November- December 2020 Vol 15. No.5

PAHO Symposium Honors the 30th Anniversary of the Caracas Declaration

13 November- PAHO’s Mental Health and Substance Use Unit hosted a virtual symposium commemorating the 30th Anniversary of the Caracas Declaration.

The symposium, which was broadcast on YouTube and attended by nearly 500 participants, invited countries from the region to reflect on the progress that has been made, share national experiences, and establish next steps for continuing to advance the processes of deinstitutionalization, the strengthening of community care, and the integration of mental health into all levels of care in the health system.

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Progress of Panama 30 years after the Declaration of Caracas

Since 1970, Panama has incorporated into Primary Health Care professionals in psychiatry, psychology, nursing and social work by the Ministry of Health, the Social Security Fund and the private sector.  However, the hegemonic and centralizing role was played by Psychiatric Hospitals, even integrating a large percentage of the Training of Human Resources in Mental Health.

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Webinar on the Results of a Rapid Assessment of the Impact of COVID-19 on Mental, Neurological and Substance Use Services in the Americas
4 December-  PAHO’s Mental Health and Substance Use Unit hosted a webinar with country Directors of Mental Health to present the results of a regional rapid assessment of the impact of COVID-19 on mental, neurological and substance use (MNS) services in the Americas.

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PAHO receives mental health and psychosocial support experts through the Dutch Surge Support mechanism

PAHO’s Mental Health and Substance Use Unit has received the support of three mental health and psychosocial support (MHPSS) experts through the Dutch Surge Support (DSS) mechanism: Drs. Mathijs Hoogstad and Edith van t Hof, both clinical psychologists from the Netherlands, and Dr. Leticia Silvela Coloma, a clinical psychologist and WHO consultant based in Peru. All three will assist PAHO in providing MHPSS support to countries in the Region during the COVID-19 pandemic.

2020 marks the launch of the Mental Health and Psychosocial Support module linked to the Dutch Surge Support water program. On request of international humanitarian organizations, the DSS MHPSS program provides emergency relief support on the subject of mental health and psychosocial support during armed conflict, violence, refugee and migration-based emergencies and natural disasters. Experts are sent to assist in ongoing relief efforts for a period of a few weeks to several months. DSS MHPSS is an initiative of the government of the Netherlands, in close cooperation with Inter-Agency Standing Committee (IASC) MHPSS Reference Group (RG) Member Agency and IASC MHPSS RG Surge Capacity Steering Committee.
Mental Health and Psychosocial Support training for health care providers

October-November 2020- Guyana, with the support of PAHO, conducted a series of trainings on mental health and psychosocial support (MHPSS) for healthcare providers, with the goal of strengthening mental health services, reducing suffering and improving the mental health and psychosocial wellbeing of people affected by the global COVID-19 pandemic in the country. The series included twelve webinars on MHPSS topics including Psychological First Aid; Doing What Matters in Times of Stress, the WHO guide; anxiety, depression, self-harm, and suicide; domestic violence and mental wellbeing; COVID-19 and alcohol and other substances of abuse; the mental health needs of children and adolescents; self-care; coping skills; and communication and listening skills and techniques. The trainings make up a part of Guyana’s more comprehensive national MHPSS response to COVID-19. 
St. Lucia trains health care professionals in the mhGAP Humanitarian Intervention Guide

23 November-8 December- St. Lucia hosted an 11-day workshop to train mental health and primary care professionals in all the modules of the mhGAP Intervention Guide version 2.0 (mhGAPIG). A total of fifty (50) health care providers signed up for this training.
The mhGAP-IG contains first-line management recommendations for mental, neurological and substance use conditions for non-specialist health-care providers in humanitarian emergencies where access to specialists and treatment options is limited. It is a simple, practical tool that aims to support general health facilities in areas affected by humanitarian emergencies in assessing and managing acute stress, grief, depression, post-traumatic stress disorder, psychosis, epilepsy, intellectual disability, harmful substance use and risk of suicide.
The COVID-19 pandemic has impacted the mental health of people worldwide. Integrating mental health and psychosocial support into primary care is a key strategy to meet the heightened mental health needs during the crisis.
Launch of PAHO Virtual Course on Mental Health and Psychosocial Support Coordination in Humanitarian Crises

14 December- PAHO held the Opening ceremony for its Mental Health and Psychosocial Support (MHPSS) Coordination in Humanitarian Emergencies Virtual Course 2020-2021. 

