Member Care Associates -- MC Resource Update

December 2016 -- Number 92

Member Care Update--December 2016
Expanding the global impact of member care

World Health Organization--Mental Health Resources
Ten Tools for Member Care

In this Update we feature 10 mental health resources from the World Health Organization (WHO). They are all available online for free and many are in different languages. These resources are tools that can inform and strengthen all of our member care work in consultation, counseling, and training. Collectively they provide both a global context for better understanding mental health issues and technical content for further developing mental health skills.

These 10 resources are also some of the main materials that we personally use as we consider new opportunities in the world to connect and contribute via “mental health as mission” (e.g., see the MC Updates
April 2016 and September 2012). We finish the Update with personal and directional reflections on the relevance of global integration (GI) for member care.
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WHO Mental Health Resources

Background. “WHO began when our Constitution came into force on 7 April 1948—a date we now celebrate every year as World Health Day. We are now more than 7000 people working in 150 country offices, in 6 regional offices and at our headquarters in Geneva. Our primary role is to direct and coordinate international health within the United Nations’ system. These are our main areas of work: Health systems; Promoting health through the life-course; Noncommunicable diseases; Communicable diseases; Corporate services; Preparedness, surveillance and response. We support countries as they coordinate the efforts of multiple sectors of the government and partners—including bi- and multilaterals, funds and foundations, civil society organizations and private sector—to attain their health objectives and support their national health policies and strategies.” (quote from the WHO website)
More Resources. In addition to the 10 items below, there are many more mental health materials on the WHO website under
Mental Health, Substance Abuse, Mental Health and Psychosocial Support in Emergencies, and Mental Health Publications. See also the WHO mhGAP Newsletter (latest issue: November 2016); materials on the WHO MINDbank website, the Mental Health Innovation Network website, and the GMH-Map website; and our recent journal article on global issues-global mental health on the Cambridge Core website.
Mental Health Action Plan: 2013-2020 (2013) WHO
“This comprehensive action plan has been elaborated through consultations with Member States, civil society and international partners. It takes a comprehensive and multisectoral approach, through coordinated services from the health and social sectors, with an emphasis on promotion, prevention, treatment, rehabilitation, care and recovery. It also sets out clear actions for Member States, the Secretariat and international, regional and national level partners, and proposes key indicators and targets that can be used to evaluate levels of implementation, progress and impact. The action plan has, at its core, the globally accepted principle that there is "no health without mental health."….The vision of the action plan is a world in which mental health is valued, promoted and protected, mental disorders are prevented and persons affected by these disorders are able to exercise the full range of human rights and to access high quality, culturally-appropriate health and social care in a timely way to promote recovery, in order to attain the highest possible level of health and participate fully in society and at work, free from stigmatization and discrimination. Its overall goal is to promote mental well-being, prevent mental disorders, provide care, enhance recovery, promote human rights and reduce the mortality, morbidity and disability for persons with mental disorders. The action plan has the following objectives: 1. to strengthen effective leadership and governance for mental health; 2. to provide comprehensive, integrated and responsive mental health and social care services in community-based settings; 3. to implement strategies for promotion and prevention in mental health; 4. to strengthen information systems, evidence and research for mental health.” (pp. 6,9,10)

Mental Health Atlas 2014 (2015) WHO
“WHO’s mental health Atlas project dates back to 2000, when a first assessment of available mental health resources in WHO Member States was carried out (WHO, 2001). Subsequent updates have been published since then (WHO, 2005; WHO, 2011). The 2014 version of mental health Atlas continues to provide up-to-date information on the availability of mental health services and resources across the world, including financial allocations, human resources and specialised facilities for mental health. This information was obtained via a questionnaire sent to designated focal points in each WHO Member State.”(p.8)

WHO QualityRights Tool Kit (2012) WHO
“The WHO QualityRights Tool Kit provides countries with practical information and tools for assessing and improving quality and human rights standards in mental health and social care facilities. The Toolkit is based on the United Nations Convention on the Rights of Persons with Disabilities. It provides practical guidance on: the human rights and quality standards that should be respected, protected and fulfilled in both inpatient and outpatient mental health and social care facilities; preparing for and conducting a comprehensive assessment of facilities; and reporting findings and making appropriate recommendations on the basis of the assessment. The tool kit is designed for use in low-, middle- and high-income countries. It can be used by many different stakeholders, including dedicated assessment committees, nongovernmental organizations, national human rights institutions, national health or mental health commissions, health service accreditation bodies and national mechanisms established under international treaties to monitor implementation of human rights standards and others with an interest in promoting the rights of people with disabilities. The WHO QualityRights tool kit is an essential resource, not only for putting an end to past neglect and abuses but also for ensuring high quality services in the future." (quote from WHO website)
Mental Health and Development: Targeting People with Mental Health Conditions as a Vulnerable Group (2010) WHO
“This report presents compelling evidence that people with mental health conditions meet major criteria for vulnerability. The report also describes how vulnerability can lead to poor mental health, and how mental health conditions are widespread yet largely unaddressed among groups identified as vulnerable. It argues that mental health should be included in sectoral and broader development strategies and plans, and that development stakeholders have important roles to play in ensuring that people with mental health conditions are recognized as a vulnerable group and are not excluded from development opportunities. The recommended actions in this report provide a starting point to achieve these aims.” (p. xxiv)
Preventing Suicide: A Global Imperative (2014) WHO
“In May 2013, the Sixty-sixth World Health Assembly adopted the first-ever Mental Health Action Plan of the World Health Organization (WHO). Suicide prevention is an integral part of the plan, with the goal of reducing the rate of suicide in countries by 10% by 2020 (1). There is no single explanation of why people die by suicide. However, many suicides happen impulsively and, in such circumstances, easy access to a means of suicide—such as pesticides or firearms—can make the difference as to whether a person lives or dies. Social, psychological, cultural and other factors can interact to lead a person to suicidal behaviour, but the stigma attached to mental disorders and suicide means that many people feel unable to seek help. Despite the evidence that many deaths are preventable, suicide is too often a low priority for governments and policy-makers. The objective of this report is to prioritize suicide prevention on the global public health and public policy agendas and to raise awareness of suicide as a public health issue. The report was developed through a global consultative process and is based on systematic reviews of data and evidence together with inputs from partners and stakeholders.” (p. 9)

