Mental Health Matters: year in review

Prof Chris Dowrick, Chair WONCA Working Party on Mental Health reports on the 2016-18 Activity Plan.

The aim of the working party is to enhance global equity of access to high quality primary mental health care. Our three objectives for 2016-2018 are to improve internal structures; to offer mental health guidance for WONCA members; and to provide global leadership on primary mental health care.

We consider that we have made substantial progress on all three objectives.

1. WWPMH internal structures are now well established

• Our membership has expanded from 46 in October 2016 to over 160 currently. Our largest groupings are from Europe and Latin America.

• 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) and Brazil; and liaison with WONCA Young Doctors (Ray Mendez, USA).

• Communication between WWPMH members involves structured e-meetings for officers every 2-3 months, and regular 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 advise Executive and Council of issues relevant to primary mental health, for example on WHO primary health care policy for the Eastern Mediterranean region.

• We encourage primary mental health care input to all WONCA conferences. In the past year we have enabled participation in regional conferences in Lima, Pretoria, Pattaya, Katmandu, Kuwait and Krakow; future presentations will include the World Conference in Seoul.

• We collaborate with other WPs and SIGs, including education, WICC, migrant care and rural practice.

• We have created 10 time-limited task groups to provide practical guidance for family doctors on topics identified as important by WWPMH members. Six have already reported and four are in progress.
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 (see relevant resources)
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 will also present it at WONCA Seoul.
v. Core competencies for primary mental health care (led by Chris Dowrick, UK). This will be presented at WONCA Seoul.
vi. Management of medically unexplained symptoms (led by Tim olde Hartmann, Netherlands). Soon to be available on WONCA website
vii. Mental health care of migrants (led by Maria van den Muijsenberg, Netherlands, chair of 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)

• We are negotiating a book deal with Taylor & Francis to publish these guidance documents in a single accessible volume.

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 offering psychological first aid after natural and political catastrophes in Nepal, Caribbean and Spain;
o developing an expanding range of primary mental health care facilities across Saudi Arabia;
o (through the WONCA President) ensuring mental health priorities were considered at the Ibero-American primary care summit in Colombia in March 2018.

• We continue to offer expert advice and training through our international primary mental health care consultancy.
o Our Ibero-American team have organised a series of mhGAP training event in Brazil.
o A group led by Ryuki Kassai is currently organising a train the trainer programme on depression for family doctors in Japan.

• We continue to promote external collaborations, including with WHO mhGAP, World Psychiatric Association, World Federation for Mental Health and International Association for Communication in Health Care.
o We are currently advising WHO on its guidelines for the physical healthcare for people with severe mental illness, and on the primary care version of ICD-11 mental disorders classification.
o In October 2018 WWPMH officers will once again participate in the mhGAP forum in Geneva.
o In December 2018 WWPMH members will participate in the Universal Health and Mental Health conference in Malta.
o We are participating in the WPA-Lancet Clinical Commission on Depression.

Biennium 2018-2020

• WWPMH members will be given opportunity to seek nomination (and if necessary election) for all officer positions for the biennium 2018-20.
• We anticipate that the Working Party’s agenda for the next biennium will be to continue our overall objectives and build on our current achievements. This will be discussed at the WWPMH meeting in Seoul, to be chaired by Cindy Lam.