Human Rights in Mental Health is active in many countries and working on many projects. Here we keep you informed of our work and what is important to us. If you wish to receive more information on any of the new-items, please write us at rvvoren@gip-global.org
How to Win a Lasting Peace? Ukraine and the World After the Guns Fall Silent
Although it is clear the war in Ukraine is going to last, and is far from the “Blitzkrieg” that Russian leader Vladimir Putin envisaged, it is also certain that sooner or later the war will end and the world will need to deal with a situation that Europe hasn’t seen since World War Two. On May 18 a public conference focused on the complex issues that Ukraine will face after the guns fell silent and the reconstruction of the country commences.
International Conference: Rethinking Mental Health Care
Service users and mental health professionals can both benefit from accessible and acceptable mental health services. But how to make sure services actually are accessible and appropriate to as many users as possible and how to empower health staff to provide services and treatments with a sustainable and positive impact?
visualizing the work of Human Rights in Mental Health-FGIP in Ukraine
In 2020, FGIP, together with the Ukrainian Psychiatric Association and the Lithuanian FGIP member Mental Health Perspectives, developed a special program to combat the social isolation of persons with mental health issues as a result of COVID-19. The campaign, Mind the Gap, had several national programs, including Ukraine. For the Ukrainian program we developed a series of clips:
In 2021, FGIP developed a number of clips for the samopomoch self-help program for victims of State repression in Belarus (www.samopomo.ch), which was set up with FGHIP member GIP-Tbilisi and the NIMH in the Czech Republic. The clips showed people who either managed to overcome their trauma or learned to live with it.
In 2022, following the Russian invasion of Ukraine, FGIP asked Lesya Kharchenko to make another series of clips visualizing the effect of war on persons with mental health issues and, specifically, those living in psychiatric hospitals and in social care homes. The English-language clips can be viewed via the following links:
The Global Initiative on Psychiatry (GIP; now officially: Human Rights in Mental Health-Federation Global Initiative on Psychiatry) is a Netherlands-based international NGO with the longest track record in mental health in Ukraine. Initially founded in 1980, it coordinated the international campaigns against the political abuse of psychiatry in the USSR, of which many of the victims were from Ukraine. It campaigned for their release, as well as for the release of opponents of this perversion of psychiatry, including two Ukraine-based psychiatrists.
In 1990 GIP became involved in the first attempts to change Ukrainian psychiatry from an outdated Soviet institutional and biologically oriented psychiatric care system to more modern approaches. It helped establish the Ukrainian Psychiatric Association (UPA) in early 1991, and subsequently the founding of relative organizations, an association of psychiatric nurses and the first consumer movement. It organized NGO-building trainings, and supported the NGO-sector both materially and through training.
In the years 1991-1993 it transported more than three thousand cubic meters of humanitarian aid to psychiatric hospitals with trucks, Fokker airplanes of the Dutch Air Force and eventually twelve IL-76 cargo planes of the Ukrainian Air Force. In 1995 it established, together with the UPA, the publishing house Sphere, which in the course of the next decade translated and printed 139 manuals, books and reports on modern mental health care delivery, ethics, law and human rights.
From early on, GIP organized trainings for Ukrainian mental health professionals. It helped develop a curriculum in social work, developed the first training program for psychiatric nursing and set up the first Center for Psychosocial Rehabilitation in Ukraine, which functioned until 2022. Hundreds of Ukrainian mental health professionals participated in training seminars of the Network of Reformers in Psychiatry during the years 1994-2004, in mental health nursing, psychogeriatrics, alcohol- and drug-addiction, child psychiatry and community mental health care services. In 1994 GIP was one of the founders of the Kyiv-based Medical Treatment Center for Victims of Totalitarianism and Civil Wars (MRC), that continues to function until today.
Following Maidan in 2014, FGIP carried out more than half a dozen assessments of social care homes, prison mental health care services, and forensic psychiatry in Ukraine together with the Office of the Ombudsman for Human Rights of the Verkhovna Rada and the Ministry of Social Affairs. With the latter a five-year reform plan for social care homes was developed and with the Ministry of Justice a reform plan was agreed upon regarding the prison mental health care sector. During the COVID-19 pandemic it supplied up top ninety mental health institutions with Personal Protection Equipment and instructions how to avoid infection.
