Mental Health Matters - annual report

Prof Christopher Dowrick, chair of the Working Party on Mental Health reports:

The aim of the working party is to enhance global equity of access to high quality primary mental health care. Our objectives are to improve internal structures; to offer mental health guidance for WONCA members; and to provide global leadership on primary mental health care.

1. WWPMH internal structures

• Our membership is currently over 240. Our largest groupings are from Europe, Latin America and Asia Pacific.
• We have representation across all WONCA regions and constituencies.
    o Our current elected officer group is Chris Dowrick (UK, Chair), Christos Lionis (Greece, Vice-Chair), Jill Benson (Australia, Secretary) and Juan Mendive (Spain, Secretary).
    o Vice-chairs for each of the seven WONCA regions are Joseph Ariba for Africa, Cindy Lam for Asia-Pacific, Abdullah al Khatami for Eastern Mediterranean, Christos Lionis for Europe, Leandro Wenceslau and Daniel Puig for Ibero-America, Kim Griswold for North America, and Pramendra Prasad for South Asia. Sonia-Roache Barker is vice-chair for the Caribbean sub-region.
    o We have specialist liaison with Sandra Fortes (Brazil) and Lucja Kolkiewicz (UK)
    o We are currently seeking to renew our formal liaison with WONCA young doctors.
• Communication between WWPMH members involves structured e-meetings for officers every 3 months, and monthly e-bulletins circulated to all members. We also arrange ad hoc working party meetings at regional WONCA conferences.

2. Mental health guidance for WONCA members

• We encourage primary mental health care input to all WONCA conferences. During the past six months we have enabled participation in the World Conference in Seoul and forthcoming Eastern Mediterranean, Asia-Pacific and European regional conferences.
• We continue to collaborate with other WPs and SIGs, including education, WICC, migrant care and the newly formed SIG on adolescents & young people.
• We continue to publicise and produce practical guidance documents for family doctors on topics identified as important by WWPMH members.
   i. First depression consultation (led by Bruce Arroll, NZ): a shortened version of this document is published in British Journal of General Practice.
   ii. Physical health care for people with severe mental illness (led by Alan Cohen, UK and Kim Griswold, USA):
   iii. Shared learning for primary mental health care (led by Helen Rodenburg, NZ): we have produced links to accessible online training materials:
   iv. Non-drug interventions for psycho-social distress (led by Weng Chin, Hong Kong); we launched our guidance on this topic at the WONCA Asia-Pacific meeting in November and presented it at WONCA Seoul.
   v. Core competencies for primary mental health care (led by Chris Dowrick, UK). This was presented at WONCA Seoul and will also be presented at WONCA Kyoto.
   vi. Management of medically unexplained symptoms (led by Tim olde Hartmann, Netherlands); a shortened version of this document has been published in the British Journal of General Practice
   vii. Mental health care of migrants (led by Maria van den Muijsenberg, Netherlands, chair of WONCA Migrant Care SIG).
   viii. Frailty, multi-morbidity and mental health (led by Christos Lionis, Greece).
   ix. Dementia (led by Ferdinando Petrazzuoli, Sweden)
   x. Adolescent mental health (led by Jane Roberts, UK)
   xi. Early years problems (led by Amanda Howe, UK)
o We have negotiated a book deal with Taylor & Francis to publish our guidance documents in a single accessible volume, with additional elements on education and service implications.
o New guidance documents are being considered on the opioid crisis and primary mental health care in humanitarian emergencies.

3. Leadership on global primary mental health care

• We continue to advocate for improved primary mental health care on behalf of family doctors and their patients, for example
   o Caribbean, Eastern Mediterranean and Ibero-American colleagues continue to organise a series of mhGAP training events.
   o Molly Shorthouse (Asia-Pacific) is planning a major mental health initiative for indigenous young people in East Arnhem, Australia.
   o A group led by Ryuki Kassai (Asia-Pacific), in collaboration with EACH, has successfully organised a train the trainer programme on depression for family doctors in Japan. The results of this will be presented at a plenary session during WONCA Asia-Pacific in Kyoto (May 2019).
   o A consortium involving WONCA, California Academy of Family Physicians and Health Performance Consulting is progressing a Train the Trainers’ initiative to improving family physicians’ management of patients with depression and anxiety across the Asia-Pacific region; this includes workshops at WONCA World in Seoul (October 2018) and WONCA Asia-Pacific in Kyoto (May 2019).
   o The International Balint Federation led by Don Nease (North America) and WONCA’s Young Doctors Movement have an active collaboration to provide Balint groups to YDM participants.
• We continue to promote external collaborations, including with WHO mhGAP, WPA, WFMH and EACH.
o In the past six months we have offered expert advice to WHO on their guidelines for the physical healthcare for people with severe mental illness (now published); their Quality Rights Toolkit; the primary care version of ICD-11 mental disorders classification; and their proposed mental health diploma for family physicians. In October 2018, I participated in the mhGAP forum in Geneva.
   o In December 2018, several WWPMH members contributed to the Universal Health and Mental Health conference in Malta.
   o I am member of the WPA-Lancet Clinical Commission on Depression.
   o Several WWPMH members will contribute to the WPA World Congress in Lisbon.

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