• Fifth World Conference 2008
• Fourth World Conference 2006
• The Third World Conference 2004
• The Second World Conference 2002
• The Inaugural World Conference 2000

The Fifth World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders presented a program firmly set in the social context of mental health, a trademark of the host organization, the Victorian Health Promotion Foundation (VicHealth) headed by CEO Todd Harper. The meeting attracted 860 participants from 44 countries and added several new plenary program topics to the themes established at previous conferences in the series. Altogether 370 presentations at various levels from plenary addresses to posters were crowded into the three-day event on 10-12 September 2008 in Melbourne, Australia.

Previous conferences had emphasized research, advocacy and policy-making, coalition building, program design, and building up workforce capacity. While carrying forward these topics, the Melbourne organizers added social participation, discrimination and diversity, violence, and access to economic resources. The sessions on violence covered many situations and incorporated discussions of human rights. Presentations on measuring population mental health and happiness from an Asian perspective were among the innovations, as were the special efforts throughout the conference to engage young people and take account of their views.

VicHealth found the timing of the conference to be valuable from a local perspective. Premier John Brumby’s Government in the State of Victoria has initiated a major review of mental health services with the goal of introducing widespread reforms. Work on the programming of the conference provided many insights at a time when the state’s policies and services were under examination. Both the Premier and the Minister for Mental Health, the Hon. Lisa Neville MP, spoke at the opening of the conference.

The partner organizations presenting the conference in Melbourne with VicHealth were the World Federation for Mental Health, the Carter Center (Atlanta, USA) and the Clifford Beers Foundation (UK). Professor Rob Moodie from the Nossal Institute at the University of Melbourne and Professor Helen Herrman of ORYGEN Research Centre headed the International Program Committee. VicHealth’s Mental Health and Wellbeing Unit headed by Lyn Walker provided a very able organizing team, with Senior Program Officer Irene Verins playing the leading role.

Violence and Human Rights
The theme of violence was supplemented by a notable emphasis on human rights throughout the plenary program. Kate Gilmore, deputy director of Amnesty International, gave a passionate address on human rights abuses which started and ended with the genocide in Rwanda. Rob Moodie, co-chair of the International Program Committee, began his presentation with a condemnation of the way that asylum seekers, who have already experienced trauma, are placed in circumstances during the asylum process that can cause or worsen mental illness. Mohammed Diaaeldin Omer, UNICEF-Sudan, described the high prevalence of common mental disorders among women living in camps in West Darfur (75.8%), and the low attention paid to it. Harry Minas of the University of Melbourne described the Pinel 21 Project that is investigating the physical restraint and confinement of people with mental illness in Aceh and Sumatra (Indonesia). Paris Aristotle, Director of the Victorian Foundation for Survivors of Torture, discussed refugee and resettlement issues including the strategies that governments use to as barriers for people with mental illness. During the conference VicHealth’s CEO, Todd Harper, launched his organization’s new program to combat violence against women by providing grants to five local service organizations.

In a very explicit way, too, VicHealth drew attention to human rights close to home. The closing item of the conference was a performance by the Choir of Hard Knocks, which has become well known in Australia through a prize-winning documentary and its two platinum CDs. The choir features more than 30 people in Melbourne, many of them homeless, who have experienced extreme disadvantage in life. The group’s intensely moving performance drew the audience into consideration of basic themes explored by the program—social participation, discrimination and economic issues.

Furthering the human rights theme, two plenary speakers spoke about the newly released report of the WHO Commission on the Social Determinants of Health (www.who.int/social_determinants/en/). Prof. Fran Baum, a member of the Commission, noted the influence of the former Surgeon General of the United States, David Satcher, in seeing that mental health issues were incorporated in the report. Prof. Carles Muntaner presented research on labor issues for the report, showing how the way the modern work place is organized has a heavy impact on mental health.

Youth Engagement Strategy
The conference incorporated a youth engagement strategy exploring ways to reach out to young people. On the first morning the State of Victoria’s Minister for Mental Health, the Hon. Lisa Neville, MP, spoke about the need to build up a “mental health platform” in early childhood services and in schools to address perceived needs and help young people reach their potential. Elsewhere the conference planners pointed towards ways to reach young people outside conventional settings, through social activities and particularly through the Internet.

