Promoting Mental Health in the Context of Global Public Health

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On July 6, 2009, the Korea Insti­tute of Brain Science (KIBS) organized a side event at the Annual Ministerial Review meeting of the United Nations Economic and Social Council in Geneva, Switzerland. The event was co-sponsored by the Conference of NGOs in Consultative Status with the United Nations (CoNGO) and the UN-NGO-IRENE Association.
__ Mental health is related to behavior, socioeconomic and environmental factors, and to sustainable development. In order to achieve sustainable development, a concerted effort among nations, agencies, partners and professionals on mental health issues is required. The Geneva event focused on mental health issues as they relate to the development agenda, the interrelationship of mental health and global public health, modifiable factors and cost-effective interventions, and successful cases and global partnerships in the promotion of mental health. The seminar was attended by 70 people, including UN staff and representatives from Permanent Missions and UN agencies (UNICEF and WHO), NGOs, health professionals, scientists and educators. The event was moderated by Ms. Hanifa Mezoui, President of the UN-NGO-IRENE Association.


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Summaries of the Speakers

Mental Health in Global Public Health and Development

Dr. Janice Wood Wetzel, Main Rep­resentative for the International Association of Schools of Social Work

“When we’re talking about development,” said Ms. Wetzel, “we’re talking about individuals, families, small groups and communities.” She spoke on the interrelationship between health and development and emphasized the impact of socioeconomic conditions on mental health in particular. “World mental health is first and foremost a question of social and economic development,” she explained. “Hundreds of millions of women, men [and] children suffer from mental illnesses. Others experience stress because of poverty, because of war, because of dislocation, violence, exploitation, and all of the rest. And women and children suffer an appalling toll of abuse.”
__ Referencing recommendations from UNICEF’s “Seven Sins of Development,” Ms. Wetzel highlighted the importance of including those who experience poverty in decision-making, of having implementation plans that focus on the “how-to,” and using creative approaches to mobilize and disseminate health knowledge. She concluded by highlighting some social- and economics-based programs around the world which are making a difference in the lives of those who have experienced serious mental illness, including European “social firms,” which provide employment for people with mental disabilities. These programs, she suggested, are effective because they help people to find meaning in their lives.

The Role of African NGOs in Preven­tative and Public Health

Ms. Saida Agrebi, President of the Tunisian Mother’s Association and Regional Coordinator of UN-NGO-IRENE Africa

Ms. Saida Agrebi’s talk focused on Millennium Development Goals (MDGs) numbers 4 and 5—to decrease child and maternal mortality. “In Africa,” she reminded the audience, “there are mothers dying, there are children dying, there is hunger, there is AIDS, violence against women, and girls going without education.” She referred to the positive example of Tunisia, which has been successful in reducing maternal and child mortality rates.
__ Ms. Agrebi highlighted the importance of health care and education for women and mothers, as well as legislation that supports the rights of women in relation to marriage, education, and family planning. Ms. Agrebi suggested that the IEC approach—informing, education, and counseling women and future mothers about the importance of pre- and postnatal care—is essential. Increasing vaccination programs, improving hygiene, sanitation and water supplies, and promoting literacy among girls and women can all directly or indirectly reduce child and maternal mortality.
__ Ms. Agrebi concluded by declaring that we are all stakeholders of development, and that together—government, the private sector, civil society, academia and the media—we should work to implement the MDGs by increasing health literacy, promotion and education.

Brain Education and Mental Health

Dr. Maryana Winston, Research Associate with the International Brain Education Association.