Building Back Better: Sustainable Mental Health Care after Emergencies (2013) WHO
“Emergencies, in spite of their tragic nature and adverse effects on mental health, are also unparalleled opportunities to improve the lives of large numbers of people through mental health reform. This is important because mental health is crucial to the overall well-being, functioning, and resilience of individuals, societies, and countries recovering from natural disasters, armed conflicts, or other hazards. Building back better: sustainable mental health care after emergencies raises awareness about this type of opportunity, and describes how this was achieved in 10 diverse emergency-affected areas. Lessons learnt and key overlapping practices emerging from these experiences are summarized. By publishing this report, the World Health Organization (WHO) aims to ensure that people faced with emergencies do not miss the opportunity for mental health reform and development. The report is divided into three distinct parts….” (pp. 9-10)

mhGAP Intervention Guide for Mental, Neurological, and Substance Use Disorders in Non-Specialized Settings (version 2.0)   (2016) WHO
“This is the second version (2016) of the mhGAP Intervention Guide (mhGAP-IG) for mental, neurological and substance use (MNS) disorders in non-specialist health settings. It is for use by doctors, nurses, other health workers as well as health planners and managers. The Intervention Guide presents the integrated management of priority MNS conditions using algorithms for clinical decision making. This update of the 2010 edition is based on new evidence as well as extensive feedback and recommendations from experts in all WHO regions who have used mhGAP-IG Version 1.0. The key updates include: content update in various sections based on new evidence; design changes for enhanced usability; a streamlined and simplified clinical assessment that includes an algorithm for follow-up; inclusion of two new modules—Essential Care and Practice that includes general guidelines and Implementation module to support the proposed interventions by necessary infrastructure and resources; and, revised modules for Psychoses, Child and Adolescent Mental and Behavioural Disorders and Disorders due to Substance Use. The mhGAP-IG Version 2.0 is a valuable tool to scale up services for people with MNS conditions and their families.” (quote from
WHO website)
mhGAP Humanitarian Intervention Guide: Clinical Management of Mental, Neurological, and Substance Use Conditions in Humanitarian Emergencies (2015) WHO and UNHCR
“The mhGAP Humanitarian Intervention Guide contains first-line management recommendations for MNS conditions for non-specialist health-care providers in humanitarian emergencies where access to specialists and treatment options is limited. This guide extracts essential information from the full mhGAP-IG and includes additional elements specific to humanitarian emergency contexts. This guide covers: Advice for clinic managers; General principles of care applicable to humanitarian emergency settings, including: Provision of multi-sectoral support in accordancegramming in Refugee Operations (UNHCR, 2013) and other emergency related tools; Instructions on stress reduction; umatic stress disorder (PTSD), Psychosis (PSY), Epilepsy/seizures (EPI), Intellectual disability (ID), Harmful use of alcohol and drugs (SUB), Suicide (SUI), Other significant mental health complaints (OTH).” (p. v)
Psychological First Aid: Guide for Field Workers (2011) WHO, War Trauma Foundation, World Vision (in 20 languages)
“When terrible things happen in our communities, countries and the world, we want to reach out a helping hand to those who are affected. This guide covers psychological first aid which involves humane, supportive and practical help to fellow human beings suffering serious crisis events. It is written for people in a position to help others who have experienced an extremely distressing event. It gives a framework for supporting people in ways that respect their dignity, culture and abilities. Despite its name, psychological first aid covers both social and psychological support. Perhaps you are called upon as a staff member or volunteer to help in a major disaster, or you find yourself at the scene of an accident where people are hurt. Perhaps you are a teacher or health worker talking with someone from your community who has just witnessed the violent death of a loved one. This guide will help you to know the most supportive things to say and do for people who are very distressed. It will also give you information on how to approach a new situation safely for yourself and others, and not to cause harm by your actions.” (p. ii)