Since the February 2022 invasion FGIP is actively involved in providing humanitarian aid to mental health institutions, including large-sized generators to allow institutions to continue their care for patients. In addition it manages a web- and social-media based psychological aid program to the Ukrainian population which has attracted tens of millions of views and includes a well-used web-based resource on psychological support. It also founded a crisis center for Ukrainian refuges in Vilnius (Lithuania).
Psychiatry in Russia again a regular method of repression
The international foundation Human Rights in Psychiatry – FGIP (FGIP) has published a new report on the resumption of political abuse of psychiatry in the Russian Federation. The report includes more than two dozen new cases in which psychiatry was used as a means of silencing a human rights activist, political opponent or a religious believer, and also provides information on abuse of psychiatry within the penitentiary system and forced sterilization of psychiatric patients.
The report is the fourth published by FGIP over the past decade and the most disturbing one. Because of the fact that political abuse of psychiatry is gathering a systematic nature, FGIP has requested the World Psychiatric Association (WPA) to review the information and take appropriate action.
FGIP was originally established in 1980 to organize the international campaign against political abuse of psychiatry in the USSR. In 1983 it managed to force the withdrawal of the Soviets from the WPA, and six years later successfully lobbied to have the Soviets return only under conditions of reform and releasing all victims of political abuse of psychiatry.
In Soviet times approximately one-third of all political prisoners wound up in psychiatric hospitals.
Mental Health and Human Rights: Setting a Rights-Based Global Agenda – Response to the report of the UN Special Rapporteur
The United Nations Special Rapporteur on the Right of Everyone to the Enjoyment of the Highest Attainable Standard of Physical and Mental Health (UN Special Rapporteur) in a March 2020 report to the United Nations Human Rights Council “Mental Health and Human Rights: Setting a Rights-Based Global Agenda,”emphasized the importance of a human rights based approach to mental health care. The report is a welcome development, supporting long-standing efforts to move mental health out of the shadows in the UN, andhighlighting key challenges.
The Federation Global Initiative In Psychiatry (FGIP) builds on some of the report’s spotlights in its efforts tostrengthening the rights-based approach to mental health. Given the intermittent attention to mental health and particularly the human rights based approach to mental health, FGIP welcomes the opportunity to discuss the issues more broadly. The FGIP response is available as a short as well as an extensive version.
The long version of our reaction can be downloaded here
Imagine a drab institution where seven hundred women spend their lives in complete idleness. Hardly any contact with family, hardly ever outside the institutional walls. The only daytime activity takes place in a small space where up to ten women can simultaneously do needlework or mend clothes behind the sewing machine. Their lives are a hopeless chain of empty days that run along the lines of a regime that applies to everyone. Everyone gets up at the same time, eats meals, goes to bed. Stripped of individuality.
This is not a bad dream, but the daily reality at the Svyatoshinsky social care home in Kyiv, Ukraine. Tens of thousands of men and women of all ages are often locked up for life in similar circumstances in one of the 145 institutions, social care homes, in the country. They are there because they have a psychiatric illness, an intellectual disability, or because they have nowhere else to go.
Our Human Rights in Mental Health-FGIP foundation started working there a few years ago. Together with the initially suspicious director, who gradually became more and more open to change, we took the first steps towards the humanization and gradual de-institutionalization of as many of the women as possible. “Transition departments” have been set up, where women have more freedom of movement and are allowed to furnish their own shared room, and work is being done on a unit where women are prepared for their return to society. There will also be computers for communication with the outside world and computer lessons. Revolutionary developments by Ukrainian standards.
We now ask for your support for the next step: the development of a vegetable garden on the grounds of the institution, where women can grow their own vegetables or create a garden; a first step towards a kind of care farm. The director has visited similar locations in the Netherlands and has enthusiastically returned to his country. This is possible with him too! We now want to help him realize this.
We ask for your financial support for our project. Every amount helps us to give the women in the Svyatosjinsky social care home a more humane life.
Global Initiative on Psychiatry-Benelus Oosterbeek IBAN: NL08 INGB 0000 8080 80 o.v.v. Svyatoshinsky boarding school
The influence of concern about COVID-19 on mental health in the Republic of Georgia: a cross sectional study.
And article by Nino Makhashvili, Jana Darejan Javakhishvili, Lela Sturua, Ketevan Pilauri, Daniela C. Fuhr and Bayard Roberts published in the journal Globalization and Health
Abstract
Background
Early evidence indicates increased mental health burden arising from COVID-19 and related control measures. The study aim was to examine concern about COVID-19 and its association with symptoms of mental disorders in the Republic of Georgia.
