“A New Feature of ECOSOC”
Nikhil Seth (Director of Office for ECOSOC Support and Coordination, DESA)
There is linkage between everything in the UN Agenda and mental health. The issues addressed by the Millennium Development Goals are poverty, women’s rights, sustainable development, the environment, hunger, and public health, including maternity mortality, infant mortality, infectious diseases, malaria, and AIDS/HIV. Each of the goals are targeted in UN agenda, and all those issues are related to public health in some way.
__ For example, conflicts impact a population’s mental health. Studies of refugee groups show 68 percent of refugees suffer from mental disorders and/or disease. We do not all live in a free market with health care and private insurance. We must be proactive and provide care, particularly in the developing world. Therefore, a global partnership is necessary that will strengthen the bonds between developed countries and developing countries.
__ The WHO has been involved in global mental illness and improvement of mental-health care since 1991, with the establishment of minimum human-rights standards to protect and enhance the rights and opportunities of disabled people. The WHO advocates global mental health, and created World Mental Health Day on October 10.
__ In order to show the role of Brain Education and its effect of promoting global mental health to the larger community through the Economic and Social Council, IBREA must engage in communications and cooperation with ECOSOC and the larger agenda of the United Nations in areas of peace and development.
“The Role of Educational NGOs in Global Mental Health”
Dr. Hanifa Mezoui (Chief, NGO Section of UN DESA)
Dr. Ilchi Lee’s achievement is surprising. IBREA has reached a high level of commitment at the United Nations in a short period of time. It is sometimes difficult for a non-governmental organization (NGO) in consultative status with the United Nations to make a contribution. It is delightful that KIBS and IBREA have shown their desire to support the United Nations and have taken actions that demonstrate their understanding of the meaning of consultative status.
__ UN member states realize that they cannot solve global problems without the involvement of civil society. The MDGs are hard to achieve without political will. Indifference is a major concern. It is frustrating that with all its resources, the UN has so many commitments and cannot alone achieve the MDGs. NGOs can. The UN needs unity.
__ NGOs are now totally involved in UN processes. From the delivery of goods and services to policy advice, their roles are not limited anymore. The UN depends a lot on support from civil society, and the active participation of NGOs is welcome.
__ A close link between the NGO community and the UN is essential. A circle of interdependence and communication between sub-national, national and trans-national organizations is necessary to improve the global situation. It is the reason ECOSOC is trying to reform its own mission, revitalizing the inclusion of NGOs and planning and implementing projects with NGO participation from the beginning.
__ NGOs have access to UN deliberation and activity, but the flow of information and ideas from NGOs to the United Nations is not as strong. The NGO section of DESA is attempting to create a mutually beneficial relationship, because the participation of NGOs is essential. Today, organizations that seek consultative status with the United Nations are demonstrating a desire to be fully integrated into the international system.
__ The UN seeks partners who can demonstrate enthusiasm for the formation of a global community. It has found such partners in IBREA and the Korea Institute of Brain Science. Examples such as this conference hosted by KIBS and IBREA is proof of a real contribution to the United Nations, and it will be reported in the Quadrennial Report of the NGO section, DESA, ECOSOC, United Nations.
Increasing Awareness for Global Mental Health
Janice Wood Wetzel, Ph.D. (Chair, the NGO Committee on Mental Health)
Many factors have brought Mental Health to the attention of the United Nations and the international community. The World Health Organization projects that by 2030, major unipolar depression will be the leading cause of disease burden after HIV.
__ The NGO Committee on Mental Health has been active in many advocacy efforts, from adding mental health language in UN documents and policies to being instrumental in adding World Mental Health to the official UN calendar and working collaboratively with the World Health Organization.
__ There is a direct association between mental health and inequitable social conditions. Policy solutions exist in both rich and poor nations. Major WHO programs have been initiated. The effects of stigma on psychosocial well-being should be highlighted, as it deters diagnosis and prevention, and is damaging to people who are labeled “mentally ill.” Global education must counter the problem.
__ Advocacy to challenge human rights abuses is essential, including the landmark UN agreement, “The Convention on the Protection and Promotion of the Rights and Dignity of Persons with Disabilities.”
__ A new social movement must emerge to strengthen mental health worldwide. The United Nations and its NGOs can and should be important players.
Mental Health Issues in an African Country
Mr. Modest J. Mero, (Minister, Tanzania, PRESIDENT of African Union)
The report prepared by the African Union and ECA in 2008, “Assessing Progress Towards Attaining the Millennium Development Goals in Africa,” shows that results on the implementation of the MDGs in Africa have been mixed. Despite this picture, the report reveals that most African countries with extreme poverty have responded positively to the resolution. Major support in implementing the MDGs is from African leaders at the national, sub-regional and continental levels. The international community has also responded positively to the challenge of achieving the MDGs by scaling up support to needy countries. Demonstrable progress has been reported in a number of areas, including primary education enrollment, the reduction of malaria deaths and reduced poverty in a number of countries. However, despite the fact that health is so important to the implementation of the MDGs, mental health was not categorized as an immediate challenge. This situation is probably diverting attention from national efforts in targeting interventions in the area of mental health.