Programming on young people’s issues was incorporated in many sessions and youth was in evidence to an unusual degree throughout, from the dancers of the Indigenous Hip Hop Project to the “Reach Out!” program’s ambassadors. Two young ambassadors from the program, Doug Millen and Ehon Chan, addressed a major session and gave the (much older) audience an insight into ways to reach young people, while also showing the importance of taking their opinions into account. The Inspire Foundation (www.inspire.org.au) and Oxfam Australia’s Youth Engagement Program (www.reachout.com.au) were represented, and VicHealth arranged for young people to participate in online forums before the conference. Film-makers from the Student Youth Network (www.syn.org.au) shot a witty video giving their view of the conference and presented it at the closing session. The video and other materials produced during the conference were used later in various youth websites.

Measuring Mental Health
There were several presentations on how to measure mental health, a particular interest of VicHealth through the work of its McCaughey Centre (www.mccaugheycentre.unimelb.edu.au), which has produced a set of community wellbeing indicators for the State of Victoria (www.communityindicators.net.au). A presentation on Bhutan’s Gross National Happiness Index attracted considerable attention. Karma Tshiteem, Secretary of that country’s Gross National Happiness Commission, proposed that measuring GNH is about a balanced and holistic approach to development using alternative definitions of wellbeing. A nationwide survey of one thousand people, using 300 questions, was used to derive 31 GNH indicators from which a single GNH Index will be derived. Apichai Mongkol from the Thai Ministry of Public Health spoke about the development of a similar index. The Thai Happiness Index has 66 items, and looks at areas such as spirituality, health and family support. As these indicators were discussed, it was observed that when mental health is mentioned in Bhutan and Thailand people think of relative degrees of happiness, while when it is mentioned in the West people think first of mental illness.

The special area of database development was also reviewed. Norway’s large project to develop a database for evidence-based interventions in prevention and promotion was described by Willy-Tore Mørch from the Norwegian Centre for Child and Adolescent Mental Health.

Karma Tshiteem, Gross National Happiness Commission, Bhutan, addressing the conference.
Photo credit: Snappy Pics.

Activities Attached to the Conference
As at previous conferences, various activities were arranged before and after the meeting. These included the biennial meeting of the Global Consortium for the Advancement of Mental Health Promotion and Prevention in Mental Health (GCAPP); a day-long pre-conference on school mental health arranged by the International Alliance for Child and Adolescent Mental Health and Schools (Intercamhs); and a meeting of the International Network of Health Promotion Foundations.

The Arts Program
Throughout the conference VicHealth showcased its belief that the arts have an important role to play in promoting community mental health (and fun). Sixteen arts projects were presented, sometimes at unexpected moments, thanks to special support from Arts Victoria. Highlights included the vocalists of Black Armband who provided contemporary indigenous music at the opening, and the closing ceremony which included the rock music of the BiPolar Bears as well as the Choir of Hard Knocks.

Choir of Hard Knocks. Photo credit: Snappy Pics.

Fourth World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioural Disorders, Oslo, Norway, October 11-13, 2006

There were many outstanding presentations at the Fourth World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders, held in Oslo, Norway on 11-13 October. Two remarkable speeches on the first day came from politicians describing personal experiences.

In the opening plenary Kent Härstedt, a prominent member of Sweden’s parliament, described how he survived the sinking of the car ferry Estonia as it sailed from Tallinn to Stockholm. Out of 989 passengers on the ship, only 137 were rescued in this Baltic Sea disaster in 1994. Later Norway’s former prime minister, Kvell Magne Bondevik, who served in that role from 1997 to 2000 and from 2001 to 2005, told the conference about experiencing an episode of depression while he was the country’s leader. In different ways these two speakers showed how mental health can be at risk in unexpected circumstances, and how the right care promotes recovery.

Their careers as politicians also provided a link to one of the conference’s main topics, the need to recognize mental health as an important component in national health policies. This was addressed in a special forum led by Mrs. Rosalynn Carter, Former First Lady of the United States, long recognized as an advocate for improvements in mental health care. In the same part of the program Dr. David Satcher, former Surgeon General of the United States, spoke about the priorities that should be addressed within mental health care policy, with particular concern for disparities in the provision of services. Shekhar Saxena put forward the viewpoint of the World Health Organization on both policy and human rights.

Other speakers in the international program included Margaret Barry (Ireland), William Beardslee, Marion Forgatch, Carol Koplan and Irwin Sandler, (United States), George Christodoulou (Greece), Helen Herrman and John Wiseman (Australia), Clemens Hosman (The Netherlands), Eva Jané-Llopis (Denmark), Martin Knapp (United Kingdom), Maurice Mittelmark and Terje Ogden (Norway), Shridhar Sharma (India) and YU Xin (China).