A cross-sectional internet-based survey of adults in Georgia using non-probabilistic sampling was used. Questionnaire topics were: (i) demographic and socio-economic characteristics; (ii) level of burden caused by common causes of COVID-19 related concerns; (iii) strategies used in response to concerns about COVID-19; and (iv) symptoms of mental disorders of anxiety (GAD-7), depression (PHQ-9), PTSD (ITQ) and adjustment disorder (ADNM8). Descriptive and multivariate analyses were conducted.
Results
There were 2088 respondents. High levels of symptoms for mental disorders were observed for anxiety (23.9% women, 21.0% men), depression (30.3% women, 25.27% men), PTSD (11.8% women, and 12.5% men), and adjustment disorder (40.7% women, 31.0% men). Factors significantly associated with increased COVID-19 concern included bad/very bad household economic situation, larger household size, current NCD, symptoms of anxiety, adjustment disorder and PTSD. Response strategies significantly associated with reduced mental disorder symptoms included meditation and relaxation exercises, physical exercise, positive thinking, planning for the future, TV/radio, housework/DIY, and working. Drinking alcohol was associated with a greater probability of increased mental disorder symptoms.
Conclusions
High levels of mental disorders were recorded, and they were strongly associated with increased concern about COVID-19. A number of response strategies were identified which may help protect against worse mental health and these could be supported by innovations in mental health care in Georgia.
The Netherlands Helsinki Committee (NHC) and FGIP have launched a regional “COVID-19 Solidarity Programme 2020-2022: Call for Proposals on Covid-19 in Prisons and Mental Health Institutions” to provide grants to CSOs to monitor the effect of COVID-19 prevention and treatment measures on the conditions of people confined to closed institutions (both penitentiary and mental health) in Eastern Partnership countries. We will provide sub-grants for CSOs in 4 countries for a period of 9 – 12 months. The grant amounts vary between 6000-12000 euro.
Objectives
CSOs to monitor and report on a full range of relevant issues; including (discontinuation of) health care and (lack of) contact with lawyers, relatives or loved ones etc.
Providing advice and assistance to stakeholders, including confined persons, personnel, relatives, lawyers, on problems they encounter in COVID-19 prevention and treatment.
Organisations (or consortia) that already have access to closed institutions under a National Preventive Mechanism (NPM) or that through another agreement with authorities have access to these institutions, are invited to submit a proposal. Applicants that do not have a formalized relationship with governmental bodies that provides access to closed institutions need to prove they have a track record of obtaining reliable information based on monitoring and explain in detail how such information will be gathered.
Proposals can be country-wide or limited to certain regions; they can be focused on one category of closed institutions (I.e. only penitentiary or only mental health) or on all of them. The aim of the proposal is to facilitate specific attention for COVID-19 related issues in closed institutions in addition to ongoing work relating to conditions in closed institutions.
Target countries
Proposed projects should target closed institutions in the following countries:
Expert opinion on proposed change in Ukrainian mental health legislation
Legal changes have been suggested at the Ukrainian Parliament, the Verkhovna Rada, with regards to compulsory psychiatric treatment that severely infringe on the rights of persons with mental illness and are in direct violation with the international commitments of Ukraine.
In order to help make sure that these changes are not accepted by the Verkhovna Rada "Human Rights in Mental Health-FGIP" has decided to send a detailed analysis to all those responsible in Ukraine, including chairs of various committees of the Verkhovna Rada.
The English version of the expert opinion can be downloaded here
The Ukrainian version of the exper opinion can be downloaded here
On June 29, 2020, the World Psychiatric Association (WPA) and the Federation Global Initiative on Psychiatry (FGIP) issued a Mental Health Policy Brief with recommendations on how to solve the current crisis in psychiatry in Ukraine and take steps to reform mental health care services soundly and structurally. The policy brief was developed at the request of the two Ukrainian psychiatric associations that are members of the WPA.A copy of the brief was also forwarded to the Ukrainian Ministry of Health. The policy brief was developed by an international team of experts chaired by the President of the Georgian Psychiatric Association, Professor Eka Chkonia, and comprising half a dozen top experts in the field of modern mental health care services who are also well-informed aboiut the Ukrainian context.
