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