The MHPSS Coordination in Humanitarian Emergencies course, currently in English, is an intensive multidisciplinary training course, aimed at humanitarian program staff working in the aid, civil society or public sector who wish to gain competency in establishing and coordinating MHPSS Coordination in areas affected by complex humanitarian emergencies.

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Launch of the Virtual Course: Capacity Building for the Operationalisation and Facilitation of mhGAP Trainings - 2020/21 
As part of PAHO's technical support to countries, a virtual course has been organized on PAHO's public health virtual campus on capacity building for the operationalization of the mhGAP programme and to facilitate mhGAP training.  

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Virtual sessions to support the adaptation of MHPSS interventions remotely
As part of the technical support that PAHO provides to countries, a series of virtual sessions have been organized to support mental health and psychosocial support (MHPSS) professionals to be able to make psychological and psychosocial interventions remotely, ensuring quality. Remote care has become very relevant since the crisis experienced by the COVID 19 pandemic, showing itself to be a very effective modality, which generates adherence and is key in preventing the development of possible mental health conditions derived from the large number of stressors to which the population is subjected (uncertainty, physical and social isolation, loss of resources, increase in situations of violence, etc). However, and that is what this initiative is based on, MHPSS remote interventions involve taking into account fundamental considerations for its implementation.

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Materials on alcohol and COVID-19

Washington DC, 8 September 2020
. The Pan American Health Organization (PAHO) has published information materials on alcohol and COVID-19 for the general public early in the year, alerting persons about the risks related to alcohol consumption in general and particularly during the pandemic. It has also conducted a regional study on alcohol consumption during the pandemic, collecting data from over 12300 participants from Latin America and the Caribbean. The main results have been published in a regional report in Spanish, English and Portuguese. During the pandemic, 32% of the sample reported at least one episode of heavy episodic drinking (HED) and about 15% increased their frequency of this pattern of drinking as compared to 2019. Despite the high levels of HED, most people never seek help in 2019 or during the pandemic (87.5% in 2019 and 90.9% in 2020). For the complete results please click here.
Results of the regional Alcohol and COVID-19 survey

11 November 2020, Washington DC (virtual). In partnership with CICAD, Dr. Maristela Monteiro presented the results of the regional Alcohol and COVID-19 survey in a regional webinar attended by more than 500 people. The webinar was exclusively for Spanish speaking persons. The regional report is published in Spanish and can be found on the PAHO website here.
Results of the regional Alcohol and COVID-19 survey for Brazil

12 November 2020, Brasilia (virtual). The PAHO office in Brazil organized a national webinar for the presentation of the results of the regional Alcohol and COVID-19 survey for Brazil. The webinar was attended by the Secretary of Citizenship (Secretary Quirino, SENAPRED), PAHO representative Dr. Socorro Gross, Ministry of Health, Secretary of Health of Minas Gerais, and included the participation of Dr. Maristela Monteiro, who presented details of the project, while Dr. Zila Sanchez, of the Federal University of São Paulo, presented the results for the Brazilian sample.
Celebration of the national day for the Prevention of Harmful Alcohol Use

13 November 2020, Mexico City (virtual). Dr. Maristela Monteiro, PAHO’s Senior Advisor on Alcohol and Substance Abuse, participated in the celebration of the national day for the Prevention of Harmful Alcohol Use in Mexico, along with several national experts. She gave a conference on the regional situation regarding alcohol consumption, harms and policies, as well as on the cost effectiveness of public policies to reduce alcohol problems. The presentation included details of the WHO SAFER initiative.
Second session of the Parliamentary Network of the Americas for Road Safety.