Dr. Winston began by referring to the World Health Organization’s (WHO) description of mental health as more than just the absence of mental disorders but a state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to contribute to his or her community.
__ Dr. Winston emphasized the interrelationship between physical and mental health and the importance of creating conditions which facilitate physical and mental health for all ages. She pointed to such programs as Brain Education to promote all aspects of health. Dr. Winston explained the principles and programs of Brain Education and discussed concepts from neuroscience such as the brain’s ability to change (neuroplasticity) and to create new neurons (neurogenesis), and the positive effects of physical exercise on the brain. She explained how Brain Education is intended to help regulate the body’s stress response and described one specific method, Brain Wave Vibration.
__ Dr. Winston reported on the positive effects of Brain Education programs, including improvements in self-esteem and communication skills, and a reduction in violence and harmful habitual behaviors in a variety of health-care, work and community settings around the world. “We believe that better understanding and better use of the brain is the key to solving humanity’s problems,” she told the audience.
__ Dr. Winston concluded by introducing the Brain Alliance Initiative, an alliance of individuals and organizations from within and without the UN community whose goal is to promote awareness about the importance of the brain at the United Nations. Dr. Winston ended her talk by reading the Brain Declaration, which emphasizes the potential of the brain and the importance of using it to create health, happiness and peace.

Technology-Enabled Public Health: Internet Opportunities in Patient Engagement and Partnership for Optimal Health Outcome

Dr. Kendall Ho, Director of the e-Health Strategy Office, Faculty of Medicine, at the University of British Columbia

Dr. Kendall Ho emphasized the opportunities that technology creates for connecting local health resources to a global public health strategy: “Through partnership with communities, academic institutions, professional policy makers and health administrators, we define our priorities with regard to public health.” He referred to the WHO’s definition of the social accountability of academic institutions, including medical schools, to direct research, education and service, and suggested four ways that academic institutions can contribute to public mental health: by translating evidence into action, by transmitting knowledge to others, by transforming through research and evaluation, and by transcending suffering into hope.
__ Dr. Ho introduced the term “Glocal” to describe the synergy between local and global public health, which can lead to co-creation of new knowledge, new policy, new education, and new hope. He described health literacy forums that were organized by his unit in British Columbia which facilitated sharing between individuals dealing with chronic diseases such as diabetes or dementia and their caregivers, health professionals and medical students. The information discussed during the forums was collected and shared via technology.
__ Dr. Ho also referred to his university’s membership in a group of 21 universities from around the world, which together are trying to improve global education regarding the UN MDGs. Dr. Ho mentioned the importance of seeking the commonalities of humanity to advocate for global health. He concluded by sharing a quote—“No one can whistle a symphony. It takes an orchestra to play it”—to emphasize the connection of education and public health practices, and the importance of better information technology to facilitate communication in our “global village.”

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Partnership to Create Global Public Health

Mr. Liberato Bautista, President of the Conference of NGOs in consultative status with the UN (CoNGO)

Mr. Bautista began by highlighting some of the key points from the Civil Society Development Forum (CSDF), sponsored by CoNGO in July 2009. He explained that the focus of the CSDF was on reviewing the commitments and progress of governments, civil society and other stakeholders in relation to the internationally agreed-upon development goals with respect to global public health. Mr. Bautista suggested that, due to the economic crisis, political will and courage from all parts of society will be required to maintain any gains that have been made previously.
__ Mr. Bautista pointed to the recommendation made at the recently concluded Conference on the World Economic and Financial Crisis, which called on all states to honor their social and economic promises, including those related to health. He suggested that the health of people is the wealth of society and that “common wealth” may be re-worded as “common health.” He stated that threats to the common health and to the common wealth of nations should be addressed by the commitments of governments and international financial institutions, with the participation of civil society. Mr. Bautista reminded the participants that the MDGs were created for the “extreme poor,” and that even if these goals were to be achieved, they would only raise the extreme poor to the level of the “normal” poor. The greater responsibility, he said, is for us to address the inequities in global public health—the social determinants of health—including race, class and gender.
__ Mr. Bautista concluded by suggesting that an understanding of health and wholeness should include, but not be limited to, the successes of Western medicine and technological advances. “Indigenous and traditional knowledge and health practices,” he said, “must be harnessed. Every possible way to address our health and unhealthy conditions must be harnessed.”