Group Interpersonal Therapy for Depression (2016) WHO and Columbia University
“Depression is an important health condition. It is the leading cause of disability worldwide, and it can be a cause of suicide. For these reasons, treatment coverage of depression, along with other severe mental disorders, is an indicator to monitor implementation of the World Health Organization (WHO)'s Comprehensive Mental Health Action Plan 2013–2020 endorsed by the 66th World Health Assembly, consisting of Ministers of Health of 194 WHO Member States. Depression will be the theme of WHO’s World Health Day 2017. Interpersonal Psychotherapy (IPT) was developed by Dr Gerald L Klerman and Dr Myrna M Weissman in the 1970s for the treatment of depression by mental health specialists. It has been adapted for different disorders and age groups and for diverse community and medical settings around the world. Its effectiveness has been demonstrated in numerous clinical trials in high-, middle- and low-income countries using both group and individual approaches. This manual modifies IPT for depression for use in 8-session groups and involves a simplified format for facilitators who may not have received previous training in mental health. The current guide uses the term Group Interpersonal Therapy (Group IPT) to aid dissemination and to clarify that IPT may be used by supervised nonspecialists, including in countries where “psychotherapy” is a regulated term. Indeed for WHO, Interpersonal Psychotherapy and Interpersonal Therapy are interchangeable terms that link to one and the same scientific literature. The acronym of both is IPT; they are the same intervention.” (p. 3)

Personal Reflections
Going Global
A Framework to Support Member Care…and More

Over the last six years we have been sharing widely about “global integration” (GI). GI is a framework which guides our work and which we believe is crucial for a) member care practice and direction; b) colleagues working in different sectors and disciplines; and c) all those who endeavor to live as global citizens (i.e. our common identity and responsibility as humans).

As Christians, our definition of GI is based on a core desire to see God glorified in all we do. GI is a framework for actively integrating our lives with global realities by connecting relationally and contributing relevantly on behalf of human wellbeing and the major issues facing humanity, in light of our integrity and core values (e.g., ethical, humanitarian, faith-based) for God's glory. 

Our GI work as psychologists in based in Geneva and focuses on global member care, global mental health, and promoting integrity/confronting corruption globally. It includes regular interactions with personnel/events in the United Nations, World Health Organization, international NGOs, and faith-based groups—and hence there are several materials, perspectives, and news items (largely from the health, development, and humanitarian sectors) that we review to inform our work and share with colleagues. The WHO resources in this Update are a prime example. We also regularly send out Global Integration Updates to over 1900 colleagues. 
GI is especially relevant in terms of our Christian values to share the good news and our good works with fellow humans, especially the most vulnerable and overlooked. It is also relevant as a framework to help us “connect and contribute” to the major multi-sectoral and international efforts to promote well being for all people and the planet. Two landmark examples are the United Nations’ Transforming Our World: The 2030 Agenda for Sustainable Development (September 2015, highlighting the 17 sustainable development goals) and the UN Secretary-General's One Humanity: Shared Responsibility (February 2016, including the five core responsibilities annexed in the Agenda for Humanity). We encourage you to carefully review and critique these documents with a view towards how you would want them to inform your work, life, and world. 
Some of our main suggestions for further developing GI within member care/mission, academic/training programs, and beyond, include:

1. Convening roundtables and special meetings of colleagues online and in vivo to discuss the GI framework and applications

2. Organizing new coalitions and affiliations of colleagues who are committed to GI

3. Referencing the term in articles, websites, presentations, meetings, courses, conversations, etc.

4. Reviewing and building upon some of the foundational GI thinking such as:
10 entries on GI and the 25 entries on Global Integrators on the CORE Member Care blogsite;
--the article on
Global Integration: Overview and Opportunities for Mental Health Professionals (Christian Psychology Around the World, March 2016)
--our two upcoming articles Multi-Sectoral Member Care: Engaging Our World as Global Integrators (Journal of Psychology and Theology, Winter 2016) and  Well-Being for All: Mental Health Professionals and the Sustainable Development Goals (Journal of Psychology and Christianity, Spring 2017).

5. Your ideas and suggestions!

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Member Care Associates

Member Care Associates is a non-profit, Christian organisation based in Geneva and the USA. We provide-develop supportive resources for workers and organizations in the mission, humanitarian, and development sectors. Our services include consultation, training, research, and publications.

Global Integration (GI)
GI is a framework for actively integrating our lives with global realities. It helps us to connect relationally and contribute relevantly on behalf of human wellbeing and the major issues facing humanity, in light of our integrity and core values (e.g., ethical, humanitarian, faith-based) for God's glory.

More MCA Resources 
Global Portal for Good Practice (our main website)
Reflections, Research, and Resources for Good Practice (weblog)
Global Mental Health: A Global Map for a Global Movement (website)
Global Integration: Common Ground-Common Good (updates, materials, webinars) 
Global Member Care: (volume one): The Pearls and Perils of Good Practice (2011)
(e-book version is available on Amazon)
Global Member Care (volume two): Crossing Sectors for Serving Humanity (2013)
(e-book version is available on Amazon)


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