20 November 2020, Washington DC (virtual). Dr. Maristela Monteiro, PAHO’s Senior Advisor on Alcohol and Substance Abuse, participated in the second session of the Parliamentary Network of the Americas for Road Safety. She presented on the role of alcohol in traffic injuries, cost effective laws and their enforcement while discussing the challenges for the region in this area. The session was led by Mr. Ignacio Ibarra, legal advisor of PAHO, in collaboration with experts from WHO/PAHO, parliamentarians from several countries, with the aim of expanding technical cooperation in health legislation.
Facebook Live: National and regional situation on alcohol consumption, associated problems and policy responses

20 and 23 November 2020, Bogota (virtual). The PAHO Colombia office organized a Facebook Live session with Dr. Maristela Monteiro on November 20, to discuss the national and regional situation on alcohol consumption, associated problems and policy responses. She discussed the existing gaps in public policies in Colombia, the progress made, and how the WHO SAFER initiative can be a good path forward for the reduction of alcohol consumption problems at national and regional levels. On the 23rd, in a virtual webinar, Dr. Monteiro presented Colombia's results from the regional survey on Alcohol and COVID-19, indicating that there was an increase in heavy episodic drinking among consumers, such increase was greater among women, and this greater alcohol use was associated with reported stress levels during the pandemic.
Fifth Annual Caribbean Alcohol Reduction Day themed Alcohol and COVID-19.
24 November 2020, Washington DC (virtual). The Healthy Caribbean Coalition (HCC) in partnership with the Pan American Health Organization (PAHO), the Caribbean Public Health Agency (CARPHA) and the Organization of Eastern Caribbean States (OECS) Commission held their Fifth Annual Caribbean Alcohol Reduction Day themed Alcohol and COVID-19.
During the webinar the speakers, a diverse panel of experts and advocates, including Dra. Maristela Monteiro, discussed a range of topics including, regional alcohol consumption patterns over the course of the pandemic, the impact of mental health on alcohol consumption under crisis conditions, and local actions of government and the alcohol industry during the pandemic. The speakers also discussed policy strategies and contributed recommendations on reducing alcohol consumption and associated harms and regulating industry marketing activity moving forward as the pandemic continues.

To watch a recording of the webinar, click here
Webinar on the SAFER technical package
18 November 2020, Washington, DC (virtual).
The Department of Noncommunicable Diseases and Mental Health presented a webinar on the SAFER technical package. The five areas of intervention were discussed from a regional perspective. The presenters included PAHO and WHO advisors, Dr. Maristela Monteiro and Dag Rekve, Maik Duennbier, Director from Movendi, Thomas Babor, Scientist, the University of Connecticut, Beatriz Marcet Champagne, Director of Coalición Latinoamérica Saludable, and Giselle Amador, ONG Costa Rica Saludable. They presented information related to alcohol consumption, harms and policies, the role of the alcohol industry including actions needed to prevent interference in policy making, and the important role of civil society in advocacy in efforts to reduce the harmful use of alcohol. For related documents click here.
Recognizing the International Day of Persons with Disabilities

3 December is the International Day of Persons with Disabilities. This year has been a particularly challenging one for people with disabilities, who have been disproportionately impacted by COVID-19. PAHO recognized the day by launching a new topic page on disability:

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Wheelchair sector capacity building in the Dominican Republic

The World Health Organization in collaboration with the International Society for Prosthetics and Orthotics (ISPO) and the International Society of Wheelchair Professionals (ISWP) is launching the development of the Wheelchair Service Standards. The Wheelchair Standards will assist Member States in delivering wheelchair services and fulfilling the commitment with the Right to personal mobility (Art. 20) of the UN Convention on the Rights of Persons with Disabilities.
In 2020, PAHO has been supporting a wheelchair sector capacity building strategy in the Dominican Republic through a collaboration between the National Disability Council (CONADIS) and the International Society of Wheelchair Professionals. The initial focus of the strategy is to increase the capacity of wheelchair service providers. On November 23rd, 39 individuals successfully completed the ISWP basic manual wheelchair service provision blended course. This group is currently completing the process to become ISWP certified Wheelchair Service Providers. In addition a cohort of 12 individuals have started a training of trainers. Upon the completion of the course, these individuals will have the capacity to train new basic wheelchair service providers at the basic level.

Editorial Committee: Renato Oliveira, Maristela Monteiro, Claudina Cayetano, Luis Alfonzo, Antony Duttine, Carmen Martínez, Amy Tausch and Martha Koev. 

PAHO’s Mental Health Bulletin is published bimonthly in English and Spanish.

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