WHO Mental Health Forum 201914-15 October 2019
WHO headquarters Geneva
Executive Board Room

Enhancing Country Action on Mental HealthSummary reportTable of Contents
SESSION 1: OPENING PLENARY............................................................................................. 4
1.1 Welcome ................................................................................................................................................... 4
1.2 Supporting Country Action on Mental Health ......................................................................................... 4
1.3 Statements by Member States ................................................................................................................... 8

SESSION 2: PLENARY – RECENTLY RELEASED WHO PRODUCTS AND LAUNCH OF
COMMUNITY MHGAP TOOLKIT .............................................................................................. 8
2.1 Recently released products on dementia, epilepsy, physical health, and mental disorders ..................... 8
2.2 Launch of the mhGAP Community Toolkit .............................................................................................. 8
2.3 Plenary Discussion on mhGAP Community Toolkit ................................................................................ 9
2.4 Upcoming Products from WHO MSD ...................................................................................................... 9

LUNCHTIME SEMINAR- SUICIDE PREVENTION: A MONTH LONG CAMPAIGN. ..................... 9
SESSION 3: SMALL GROUP DISCUSSIONS- IMPACT THROUGH IMPLEMENTATION: HOW ARE
WHO TOOLS BEING USED IN COUNTRIES? ............................................................................. 10Group 1: Implementation of Policy ............................................................................................................. 10
3.2 Implementation of Mental Health Interventions to Adult Populations .................................................. 11
3.3 Implementation of Mental Health and Brain Health Interventions to Children and Adolescents ......... 12
3.4 Implementation of Mental Health Interventions in Humanitarian Settings ........................................... 13

SESSION 4: WHO SPECIAL INITIATIVE: SUGGESTIONS FROM THE FIELD ............................. 15
4.1 Introduction ........................................................................................................................................... 15
4.2 Summary of small group discussions and country presentations on mental health system reform........ 16
4.3 Country presentations on mental health system reform ......................................................................... 16
4.3 Plenary Discussion ................................................................................................................................ 16

SESSION 5: SMALL GROUP DISCUSSIONS ............................................................................ 16
5.1 Consultation: Strategies to scale up WHO QualityRights in and across Countries .............................. 16
5.2 Consultation: The development and implementation of a Minimum Services Package for mental healthand psychosocial support in humanitarian settings ..................................................................................... 17
5.3 Consultation: Integrated approach to Brain Health .............................................................................. 19

LUNCHTIME SEMINAR: PROMOTING HUMAN RIGHTS AND RECOVERY-ORIENTED SERVICESAND SUPPORTS FOR PERSONS WITH PSYCHOSOCIAL DISABILITIES. ....................................... 20
SESSION 5: SMALL GROUP DISCUSSIONS (PART 2) ............................................................. 21
5.4 Consultation: Implications of ICD 11 for health care practice and training ........................................ 21
5.5 Consultation: Planned EQUIP (Ensuring Quality in Psychological Support) training materials
including training guidance and foundational skills training ...................................................................... 22
5.6 Consultation: The role of mental health and psychosocial support in emergency preparedness, climatechange and disaster risk reduction .............................................................................................................. 23

SESSION 6: PLENARY DISCUSSION AND CLOSE ................................................................... 24
6.1 Reports from small groups ..................................................................................................................... 24
6.2 Updates from WHO Regional Advisors ................................................................................................ 24
6.3. Evaluation of the Forum ....................................................................................................................... 25
6.4. Conclusions and close........................................................................................................................... 26