The crisis in Ukrainian psychiatry was the result of the second stage of the health reform that was implemented on April 1, 2020, and led to a reduction of funds for in-patient treatment. On top of this came the problems of coping with mental health care in the face of the COVID pandemic which hit Ukraine at almost the same time. As a result of the crisis, many mental health professionals were losing their jobs,hospital departments were closed and many chronic patients were discharged, often without any place to go.
The WPA Expert Committee recommended the Ukrainian government implement the existing draft National Mental Health Action Plan after having been fine-tuned by an inter-Ministerial working group that would include representatives of other relevant Ministries e.g. the Ministries of Social Policy and Education, as well as professional mental health related associations and consumer representatives. The Expert Committee also stressed the necessity of a twin-track financing approach that would provide adequate resources for in-patient care (possibly with an increase of funding during the actual shift to community care) while developing community-based mental health care services. It also pointed out the importance of a regular consultation process between the Ministry and the professional psychiatric associations. It further recommended to set up train-the-trainer programs for multi-disciplinary approach in community-based mental health-services to support the de-institutionalization process and called upon Ukraine to meet its international obligations, e.g. with regard to the UN Convention on the Rights of People with Disabilities-CRPD.
The report can be downloaded in English here, in Ukrainian here, and in Russian here
Project: Supporting Ukrainian Mental Health during COVID – 2020/416-691
The COVID-19 pandemic has not passed Ukraine and although the figures are still lower than in some other countries, the pandemic is gathering speed and not under control. Internationally it is also clear that institutions where vulnerable people are living in close quarters, e.g. psychiatric hospitals, social care homes and nursing homes, are the worst affected. Also in Ukraine a growing number of institutions are affected and the number of cases is growing. Most institutions lack Personal Protection Equipment (PPE; e.g. masks, goggles, gloves, protective suits) and even methods to detect infection at an early stage e.g. hand-held thermometers. When the infection becomes noticeable it is already too late. The Federation Global Initiative on Psychiatry and the Ukrainian Psychiatric Association, in collaboration with the Ministry of Health and the Ministry of Social Policy, have established a distribution system has been set up that guarantees delivery to the destined institutions and prevents dislocation of the dispatched PPE.
For our program to provide psychiatric hospitals and social care homes in Ukraine with much needed PPE we are inviting firms to provide us with a quote for the purchase of the following PPE:
600 hand held thermometers
3,000 Fpp-3 masks
9,000 Fpp-2 masks
Requirements:
The thermometers should be reliable and coming with adequate certification. Experience in Lithuania has shown that Microlife thermometers should not be used. Thermometers produced by Rossmax have proven to be very reliable;
Rapid delivery to a provided address in Kyiv. Speed is of importance in light of the continuing spread of the virus.
The quote should include delivery costs and VAT should be indicated
Payment will be made in Euro
Envisaged time-frame:
Submission of the quote: closing date July 5, 2020
Selection: before July 10, 2020
Delivery: as early as possible following that date
The foundation Human Rights in Mental Health-FGIP will start in May 2020 a quarterly newsbulletin to update you on our activities. You can subscribe to the news bulletin by clicking here
Комиссия Ланцет по вопросам глобального психического здоровья и устойчивого развития
От имени Комиссии Ланцет по вопросам глобального психического здоровья и устойчивого развития (https://globalmentalhealthcommission.org/) предоставляет Вам перевод ее доклада на русский язык, который, мы надеемся, будет полезен для Вашей работы.
Комиссия Ланцет генерирует самые актуальные сведения о глобальном психическом здоровье на сегодняшний день и призвана направлять действия по уменьшению глобального бремени проблем психического здоровья. Первоначально представленный в октябре 2018 года на английском языке доклад Комиссии был подготовлен 28 международными специалистами, обладающими экспертными знаниями в различных научных и политических дисциплинах, а также имеющими опыт психических заболеваний.
Призываем Вас поделиться этим материалом с коллегами, а также содействовать его распространению через социальные сети, на Вашем сайте, в информационных бюллетенях и т. д.
On Friday September 28, 2018 the international foundation “Human Rights in Mental Health-FGIP” presented a report on the social care home in Slovyansk and the Svyatoshinsky social care home in Kyiv based on an assessment visit carried out in may 2018, within the framework of the project “Combatting Torture and Ill-Treatment in Georgia, Ukraine and Armenia, financed by the European Union.