Rehabilitation of Mental Function by Cognitive Training in Children

Dr. Torkel Klingberg, Professor in Cognitive Neuroscience, Karolinska Institute, Sweden


Dr. Klingberg explained the symptoms associated with Attention Deficit Hyperactivity Disorder (ADHD), including being easily distracted, having difficulty maintaining attention and following instructions, and increased impulsivity. He reported that ADHD is the most prevalent childhood psychiatric condition worldwide (3–5%) and is associated with increased risk of academic failure, unemployment, and high risk for drug abuse and accidents. Dr. Klingberg described the regions of the brain which have been identified as affected in ADHD, and explained that the cause of the behaviors typically seen in ADHD are the underlying psychological functions, which depend on the brain, and are shaped by genes and environment.
__ Dr. Klingberg explained that working memory is one psychological function that is implicated in ADHD. The ability to retain information—visual or verbal—for a short period of time is closely related to attention. He described how working memory varies from individual to individual and affects the ability to follow instructions and to plan and organize activities. Working memory is impaired following traumatic head injury, after stroke, in ADHD, in adults with schizophrenia, and due to stress.
__ Dr. Klingberg then presented a computer-based method for training working memory which showed the effects of training within a variety of populations. The research showed not only that children could improve their working memory but also improvements in symptoms of ADHD as rated by teachers and parents. These effects are retained six months after the training, and was shown to be equal to the effects of stimulants such as Ritalin. Studies also demonstrated changes in the brain due to the training: increased activity in the pre-frontal and parietal regions, and changes in the receptors in the brain. “The brain is plastic,” Dr. Klingberg told the audience. “You can change it with as little as five weeks of intensive training.”
__ Dr. Klingberg reported on other tasks that may have similar effects on cognitive performance, such as playing board games, playing a musical instrument, computer games, and meditation. Dr. Klingberg concluded by suggesting that cognitive training is a promising new venture that can have an effect on mental health globally.

Global Partnerships for Strengthening Mental Health

Mr. Ilchi Lee, President of the Korea Institute of Brain Science

Mr. Lee began his talk by leading the participants in some simple exercises to help them release tension from their necks and shoulders. He then described the difficulties he had had as a child, struggling with ADHD-like symptoms, and his search to overcome the hopelessness and despair he felt as a result of his difficulties. Mr. Lee explained that over 15 years he came to understand how to use his own brain. He described the results of his brain imaging, which showed he had problems in his frontal lobe. Yet, Lee explained, he still managed to be successful. Mr. Lee said that the doctor who did the brain imaging explained to him that neuroplasticity, or the brain’s ability to restore and recover itself even though parts have been damaged, was what had allowed him to be successful. Mr. Lee shared how this experience gave him hope for the potential of the brain.
__ Mr. Lee suggested that the problems of individuals, including issues of mental health, are also the problems of our society. He suggested that not just decision-makers but all people need to use the potential of their brains. Mr. Lee also emphasized that greater wealth does not correspond to happiness or mental health, and cited his home country as an example. The Republic of Korea developed quickly after the Korean War to become one of the top 13 economic powers in the world, but ranks about 100th in the world in terms of happiness. In order to be mentally healthy, individuals need to be able to cope with the normal stresses of life and to reach their potential.
__ Mr. Lee suggested the need for new values, a new culture, and a new world. He discussed Brain Education as a method to help individuals use their brains well, and explained the ways that Brain Education is shared, including the University of Brain Education in the Republic of Korea, a recently established online university, and in schools in the Republic of Korea, in the United States, and in Canada.
__ Mr. Lee described how the Brain Education program had such a positive effect on one school that parents joined the school principal in petitioning to declare an official Brain Education Day in New York City. He emphasized the simplicity of this method, and emphasized that any good educational method for promoting health should be effective, easy to teach and easy to learn. Mr. Lee concluded by introducing a new website, BrainWorld.com, an online forum intended to foster new values, a new culture, and a dream for a better humanity and world through helping people to better understand and use the brain. bw

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