WHO conference: Ministers set must dos for improving mental health policy

- Helsinki conference lauded as starting point for stronger action

Helsinki 14 Jan: Participants in the WHO European Ministerial Conference on Mental Health adopted Friday a declaration and action plan that seek to establish mental health policy and practice at the centre of public health in the member states that make up the WHO European region.

The declaration of the ministerial meeting outlines the main responsibilities of member states in developing mental health promotion and preventive strategies. The action plan describes 12 priorities for developing and carrying out policies, and proposed actions that countries could follow.

The conference recommendations aim for major improvements in the mental health situation in the WHO European region, covering 850 million people in 52 countries. The region is beset by mental ill health with the world’s highest statistics for suicide, alcohol consumption and neuro-psychiatric disorders.

Endorsing the conference documents, Marc Danzon the WHO Regional Director for Europe said that they “will enable the development of mental health in all countries that is clear and understandable to the population." He stressed that the situation of children and adolescents will be a special focus of the follow-up work on the recommendations and commitments approved by the conference.

“The declaration of the conference has been the fruit of the efforts of member states in strict compliance with the values we [WHO] have developed." He said these values are solidarity, fairness and citizens’ participation.

Call for cooperation

Vera Boltho of the Council of Europe said that, as with the Stockholm conference on mental health held in 1985, the Helsinki forum had seen much emphasis on the problem of stigma attached to mental ill health. “This shows that maybe we haven’t made as much progress as we would have liked."

But she lauded the results of the Helsinki conference for breaking new ground. “What I find innovative is that the declaration lists responsibilities and there is a clear call for cooperation between organizations - particularly the WHO, the European Commission and the Council of Europe."

European Commissioner Markos Kyprianou also praised the outcome of the conference. “With the signing of the declaration and action plan we have come to an important stage in the process of the development of mental health. There is a high degree of consensus on mental health issues. The main work of this conference has been to develop actions."

He said that the EU would launch an ambitious new health strategy focusing on health promotion and the prevention of illness. “Mental health will take its appropriate place in this strategy."

Summing up the work of the conference, Professor David Hunter of University of Durham, UK, welcomed the genuine endorsement by ministers and delegates for the declaration and action programme. He called the work of the conference a “genuine paradigm shift" in mental health policy.

“This is a truly historic moment in the history of mental health policy in Europe. But talking the talk is one thing; walking the walk is another. The hardest part comes next." He said that there was no room for complacency in the area of mental health policy development. “But there is an overwhelming wish to put words into action."

All in a name

Describing what he termed “the meaning of Helsinki", Hunter characterised the work of the WHO conference through the city’s name in the form of an acronym.

“‘H’ is for Health: this is important as we have heard much about the need to rebalance public health policy. Mental health still suffers from an overemphasis on acute hospital care." He said that the special emphasis on health promotion in the conference showed that more attention on it is needed in policy.

“‘E’ is for Empowerment: we have heard much about this concerning users and families. They should be co-producers of health alongside professionals. At a more strategic level, policy and services have to be shaped by users.

“‘L’ is for Learning: there is a need for more learning both in and between countries of the European region. In R&D we focus too much on research and too little on development. We need a D&R strategy, placing more emphasis on developmental needs.

“‘S’ is for Sustainability: this is used in development work in poor countries and in environmental policy. But it applies as well in the area of mental health. There has to be long-term sustainability if the declaration and action plan are to become reality.

“‘I’ is for Innovation: There is no single perfect model for mental health provision. We must be open to innovation and change and the search for new models.

“‘N’ is for Need: there is a need for joined up policy and practice.

“‘K’ is for Knowledge: we need better information about developments in Europe and comparative data. We must also act on and apply the considerable knowledge we already have. The greatest problem is often a failure to act on what we already know. We don’t need more research describing problems but research on what interventions are effective."

“‘I’ is for Implementation: This is the most important challenge. For implementation to succeed it is vital to translate these documents into policy." Professor Hunter said that there is no single approach to this and that the recommendations and ‘responsibilities’ adopted by the conference need to be tailored to national contexts.

“Maybe this week Helsinki will take on a new meaning," said Professor Hunter. He described the conference documents as a list of must dos for the years ahead.