WORLD HEALTH ORGANIZATION
ORGANISATION MONDIALE DE LA SANTE
REGIONAL OFFICE FOR THE WESTERN PACIFIC BUREAU R£GIONAL DU PACIFIQUE OCCIDENTAL
REG IONAL COMMITTEE
WPR/RC29/13
15 June 1978 Twenty-ninth session Manila 21 to 25 August 1978 Provisional agenda item 16 ORIGINAL: ENGLISH
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REGIONAL COORDINATING GROUP ON THE MENTAL HEALTH PROGRAMME
1.
INTRODUCTION
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At the twenty-eighth session of the Regional Committee for the Western Pacific, held in 1977, a proposal to establish a regional coordinating group for the mental health programme was discussed briefly. The Regional Director was requested to include an item in the agenda for the twenty-ninth session to enable the matter to be considered further and for guidance to be given by the Committee on how such a group might function. l A short presentation follows on the role of coordinating groups in the development and implementation of the WHO mental health programme and in particular the proposed functions of a regional coordinating group for the Western Pacific. 2. DEVELOPMENT OF THE WHO MEDIUM-TERM PROGRAMME FOR MENTAL HEALTH POLICY BAS IS
During the past few years action with regard to mental health has been repeatedly requested by the World Health Assembly and the Regional Committee. Resolutions have been adopted on psychosocial
lSee Report of the Regional Committee for the Western Pacific, twenty-eighth session, October 1977, pages 12-13 and 106-107.
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WPR/RC29/13 page 2 factors and health,l drug dependence and alcohol-related problems,2 mental retardation,3 on actio~ in implementation of international conventions on narcotic drugs and requesting the Director-General to implement a special programme of technical cooperation in mental health. 5 The global medium-term programme for mental health was developed in response to those resolutions, to requests from Member States and to the resolutions adopted by the World Health Assembly which resulted in reorientation of the Organization's overall programme policy and strategy, underlining particularly the importance of Racially relevant technical cooperation towards national health goals. 3. THE SCOPE OF MENTAL HEALTH ACTION
During the past few years a new image of mental health has emerged, in which, rather than it being narrowly linked to mental disease and psychiatry, the public health and social aspects are stressed. Another important aspect of mental health is related to social action to combat the adverse effects of rapid socio-economic development including urbanization and changing systems of value and family structure. In promoting the new image, emphasis is being given to the need for intervention to be simple, realistic and capable of achieving results within a relatively short time.
lSee resolutions WHA28.50 and WHA29.2l, WHO Handbook of Resolutions and Decisions, Volume II (2nd edition), 1977, pages 47-48. 2See resolution WPR/RC26.Rll, Handbook of Resolutions and Decisions of the WHO Regional Committee for the Western Pacific, Volume I, 1976, pages 98-99; resolution WPR/RC27.R5, Handbook of Resolutions and Decisions of the WHO Regional Committee for the Western Pacific, Volume II, 1978, page 19; resolutions WHA28.80 and WHA28.8l, WHO Handbook of Resolutions and Decisions, Volume II (2nd edition), 1977, pages 48-49. 3See resolution WHA28.57, WHO Handbook of Resolutions and Decisions, Volume II (2nd edition), 1977, pages 46-47; resolution WHA30.38, WHO Official Records, No. 240, 1978, page 21. 4See resolution WHA30.l8, WHO Official Records, No. 240, pages 8-9. 5 See resolution WHA30.45, WHO official Records, No. 240, page 26.