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Context
The World Health Organization (WHO) is leading the effort for achieving the objectives ofthe Mental Health Action Plan 2013-2020, adopted by the World Health Assembly in May
2013 and extended to 2030 at the 72nd World health Assembly in 2019. The WHO Mental
Health Forum (WHO MH Forum, previously “mhGAP Forum”) is a partnership event
organized by WHO every year in Geneva, coinciding with World Mental Health Day (10October). The WHO MH forum offers a platform by which to exchange information on theimplementation of the Mental Health Action Plan and to strengthen collaboration among
partners.
The eleventh meeting of the WHO MH Forum took place at the World Health Organization,
Geneva on 14 and 15 October 2019. The primary focus of the 2019 WHO MH Forum was on“Enhancing Country Action on Mental Health”. The second focus centred on the theme of the2019 World Mental Health Day: “Suicide Prevention”.
The forum was attended by approximately 297 participants. These included 72 country
representatives from 49 Member States, 14 participants from 11 WHO Collaborating Centres,
35 representatives from all regions of WHO, 11 participants from other UN agencies, and 159
participants representing 115 organisations (including academic institutions, NGOs, mental
health service user groups). The programme and list of participants are attached as Annex A.

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SESSION 1: Opening Plenary
1.1 Welcome
The forum was opened by Dr Ren Minghui (WHO Assistant Director-General, Universal
Health Coverage/Communicable and Noncommunicable Diseases). He emphasised theimportance of the 2019 MH forum due to the launch of the WHO Special Initiative on Mental
Health in May 2019, a priority for the WHO Director General and WHO. He also highlighted
the landmark political declaration on Universal Health Coverage at the United Nations
General Assembly where heads of state reaffirmed their commitment to spending on essential
health services to a billion more people. This included commitments to implement measures
to promote and protect mental health and wellbeing.
Reflecting on the past 12 months since the 2018 forum, Dr Ren highlighted the global
momentum, noting many important events and the increased global awareness thanks to anumber of initiatives. He noted that the World Health Organization Special Initiative on
Mental Health will serve as a further catalyst to the development of this important area of
public health. The exchange of lessons learned, at the 2019 forum was highlighted as being
particularly important in guiding the implementation of mental health services and policies incountries.

1.2 Supporting Country Action on Mental Health
The WHO Special Initiative for Mental Health (2019-2023): Universal Health Coverage for
Mental HealthDévora Kestel (Director, Department of Mental Health and Substance Abuse, WHO),
introduced the section on Supporting Country Action on Mental Health, noting that the forum
has changed its name from the mhGAP Forum to the WHO Mental Health Forum, toencapsulate the breadth of WHO’s work in the field of mental health, extending beyond, but
inspired by, the WHO mental health Gap Action Programme.
Dévora Kestel emphasised that the 2019 WHO MH forum has a special focus on
implementation and highlighted the high level of participation from representatives ofMember States, that will help ensure that the global agenda for mental health can progresssuccessfully in countries. She introduced key updates from this year’s efforts of thedepartment:•

The WHO Mental Health Action Plan which was endorsed by Member States in 2013and due to finish in 2020, was approved for extension to 2030 during this year’sWorld Health Assembly.

•

The WHO Secretariat have been asked to provide a menu of policy options of costeffective interventions for consideration by next year’s World Health Assembly. An
update of the WHO-CHOICE interventions, updating original models and including
new models on the cost effectiveness of pesticide bans for suicide prevention andschool-based social-emotional learning interventions in adolescents to promote mental
health and prevent suicide.
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•

The WHO Secretariat was asked to provide updates to the appendices of the WHO
Mental Health Action Plan in consultation with Member States and taking into
account the views of key stakeholders.

•Appointment of Cynthia Germanotta, co-founder of the Born This Way Foundation,
as the first ever WHO Goodwill Ambassador for Mental Health.