__ Mental health is a psychological state of someone who is functioning at a satisfactory level of emotional and behavioral adjustment. It is a desirable state for all mankind.
__ Worldwide, approximately 20 percent of children and adolescents suffer from a disabling mental illness. Anxiety disorders, depression and other mood disorders, and behavioral and cognitive disorders are among the most common problems. Half of all lifetime cases of mental disorders start by age 14. Every country and culture has children and adolescents struggling with mental health problems. Most of these young people suffer needlessly, unable to access appropriate resources for recognition, support and treatment. Ignored, these young people are at high risk for abuse and neglect, suicide, alcohol and other drug use, school failure, violent and criminal activities, mental illness in adulthood, and health-jeopardizing impulsive behaviors.
__ Each year, about four million adolescents attempt suicide. It is the third leading cause of death among adolescents. Adults are also affected by stress, uncertainty and change of life patterns as the cost of living increases, and poverty in developing countries leads to increased mental disorders.
__ The subject of mental health, since introduced in the ECOSOC, has gained momentum, attracting the interest of various stakeholders including NGOs, international organizations, civil societies and governments. UN Secretary General Ban Ki-moon, in his message on World Mental Health Day, emphasized that mental disorders occur in all cultures and at all stages of life, and said “there can be no health without mental health.”
__ Statistics show that one person in four will be affected by mental illness at some stage in life. It can be depression, schizophrenia, or another related illnesses. More than 400 million people worldwide are estimated to be suffering from some kind of mental and neurological disorder, including alcohol and substance abuse. According to the WHO, of the 10 to 20 million people who attempt suicide each year, one million die. That’s as high as the death toll from malaria.
__ In Tanzania, health experts state that the number of mental-health patients has tripled from 31,238 in 2001 to 97,570 in 2007. They attribute the increase to causes including mental retardation, epilepsy, stress, drug abuse, alcohol, diseases such as HIV/AIDS, tuberculosis, cancer, diabetes and chronic malaria. It is estimated that there are 2.5 million people with mental illnesses in Tanzania, but only a fifth of these obtain professional treatment. Alarming inequities in mental health care have been reported in Africa. According to the WHO there are 1,200 psychiatrists and 12,000 psychiatric nurses serving a population of 620 million people in Africa. In contrast, the European region, which includes the countries of the former Soviet Union, has 86,000 psychiatrists and 280,000 nurses serving a population of 870 million.
__ African countries are characterized by low incomes, a high prevalence of communicable diseases and malnutrition, low life-expectancy and poorly staffed services. Mental health issues often come last on the list of priorities for policy makers. Wars and conflicts are other main causes of mental disorders, resulting from stress and hopelessness created by war and conflicts within society. The morbidity and disablement due to mental illness receives very little attention from governments because attention is directed at more conspicuous diseases. Mental health in general is still a poorly funded area of social services in most African countries and, compared to other areas of health, mental health services are poorly developed.
__ Increasing poverty, natural disasters, wars and other forms of violence and social unrest in Africa are major causes of psychosocial problems, which include alcohol and drug abuse, prostitution, homelessness of street children, child abuse and domestic violence. In many African countries, the most frequent type of psychosis results from cerebral involvement in infectious diseases such as malaria, typhoid fever or HIV infection. These conditions produce only temporary disability but cause much suffering and can have chronic mental-health consequences if not properly treated. Epilepsy is still highly stigmatized, particularly because it is often considered infectious, which leads to the social isolation of the sufferer.
__ The African Union recognizes a number of constraints to the development of mental-health interventions in Africa, including:
• Lack of awareness of the magnitude of the problem.
• Lack of a reliable information system.
• Insufficient human and financial resources.
• Absence of national mental-health policies.
• Shortage of specialized personnel.
• Constant “brain drain.”
• Widespread civil strife and violence.
There is a growing recognition that mental health is a crucial public health and development issue in Africa. Mental health is finally drawing the attention it deserves in African countries through WHO support. Countries are working on national mental-health policies.
__ In short, mental health is a global challenge facing members of the United Nations today and the world at large. Poor and developing countries do not have adequate capacity to cope with the challenge of mental health, starting with inadequate human resources at all levels, critical infrastructure for caring for mental-health disorders, and medical technology. It is also evident that mitigation of new cases in society could be the best preventive measure, by resolving conflicts, addressing socio-economic development, and using legal and regulatory systems to deter consumption of substances that lead to mental disorders.
__ The lack of, or weak, national policies on mental health leads decision makers to concentrate on more conspicuous diseases because of the publicity they receive from the international community. Lack of early detection mechanisms of mental-health disorders and inadequate specialized hospitals in Africa present a serious challenge. New impetus is needed to raise the issue of mental health as an important agenda item in the health sector. Support must be given to those countries attempting to develop a policy framework on mental health, which will be a linchpin in developing a workable program for mental health. bw