WPR/RC 29 /13
page 3 The main concerns of the mental health programme are as follows: (1) the promotion of mental health, as exemplified by work being carried out on the psychosocial development of the child, control of the industrial environment, and preservation of the protective aspects of traditional life styles and family relationships; (2) the prevention and control of mental and neurological disorders, including psychosocial problems such as those associated with drug dependence and alcoholism and the psychological components of physical illness which adversely affect recovery and rehabilitation;
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(3) the psychosocial factors which may determine the success or failure of major public health initiatives such as the acceptance of immunization campaigns, water fluoridation, or fertility regulation; the orientation and motivation of health workers; and the establishment of self-help groups and other forms of community participation. 4. COORDINATING GROUPS IN THE MENTAL HEALTH PROGRAMME: A NEW MECHANISM OF PROGRAMME DEVELOPMENT AND TECHNICAL COOPERATION
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To ensure that the mental health programme 1s coherent, socially relevant and well coordinated, coordinating groups have been developed as a new mechanism for technical cooperation. They exist at national, regional and global level and are linked to each other, being parallel in structure and composition. They involve representatives of a wide range of sectors and disciplines, such as social scientists, psychiatrists and public health and social welfare administrators; and representatives of WHO collaborating institutions, other agencies of the United Nations system and governmental and non-governmental organizations. Members of the policy-making organs of WHO, as well as the WHO national, regional and Headquarters staff responsible for mental health and other programmes, participate fully in the work of the groups. 4.1 The global coordinating group
At the first meeting of the global coordinating group held in Geneva in February 1976, agreement was reached on the content of the medium-term programme, on methods for-coordinating work, and on who would have the principal responsibility for each activity of the programme. At the second meeting, held in Manila in August 1977, progress of activities under the medium-term programme was and strategies for coordinating groups at different levels discussed. Agreement was reached on the work necessary to the reviewed were develop
WPR/RC29/13 page 4 and implement the programme, emphasis being placed on activities designed to include mental health considerations in national health policy formulation. The group recommended further strengthening of regional and national coordinating groups. 4.2 Regional coordinating groups
Regional coordinating groups are already in operation as regular coordinating mechanisms in most WHO Regions. Their primary purpose is critically to review the needs and priorities within a Region; make recommendations for action in relation to the regional mental health programme; and recommend what contributions the activities in relation to mental health in the Region might make to other regional and country health programmes. It is most important that members of such groups should not only recommend the activities to be undertaken, but accept responsibility for carrying them out or assisting in coordinating them within their own countries. Regional coordinating groups have been functioning in the Eastern Mediterranean Region since 1976, in the European Region since 1976 and in the South-East Asian Region since 1977. Similar mechanisms have been developed for the African and American Regions where they will be~ome operative during 1978. 4.3 National coordinating mechanisms
Various types of coordinating mechanism have been established in different countries, such as multidisciplinary resource centres and intersectorial national planning groups. In the Western Pacific Region, a liaison group has been established in Australia, the members of which include an international public health official, a representative of the national professional association and specialists in mental health. The group has been functioning for two years and has served as an excellent model for ensuring effective collaboration in mental health programmes. 5. PROPOSAL FOR A COORDINATING GROUP FOR THE MENTAL HEALTH PROGRAMME IN THE WESTERN PACIFIC REGION
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5.1
Terms of reference
The proposed terms of reference for a coordinating group in the Western Pacific Region would be: (1) to inform the Regional Director of the current mental health situation in the Region pertaining particularly to: the nature and extent of mental health and other psychosocial problems;
WPR/RC29/l3 page 5 resources available for preventive, therapeutic and research activities; (2) to advise the Regional Director on: priority needs and areas for WHO technical cooperation in mental health; development of collaboration in mental health programmes at regional and country level; (3) to make suggestions and proposals on: specific mental health activities at intercountry and coun try 1 eve 1 ; mechanisms for the exchange of information on mental health; the development of criteria for the evaluation of mental health programmes; the establishment of appropriate coordinating mechanisms at country level; activities suitable for interregional and international collaboration and mechanisms for facilitating such joint undertakings. 5.2 Composition of the proposed coordinating group
The members of the coordinating group should be representatives of countries or areas in the Region, of different public sectors having an interest in mental health (for example health, education and social welfare) and of various diSCiplines concerned with mental health problems (for example the social sciences, public health administration, psychiatry). At least one member should also be a Representative to the Regional Committee and/or a member of the global coordinating group. The Regional Adviser in Mental Health would act as secretary of the group. The secretariat would consist of the Assistant Director of Health Services responsible for the regional mental health programme and regional advisers -and other staff of the Regional Office whose areas of responsibility include a mental health component, for example health education, maternal and child health, health manpower development, primary health care, nursing, health information and health services development. At least one WHO Representative from the Region should be a member of the group, together with a staff member from the Division of Mental Health, WHO, Geneva. Representatives of interested United Nations agencies would be invited to attend the meetings of the group.
WPR/RC29/l3 page 6 5.3 Loca Hon and timing of the. firs t meeting of the group
The first meeting of the coordinating group would be held in 1979 at the WHO Regional Office, Manila. An attempt would be made to hold a meeting every two years, timed to fit in with the schedule of the global coordinating group and the programme budgeting cycle. 5.4 Agenda of the first meeting
The major item on the agenda of the first meeting would be an examination of the regional medium-term mental health programme.
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The Committee will wish to discuss the feasibility of establishing a coordinating group and, if it agrees that such a group be constituted, give the Regional Director authority to appoint the members and convene meetings as proposed above.