•

The first ever Technical Briefing on Mental Health at the World Health Assembly

The WHO Special Initiative for Mental Health (2019 – 2023): Universal Health Coverage for
Mental HealthDévora Kestel then introduced the WHO Special Initiative for Mental Health (2019-2023).
Launched at the World Health Assembly, the Initiative focuses on universal health coveragefor mental health, and forms a primary theme for this year’s WHO mental health forum. The
Special Initiative has a goal of supporting universal health coverage by ensuring access toquality and affordable care for mental health conditions in 12 priority countries to 100 million
more people.
Strategic actions of the special initiative:- Strategic Action 1 is about advancing mental health policies, advocacy and humanrights- Strategic Action 2 is about scaling up interventions and services across communitybased, general health and specialist settings. It will be implemented in 12 priority
countries covering all 6 WHO regions through partnership efforts with Member
States, local and interventional implementation partners it will adopt a ‘whole ofWHO’ approach, bringing together country, regional and HQ offices to support theInitiative. The WHO Special Initiative will look to advancing mental health policies
and mental health reform at multiple levels.
To achieve this novel work which emphasises the sustainability of programmes for mental
health, the Special Initiative will require US$ 60 million of catalytic funding, with US$ 1
million, per country, per year.
Finally Dévora Kestel noted that in the recent UN General Health Assembly, Member States
endorsed a political declaration for Universal Health Coverage. WHO MSD intends tocontribute to this through the work of the Special Initiative.
Updates from the WHO Department of Mental Health & Substance Use
Dzmitry Krupchanka (WHO), speaking on behalf of Vladimir Poznyak (WHO), introduced
updates of the key areas of work from the Management of Substance Abuse Unit of the
Department of Mental Health and Substance Abuse, WHO:••The WHO SAFER Initiative launched in 2018.
Provision of the Global Status Report on Alcohol and HealthPage 5 of 26

•
•
•
•
•

A request for WHO to report on the implementation of the aforementioned global
strategy to the WHO Executive Board and 73rd World Health Assembly, in
consultation with Member States.
In 2019, WHO and UNODC will launch the multisite implementation study oncommunity management of opioid overdose being conducted in three central Asian
countries (Stop-Overdose-Safely programme, SOS).
A tool to support health workers in perinatal care to identify, diagnose and manage
substance use during pregnancy has been created to increase dissemination ofguidelines on substance use in pregnancy.
The Unit was involved in the development of the ICD 11 chapter on disorders due tosubstance use and addictive behaviours, where field testing in 12 countries will be
conducted to pave the way toward better implementation.
Multiple projects exist, to generate and disseminate new evidence. For example, there
is a dedicated section for substance use in the WHO Global Health Observatory,
resources for the prevention and treatment of substance use disorders in the WHO
Atlas and a Global Information System on Alcohol and Health (WHO GISAH).

Key Messages from the Netherlands Summit on Mental Health and Psychosocial Support in
Crisis Situations
H.E. Nathalie Olijslager (Ambassador, Permanent Representation of the Kingdom of theNetherlands) showed an inspiring video of the Netherlands Summit of Mental Health andPsychosocial Support in Crisis Situations, which took place the week before the WHO MH
Forum. The summit focussed on people living in crisis situations, with the aim of making the‘the invisible, visible’. During the Summit, eight challenges were defined for the
improvement of global MHPSS:
1.
2.
3.
4.
5.
6.
7.
8.

Fighting ignorance, denial, stigma and shame concerning mental health conditions
Engaging affected people and communities from the start
Building emergency preparedness
Choosing the right MHPSS tools for the situation
Building accessible MHPSS resources from the bottom up
Being clear about aims and claims
Adequate training and supervision
Emotional support for MHPSS providers