The conference, which was organized by the WFMH, The Clifford Beers Foundation, The Carter Center and the Norwegian NGO Voksne for Barn, was supported by the Norwegian Directorate of Health and Social Welfare. The chair of the program committee was Patt Franciosi, Immediate Past President of WFMH. Randi Talseth, Secretary General of Voksne for Barn, chaired the hard-working Norwegian host committee. Her staff at Voksne for Barn made exceptional efforts to see that everything ran smoothly.

On the day before the conference there was a meeting on mental health in schools, another on support for children of mentally ill parents, and a network meeting on the same subject. The Global Consortion for Advancement of Promotion and Prevention (GCAPP) also met before the conference. At the end of the conference WFMH convened its annual Board meeting.

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The Third World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders, Auckland, New Zealand, September 15-17, 2004

At the New Zealand conference (left to right):
Thomas Insel, M.D., Director National Institute of Mental Health, U.S.; Preston J. Garrison, Secretary General and CEO, WFMH; Rosalynn Carter, Patron of the Biennial Conferences; Thomas Bornemann, Conference Program Chair and Director, Carter Center Mental Health Program; Beverly Long, Chair Consortium for the Worldwide Advancement of Promotion and Prevention; and Charles G. Curie, Administrator, Substance Abuse and Mental Health Services Administration, U.S. Department of health and Human Services.

The Third World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral brought together many different groups concerned with these subjects, and took the biennial conference series to a new standard of excellence. This was evident from the larger number of registrations, the variety and innovations in the program and workshop sessions, and the seven pre-conference meetings at the start of the week. In addition three publications were released, two summary reports from the World Health Organization (WHO) on promotion and on prevention, and a joint publication by World Federation for Mental Health (WFMH) and the WHO presenting 35 country case studies on mental health promotion.

New Zealand Conference: After the opening Ceremony and Maori Welcome.

The Auckland conference was organized by WFMH, The Clifford Beers Foundation (U.K.) the Mental Health Foundation of New Zealand, and The Carter Center Mental Health Program. It was co-sponsored by WHO. Some 360 people attended and 31 countries were represented. Dr. Thomas Bornemann of The Carter Center headed the scientific program committee. Dr. Alison Taylor of the Mental Health Foundation led the local host committee.

The Auckland meeting’s focus on policy development was carried forward by health agency leaders from New Zealand and the United States: Karen Poutasi, M.D., Director General of Health in New Zealand’s Ministry of Health; Janice Wilson, M.D., Deputy Director General for New Zealand’s Mental Health Directorate in the Ministry of Health, Thomas R. Insel, M.D., Director of the U.S. National Institute for Mental Health; Charles G. Curie, Administrator, Substance Abuse and Mental Health Services Administration in the U.S.; and A. Kathryn Power, Director of the U.S. Center for Mental Health Services.

The speakers also included David Morris, Director of the Social Inclusion Program at the National Institute for Mental Health in England, Liz Sayce, Director of the U.K. Disability Rights Commission, and Gerard Vaughan, Manager of the successful Like Minds, Like Mine program in New Zealand.

The message at this level of the conference was that government agencies play a vital role in moving the concepts of promotion and prevention, as developed by evidence-based research and pilot programs, into the mainstream.

Indigenous Mental Health
Another strand of programming drew attention to the special issues of indigenous peoples in mental health. The conference’s attention to Maori traditions and to other cultures in New Zealand – supplemented by presentations from South Africa – underscored the need to take cultural issues into account when drafting policy and undertaking research. Auckland itself served as a suitable backdrop; a walk through the city center confirmed its remarkable multi-ethnic character formed by recent immigration. In addition to the Maori population and people of European origin, a high proportion of residents come from Asian countries and from various Pacific islands.

Former U.S. First Lady Rosalynn Carter, the patron of the conference series, participated in many activities. The program included a special lecture by Prof. George Albee reviewing issues of importance during his long career. Thomas Insel, M.D., Director of the U.S. National Institute of Mental Health, gave a presentation on the relationship of neuroscience research to mental health promotion that was perfectly pitched to non-neuroscientists. Prof. Mason Durie gave an important overview of indigenous mental health issues worldwide, before focusing on matters related to Maori mental health.

Two WHO books were released at the conference:
(left to right) Helen Herrman, Shekhar Saxena, Rob Moodie, Eva Jane-Llopis, Clemens Hosman and Preston Garrison.