The same day, a large meeting was held at the Ukrainian Parliament, the Verkhovna Rada, on the issue of guardianship. More than 130 persons, including officials, professionals and relatives, discussed ways how to end the law on guardianship that makes tens of thousands of Ukrainian citizens legally incapacitated and voiceless. During the same days, several training events were organized, among them a public lecture by Professor Sir Graham Thornicroft, Chairman of the board of FGIP.
The English version of the report can be downloaded here
The Ukrainian version of the report van be downloaded here
Report on privatization of psychiatric services in Georgia published
More than twenty-five years after the collapse of the Soviet Union, much of the highly institutionalized and biologically oriented psychiatric service of the USSR is still in place, and resistance against the introduction of modern, community-based and user-oriented services remains very strong. Over the past decade Georgia has implemented a national mental health reform program that focused on the introduction of a humane and community based mental health system that meets basic standards of human rights. However, the full implementation of the program has not been realized. Of the newly developed services some were never fully operationalized and in other cases the process was halted or even reversed. Recently, privatization has been introduced in general health care as a format that would allow an influx of non-governmental capital, providing a new format that is targeted at upgrading services in mental health to an acceptable level.
Hitherto the state program to privatize health care facilities in the country did not include its mental health hospitals. The sudden and rather unexpected privatization process that started with the privatization of the hospitals in Qutiri and Batumi was not part of any of the national mental health plans that were adopted in recent years. For that reason, FGIP felt the urgent need to assess the situation, understand the basis and format of the privatization process and see where modifications ought to be implemented in order to ensure the continuation of care and protect the rights of persons with mental illness seeking professional help from national mental health care services.
The English version of the report can be downloaded here
The Georgian version of the report can be downloaded here
Call for applications: 2017 Jim Birley Scholarship
Jim Birley Scholarship 2017
For young mental health professionals and other stakeholders who have shown exemplary commitment to issues of human rights in mental health
In November 2013, the Board of the Federation Global Initiative on Psychiatry decided to honor its late Past Chairman Dr. Jim Birley by instituting a scholarship focusing on issues that Dr. Birley was especially committed to: issues of human rights in mental health, and stimulating young mental health professionals and other stakeholders to pay special attention to the rights of persons with mental illness.
The Jim Birley Scholarship will be provided once a year during a high visibility event to a young mental health professional or another stakeholder (user, family-member or carer) who has shown exemplary commitment to the issue of human rights in mental health.
In 2017 one scholarships of 5,000 euro will be awarded (in case of equal points the scholarship might be divided between two winners). The scholarship is to be used for a cause to be proposed by the winner and should contribute to the strengthening of human rights in the field of mental health.
A committee consisting of four members, including a member of the Birley family, will select the winners from the submitted applications.
How to apply?
Candidates for the Jim Birley Scholarship should write to Human Rights in Mental Health-FGIP and in a letter explain:
Why they should be eligible,
Provide details about their background and what they have done to further human rights in mental health, and
What they intend to do with the scholarship.
Two letters of recommendation should be added.
Applications should be submitted before June 11, 2017.
The Selection Committee will then select the winners of that year.
The winners of the award will be announced in late June 2017.
On 10 December 2015, on the World Day of Human Rights and after a big meeting of workers in mental health field who are responsible for coordination of programs in municipalities, Marcelo Castro, the new Minister of Health in Brazil, has announced that Roberto Tykanori Kinoshita, the current Federal Coordinator of Mental Health and one of the main leaders of Brazilian mental health reform, would be substituted. Instead of him, the new Minister announced as the new federal coordinator is Valencius Wurch Duarte Filho, a psychiatrist who publically has affirmed to be against the principles of mentalhealth reforms and made opposition to the creation and implementation of the main law of mental health reform, approved in 2001. Also, he has been the director of one of the most horrible psychiatric hospitals of Brazil during the 1990’s, named Dr. Eiras and located in Rio de Janeiro. This psychiatric hospital, the biggest of Latin America during the 1990’s, was definitely closed in 2012, after a federal intervention due to several denounces of violation of human rights.
On 14 December 2014, Roberto Tykanori Kinoshita was dismissed and Valencius Wurch Duarte Filho was officially nominated.
It is unacceptable the nomination of this psychiatrist to be the federal coordinator of mental health. Brazil is one of the countries with the most innovative and impressive reforms in mental health field in the world, recognized by WHO. The Brazilian mental health reform should continue.
It is not easy to explain how we get to this situation for who does not accompany politics in Brazil, especially the last year and a half, as it involves a big political and very serious scenario. But, for sure, it can be said that this situation is due to advance of a conservative politics. This is affecting not only health policies in general, but all the progressist politics on which we have made advances on the last 13 years.
