiatry and Allied Professions; EDC/INTERCAMHS….
Endorsed by the WFMH Board of
Directors, August 22, 2007
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WFMH Volunteer UN
Representatives
New York
Nancy Wallace, L.M.S.W., Main Representative (also DPI Main
Representative)
Ricki Kantrowitz, Ph.D.
Richard Donahue, M.S.W.
Haydee Montenegro, Ph.D.
Gary Belkin, M.D.
Geneva
Myrna Lachenal, R.N., Main Representative
Anne Yamada
Stanislas Flache, M.D.
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