Value of Exercise
The New Zealand organizers wanted to emphasis the value of exercise for mental well-being and overall good health. This theme appeared at several points in the program, and notably in the plenary session given by Ken Fox of Bristol University in the U.K. and Steve Edwards of Zululand University, South Africa.

A special symposium on “Peer Support and Recovery” was made possible through scholarships for consumers from the United States provided by the U.S. Center for Mental Health Services.

Many of the New Zealand presenters opened with greetings in Maori, and in accordance with custom local members of the audience rose to sing a waiata (a Maori song expressing support and respect) at the end of such presentations. The final waiata, following the Maori closing ceremony, was a genuinely moving end to an exceptional meeting.

(NOTE: The official proceedings for the 2004 conference will be prepared by the World Federation for Mental Health and should be available by late autumn 2005. To be added to the mailing list to receive a copy of the proceeding, please contact WFMH at  info@wfmh.com )

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The Second World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders, London, September 11-13, 2002

The London conference attracted an audience enthusiastic about the field of mental health promotion and prevention, and speakers gave an impressive overview of the latest developments. In deference to the events of September 11, 2001, the meeting began with information about Britain’s national minute of silence at 1.46 pm local time. Later in the day conference participants joined this observance, which was followed by a plenary session about prevention in relation to violence and trauma. Mrs. Rosalynn Carter, wife of former US President Jimmy Carter, spoke about posttraumatic stress disorder as a consequence of natural and man-made disasters. Beverly Raphael, Director of the New South Wales Department of Health, Australia, discussed the many sources of violence in society and its results for individuals, especially children. She said that some interventions, but not all, could be helpful after incidences of mass violence. Prof. Dusica Lecic-Tosevski of the University of Belgrade, Serbia and Montenegro, spoke about the war in the countries that formerly were part of Yugoslavia and noted the importance of including disaster preparation in prevention programs.

The overall program was designed to highlight five core tasks in prevention and mental health promotion. The first was developing insight into the onset of mental health problems and the development of positive mental health. The other core tasks were:  Influencing national policies to improve mental health and reduce the incidence of disorders;  Developing stakeholder partnerships;  Moving from research to effective programs; and  Developing a competent workforce for prevention and promotion. Speakers who described current scientific research and the implementation of programs came from government agencies and departments, academic institutions, NGOs and mental health associations.

The World Health Organization was represented by Benedetto Saraceno, M.D., Director of the Department of Mental Health and Substance Dependence, and by Shekhar Saxena, M.D., Coordinator for Mental Health Evidence and Research. A session in the program was devoted to WHO’s current work in prevention and promotion. To coincide with the conference, WHO released a new publication -- Prevention and Promotion in Mental Health. This will be followed by other reports, now in preparation, on prevention (2005, edited by Clemens Hosman, Eva Jane-Llopis and Shekhar Saxena) and promotion (2005, edited by Helen Herrman, Shekhar Saxena and Rob Moodie). Professors Hosman and Herrman gave overviews of their work on these projects.

The British authorities paid significant attention to the conference: improving mental health services is one of the government’s top three health priorities. The Minister for Health and Social Services for Wales, Jane Hutt, gave a presentation at the welcome reception on 10 September. On the following day the U.K. Minister of State for Health, Jacqui Smith, opened the conference. That evening she hosted a government reception for participants at the Foreign and Commonwealth Office.

From Research to Implementation
Prevention and promotion programs operate at many levels and selectively target age groups throughout the lifespan. A large number focus on prenatal health, effective parenting, and school-based initiatives. Others target women’s mental health, workplace conditions, and issues affecting older people. Moving from research to demonstration programs, and then to broad-based government policy initiatives, is a time-consuming process. Transferring the knowledge gained from one culture to another is even more difficult.

Many speakers gave a Western perspective, and so the views of those who represented developing countries were particularly welcome. Vikram Patel discussed the limited provision for general health care in India, and how difficult it is to implement services for prevention and promotion in mental health when basic programs are lacking. A WFMH Board member from South Africa, Shona Sturgeon, spoke about the wide gap between rich and poor countries and how poor countries react when help is offered without a realistic appreciation of their circumstances. The Federation’s Regional Vice President for Africa, Elizabeth Matare of Zimbabwe, gave a witty and energetic address about ways to campaign at grassroots level for improved mental health services.

In the closing session WFMH Board Member Janet Meagher spoke about the need to close the gap between scientific research and those who receive services, which she presented as an essential requirement for the general implementation of demonstration projects. She urged the organizers to consider broad approaches, such as involving self-help groups in promotion and prevention.