Now, more than ever, we are facing the necessity to struggle towards the continuity of the psychiatric reform. This means that workers, users of services, families, civil society, and others have now to get together to think about what strategies we are going to develop to face this. And, for sure, this means to recover our historical banner to fight for a society without asylums. To stop this nomination, several meetings and protests are taking place in Brazil. But we have to join forces with other countries.
Defend the Brazilian mental health reform is to advocate for a society without asylums.
Cláudia Pellegrini Braga Occupational Therapist Brazil
It is with great pleasure that the Netherlands-based international foundation “Human Rights in Mental Health-FGIP” announces the first winners of the new Jim Birley Scholarships. The Scholarship is shared in 2015 between two outstanding advocates for human rights in mental health. The winners of the 2015 Jim Birley Scholarships are Anka Jgenti from Georgia and Charlene Sunkel from South Africa
Call for applications for the Jim Birley Scholarship
Jim Birley Scholarship 2015
In November 2013, the Board of the Federation Global Initiative on Psychiatry decided to honor its late Past Chairman Dr. Jim Birley by instituting a scholarship focusing on issues that Dr. Birley was especially committed to: issues of human rights in mental health, and stimulating young mental health professionals and other stakeholders to pay special attention to the rights of persons with mental illness.
The Jim Birley Scholarship will be provided once a year during a high visibility event to a young mental health professional or another stakeholder (user, family-member or carer) who has shown exemplary commitment to the issue of human rights in mental health.
In 2015 one scholarships of 5,000 euro will be awarded. The scholarship is to be used for a cause to be proposed by the winner and should contribute to the strengthening of human rights in the field of mental health.
A committee consisting of four members, including a member of the Birley family, will select the winners from the submitted applications.
How to apply?
Candidates for the Jim Birley Scholarship should write to Human Rights in Mental Health-FGIP and in a letter explain:
Why they should be eligible,
Provide details about their background and what they have done to further human rights in mental health, and
What they intend to do with the scholarship.
Two letters of recommendation should be added.The address: FGIP, P.O.Box 1956, 1200 BZ Hilversum, The Netherlands.
Applications should be submitted before March 15, 2015. The Selection Committee will then select the winners of that year.
The first award ceremony is planned for late June 2015.
Though lately the attitudes towards mental illness are slightly shifted to the right direction in Georgia, there is still a serious stigma attached to the mental health disorders and, specifically to schizophrenia.
Thus, this year we tried to reach out to young generation, but also to service users and their carers for raising awareness on self-stigma, among others.
The 10 October event “Life with Schizophrenia” organized by Foundation Global Initiative on Psychiatry (GIP) at National Library of Georgia intended to help the audience to realize that being diagnosed with schizophrenia can still mean that many can go on and have full and productive lives.
FGIP Chief Executive Dr. Robert van Voren spoke about stigma on mental disorders, silence surrounded the experiences and called to speak out and be open about schizophrenia, depression, etc.
Among the attendees were many young people asking stimulating questions, service users and their family members, MH professionals. The following discussion was moderated by Dr. Nino Makhashvili, GIP-Tbilisi director.
The paintings of Gela Jincharadze and Gio Kiladze - beneficiaries of art therapy workshop at Tbilisi Mental Health Center decorated the conference room during several days.
FGIP joins global movement to include mental health in MDG's
Human Right in Mental Health-FGIP calls all leaders to join global movement in most important mental health initiative addressing world’s biggest single cause of reduced lifespan
Human Right in Mental Health-FGIP announces today it joins to support the #FundaMentalSDG initiative to advocate adding clear, measurable mental health targets to the United Nations’ Post-2015 Sustainable Development Goals, which are about to be negotiated by the UN member states following the UN High-level Stocktaking Event on the Post-2015 Development Agenda in New York on 11 – 12 September 2014. The initiative takes up on the Preventing Suicide, A Global Imperative report, which was publicly released by the World Health Organization (WHO) last week at a mental health leaders and advocates gathering in Geneva, Switzerland, just a year after the WHO launched implementation discussions of the Global Mental Health Action Plan adopted by the United Nations 66th assembly.
According to the report by WHO, suicide is preventable, mental health disorders are treatable, and yet because we don’t significantly address it we lose over 800,000 lives annually, it is the second leading cause of death globally for youth ages 15-29, and is estimated to cost the United States alone over 100 billion dollars every year. Human Right in Mental Health-FGIP invites other organizations to support #FundaMentalSDG to join in the effort, asking the United Nations to include a specific mental health target and two indicators in this critical post-millennium agenda.
The July 19th 2014 United Nations draft of the Post-Millennium Goals includes an overall Health Goal: ‘Proposed goal 3. Ensure healthy lives and promote well-being for all at all ages’. A recent Editorial in the British Medical Journal (BMJ) by Professors Graham Thornicroft, Chairman of Human Rights in Mental Health-FGIP, and Vikram Patel the London School of Hygiene and Tropical Medicine, calls upon colleagues worldwide to include within this Health Goal the following specific mental illness target:
‘The provision of mental and physical health and social care services for people with mental disorders, in parity with resources for services addressing physical health.’
They also propose that this is directly supported by 2 indicators related to the WHO Mental Health Action Plan 2013-2020, adding that it is very difficult to achieve results without specific measurements:
(1) 'To ensure that service coverage for people with severe mental disorders in each country will have increased to at least 20% by 2020 (including a community orientated package of interventions for people with psychosis; bipolar affective disorder; or moderate-severe depression).'
(2) ‘To increase the amount invested in mental health (as a % of total health budget) by 100% by 2020 in each low and middle income country’
According to Thornicroft and Patel’s article in the BMJ, there is compelling evidence to show that improved global mental health is a necessity for overall human and societal development. For example, “poorer mental health is a precursor to reduced resilience to conflict,” and not only that, “it is also a barrier to achieving the suggested goal for promoting peaceful and inclusive societies for sustainable development, providing access to justice for all, building effective, accountable and inclusive institutions at all levels.”
Ukrainian psychiatrists appeal for help to prevent political abuse of psychiatry
September 3, 2014
Appeal to the world psychiatric community
The history with the Ukrainian air force officer Nadezhda Savchenko has acquired a psychiatric aspect. Detained by Russian secret services on the territory of Ukraine, she was illegally transferred to Russia and by a decision of a Russian court sent to the Serbski Institute (currently the Federal State-budget Institution «State Scientific Center for Social and Forensic Psychiatry named after Serbski» of the Ministry of Health of the Russian Federation) to undergo a forensic psychiatric evaluation.
As a air force pilot on duty and a officer of the Ukrainian army, she regularly underwent medical check-ups, among them psychiatric ones. The mental health of Ms. Savchenko was before never subject to any doubt. This is confirmed both by relatives and fellow officers. On basis of this we can assume that the motive to send the Ukrainian officer Nadezhda Savchenko for psychiatric examination is her courageous behavior in a Russian court.
We, Ukrainian psychiatrists, remember the recent history of declaring healthy people mentally ill behind the walls of the Serbski Institute in Moscow. We also know about new cases of political abuse of psychiatry in the Russia of today. The authoritarian political regime in Russia is able to use the «psychiatric cover up» also in the case of Nadezhda Savchenko.
We urgently ask you to pay attention to this case. And to put pressure, both personally and within the framework of the work of national psychiatric associations, on the Russian authorities, who continue the practice of psychiatric repression in their country.
We, psychiatrists, have the obligation to terminate this practice. Otherwise, to the list of victims of abuse of psychiatry for political purposes who were “determined” mentally ill in the Serbski Institute in the USSR (Natalya Gorbanevskaya, Valeriya Novodvorskaya, Anna Mikhailenko, Vladimir Bukovsky, Pyotr Grigorenko, Leonid Plyushch and hundreds of other dissidents) the name of Nadezhda Savchenko can be added.
DSM and ICD – two psychiatric classifications on the block - Peter Tyrer
What are these acronyms and are they of value to psychiatry? The answers to the first question are simple. DSM stands for Diagnostic and Statistical Manual for Mental Disorders, and its 5th revision was published in May 2013, and ICD is short for the International Classification of Diseases, the 11th revision which is due to be published in 2015 or 2016. The value question is a matter of debate. Only the complete anti-psychiatry zealots believes neither classification is of value, but the amount of confidence we have in both of them varies from almost religious belief to extreme scepticism.