(NOTE: The proceedings of the 2002 World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders are available from the World Federation of Mental Health. To request a copy, contact WFMH at info@wfmh.com .)

Inaugural World Conference
The Promotion of Mental Health and Prevention of Mental and Behavioral Disorders The Carter Center,  Atlanta, Georgia, USA,  5-8 December 2000

The goal of the conference held at the Carter Center in Atlanta, Georgia, was to recognize promotion and prevention as fundamental parts of the mental health spectrum alongside treatment and care. WHO Director-General Gro Harlem Brundtland, M.D., signaled her interest in the meeting by coming directly from a conference in Japan to address the closing session.

The program opened with a welcome from Mrs. Rosalynn Carter, the patron of the meeting, and Gregory Fricchione, M.D., Director of the Carter Center Mental Health Program. The session’s keynote address was given by Prof. William Foege, M.D., M.P.H., Department of International Health at Rollins School of Public Health, Emory University, Atlanta. Other opening speakers were Benedetto Saraceno, M.D., Director of the Department of Mental Health and Substance Dependence at the World Health Organization, Geneva, Switzerland; Ahmed El Azayem, M.D., President of the World Federation for Mental Health; and former WFMH President Beverly Long. Mrs. Long, well known as a leading advocate for prevention, chaired the program planning committee.

The organizers designed a fast-paced series of plenary addresses and panel sessions, followed by presentations to small work groups that later drafted a number of recommendations. The program reviewed the present state of prevention science as it affects people across various stages of the life span, from interventions in pre-natal care, parenting and early childhood, to school-based research, projects affecting the workplace and the unemployed, and interventions to help the elderly.

Prevention and Promotion The conference recognized the close association of prevention and promotion in mental health. Prevention of the initial occurrence of a mental disorder (primary prevention) was the strong focus of the conference, although it is recognized that some prevention scientists include prevention of relapse in the definition. Promotion emphasizes efforts to increase positive developmental strengths and resilience to stress. The organizers felt that the complimentary nature of the two concepts should be encouraged, so that an overall strategy of using prevention and promotion together can be developed as research moves to a more advanced stage.

Successful prevention research on specific interventions has created interest in combining interventions for greater impact, and in examining how culture, social class and gender affect results. There is also a growing need for work on how to adapt small scientifically-researched programs for large-scale use in public health. Taking a small intervention program from one country and adapting it for use in another creates many other issues requiring assessment and research.

Need for Outreach Much of the existing research on prevention is multidisciplinary and has been done in the United States, Canada, North-Western Europe and Australia. At this stage it is not easy to apply in countries which have no experience of prevention and promotion, and where mental health may not even be included in primary health care. The conference organizers were eager to attract interest in developing countries and to make the research more culturally adaptable. Ideally collaborations across communities in different cultural contexts should be included in the next stage of research. Of the 243 people who attended, 75 came from overseas (25 countries), reflecting the program committee’s outreach efforts.

Keynote Addresses Major recognition of the potential value of promotion and prevention came from the keynote addresses by U.S. Surgeon General David Satcher, M.D., Ph.D., on the opening day, and WHO Director-General Gro Harlem Brundtland, M.D., at the closing session.

Dr. Satcher reviewed many areas where prevention could be of value but is still neglected. Dr. Brundtland gave a similar message with an international perspective, reflecting that less was known about primary prevention than about primary health care. “Health promotion is a question of empowerment,” she commented, noting that more research was needed and more awareness should be encouraged among policy-makers. She stressed the importance of educating families about early childhood development, and training teachers to know how to recognize vulnerable children. Dr. Brundtland’s speech also focused on the “vast neglect” of people with mental health problems in developed and developing countries, and on the failure to provide treatment for large numbers of the people affected.

Organizers and Supporters The inaugural conference in Atlanta was a program of the World Federation for Mental Health in collaboration with The Clifford Beers Foundation of the U.K. The World Health Organization and the Carter Center were the original co-sponsors. Other co-sponsors included the U.S. Centers for Disease Control and Prevention; the U.S. Center for Mental Health Services, Substance Abuse and Mental Health Services Administration; the U.S. National Institute of Mental Health, National Institutes of Health; the U.S. National Institute on Drug Abuse, National Institutes of Health; and the U.S. Bureau of Primary Health Care, Health Resources and Services Administration.

(NOTE: The proceedings of the Inaugural World Conference on the Promotion of Mental Health and Prevention of Mental and Behavioral Disorders (December 2000) are available from the World Federation for Mental Health. To request a copy, contact WFMH at info@wfmh.com .)

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