Where do I stand? In the middle, wobbling on top of a rickety fence. I have rechristened the acronym, DSM as both Diagnosis for Simple Minds, and Diagnosis as a Source of Money (Tyrer, 2012), as both are true. The ‘operational criteria’ are listed for each disorder and can be ticked off simply, and the American Psychiatric Association relies on the income from DSM for much of its core work. But I am being slightly unfair; DSM is a noble but flawed attempt to give order to a very disordered subject. Psychiatric classification involves much more guesswork than medical classification and filling the gaps is a task that all can criticise successfully with all getting prizes. DSM-5 has come in for heavier criticism than other revisions, as it planned originally on making the classification a true beacon of science – a ‘paradigm shift ‘ in which biological measures would be used to describe the new disorders. But it never got to first base. Instead we have a reshuffle of disorders, and new ones that tend to increase pathology in the population. These include premenstrual dysphoric disorder, disruptive mood dysregulation disorder, illness anxiety, hoarding, binge eating and minor neurocognitive disorder. Allen Frances, the chair of DSM-IV, berates the new DSM masters as being out of control and has led the campaign to save the world from being diagnosed with a DSM disorder (Frances, 2013).
ICD is in somewhat better odour, not least as it is the official classification of disease across the world. But the revision of the classification is badly resourced and it is difficult for it not to follow the much better funded studies that back up DSM. But it is fighting back, and when I spoke in Vilnius in April at a meeting of the Lithuanian Psychiatric Association (Lietuvos psychiatry asociacija) there was much more enthusiasm for a reinvigorated classification that was not linked to any one country and which could be embraced by practitioners across the world. And there are benefits from a world-wide approach. Russia uses ICD and at a meeting of the Serbian Psychiatric Association two years ago Valery Krasnov of the Moscow Research Institute of Psychiatry presented data on the epidemiology of ‘sluggish schizophrenia’. Although this was never an ICD diagnosis it was widely used to imprison dissidents in psychiatric institutions, and Valery’s statistics showed that this strange disorder had almost completely disappeared from national figures since its heyday 40 years ago – mainly being replaced by personality and mood disorders. One of the essential tasks of a good psychiatric diagnostic system is to be embraced sufficiently to be independent of political pressures of all sorts and we hope that ICD-11 when it appears will be a much cleaner and well-organised diagnostic system than it has been in the past.
Tyrer P. (2012). DSM – in 100 words. British Journal of Psychiatry, 200, 67.
Frances A. (2013). Saving Normal: An Insider's Revolt Against Out-of-Control Psychiatric Diagnosis, DSM-5, Big Pharma, and the Medicalization of Ordinary Life. New York: William Morrow.
strategic alliance Human Rights in Mental Health - FGIP with Maudsley International
The organisations Maudsley International and Human Rights in Mental Health-FGIP (formerly the Federation Global Initiative on Psychiatry) have decided to engage in a strategic alliance in order to respond more effectively to requests for assistance from the global mental health community. The alliance combines the internationally acclaimed expertise of Maudsley International (and their partners in the Institute of Psychiatry, King’s College London and South London & Maudsley NHS Foundation Trust) with the decades of experience in supporting the development of community-based and user-oriented mental health care services in developing countries around the world of FGIP. Apart from collaborating closely in projects and thus increasing both the quality and cost-effectiveness of our output, the alliance plans to hold regular meetings and conferences on the issue of mental health care development in developing countries. More information will be posted within the near future.
Click here for more information about Maudsley International.
Over the past three months, the world has witnessed momentous events in Ukraine. What started as a protest by students in favor of an associate agreement with the European Union, turned into a people’s uprising against an autocratic and corrupt regime. After three months of mass demonstrations at the Maidan in Kyiv, and later in cities all across Ukraine, the old rulers fled the country. What happened before our eyes is not as much a choice between “East” or “West” but a revolution led by the first post-Soviet generation.
"Piece of Progress" prize is awarded to Nino Makhashvili, GIP-Tbilisi Director, for the contribution to the field of Georgian penitentiary healthcare
On December 3, 2013 the Ministry of Corrections and Legal Assistance with a joint initiative of the European Union and the Council of Europe held a mid-term conference entitled " Prison Health Care Reform in Georgia – we are keeping our promise".
FGIP has been working in Ukraine for more than thirty years and has a huge community of friends and colleagues there. FGIP is doing everything possible to help them during these difficult times. We have started a large-scale psychological aid program for the victims of this military conflict. A new self-help program was been set up in Ukrainian that provides resources to mental health professionals and helps the general population to deal with the psychological consequences of this war. Please support us with your donation.