The Ambassador ended by emphasising the need to consider a person-centred approachthroughout this work.
The French Ministerial Summit in Paris, 2020
Frank Bellivier, (Délégué ministériel à la santé mentale et à la psychiatrie, Ministère desSolidarités et de la Sante), announced the next and third ministerial summit for mental healthto take place in Paris on the 9th and 10th October, 2020. Frank Bellivier indicated that mental
health is a top health priority for France. The French Government is proud to host the next
Summit and are actively defining the theme for next year’s Summit. Three objectives havebeen identified for the Paris Summit: to maintain pressure on the global mental healthagenda; to encourage sharing practices between countries; and to consolidate the global
deliverables and the mobilization of key partners, including financial.
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The WHO Special Initiative for Mental Health - USAID
Ann Willhoite (Senior Mental Health Advisor, USAID) commended the work by the
Department and the global mental health community. She noted the important role USAID
play as the largest bilateral funder of Global Mental Health in Development and MHPSS in
Emergencies. The WHO Mental Health Special Initiative makes a statement to the rest of theworld that there is no health without mental health. Ann Willhoite announced the beginningof a partnership between USAID and WHO on the Special Initiative for Mental Health.
USAID, through its Victims of Torture Fund, is contributing 3 million dollars over the
coming three years to support scaling up of services.
The WHO Special Initiative for Mental Health - Swiss Development Coorporation
Enrichetta Placella (Deputy Head, Global Program Health, Swiss Agency for Development
and Cooperation- SDC) showed a video of a mental health programme in Bosnia, supportedby the SDC. She reflected that the SDC’s experiences in Moldova and Ukraine have theopportunity to be leveraged and replicated in other countries through the WHO Special
Initiative. Enrichetta Placella noted the affinity in strategic outlook between the work of the
SDC and the WHO Special Initiative, for example both build the case for investment inmental health and both look towards shaping norms at the global and country level, in termsof capacity building, and re-shaping services in primary care for mental health. This affinity
encourages the SDC to support the WHO Special Initiative and in turn Erika Placellahighlighted the hope that this would encourage more donors for the Special Initiative.
Mental Health and Human Rights
Dainius Pkras (UN Special Rapporteur on the right of everyone to the enjoyment of thehighest attainable standard of physical and mental health) stated that human rights based
approach should be mainstreamed in mental health care. Challenges raised: there arewidespread violations of human rights for those who use mental health services; the mainprinciples in the Convention on the Rights of Persons with Disabilities (CRPD) are largely
not addressed; institutionalisation in mental health services remains; excessive use ofbiomedical interventions in many areas continues; and diversity, human misery and theeffects of social determinants on mental health (inequalities, poverty, violence,
discrimination) are pathologised. To overcome these, recommendations included a shift inpolicies and services away from investments in systems with prevailing patterns ofinstitutionalisation, coercion and exclusion; the removal of obstacles to empowerment,
participation, non-discrimination inclusion; take targeted, concrete measures to radicallyreduce coercive practices; seek technical assistance from the WHO QualityRights initiative toimprove the quality of mental health care; address power asymmetries by involving users ofservices and non-psychiatric professionals in all levels of decision making; and prioritise andscale up investment in non-coercive mental health services and support models.
Global Campaign for Mental Health (Update)Sarah Kline (Deputy CEO, United for Global Mental Health; UGMH) outlined the advocacy,communications, campaign and financing work of UGMH:- The Blueprint Group: aims to encourage greater global collaboration on mental
health advocacy and communications. It includes over 280 representatives ofPage 7 of 26

-governments, international organizations, NGOs, trusts and foundations, academia
and the private sector. So far this group has jointly agreed messaging for mental
health, organized influential events with key stakeholders, successfully advocated forthe inclusion of mental health in the UHC political declaration; inputted into theNetherlands ministerial summit.
Social media messaging promoted by the group (#TimeToAct #MentalHealth) at key
events including UNGA 2018, the UK Ministerial Summit 2018 and the World
Economic Forum meeting in 2019.
Speak Your Mind campaign: formally launched at the UN General Assembly thisyear, the campaign strives to improve the accessibility and quality of mental healthservices nationally and globally.
Raising the profile of World Mental Health Day, where this year they joined forces
with campaign partners: WHO, WFMH and IASP in promoting a call to action for
suicide prevention which was this year’s theme #40seconds. UGMH also launched the‘museum of lost and found potential’ to highlight personal stories of mental health.

1.3 Statements by Member States
Seventeen Member States provided statements during the opening of the 2019 WHO MH
Forum, presented in Annex B.

SESSION 2: Plenary – Recently Released WHO Products andLaunch of Community mhGAP Toolkit
2.1 Recently released products on dementia, epilepsy, physical health, andmental disorders
Moderator Shekhar Saxena (Professor for the Practice of Global Mental Health, Harvard
University) introduced the session by highlighting WHO's role in providing strong technicalguidance. Tarun Dua (WHO) then provided an overview of four products launched in the past
year: 1) Epilepsy: A Global Health Imperative, 2) WHO Dementia Risk Reduction
Guidelines, 3) iSupport for dementia caregivers, and 4) WHO guidelines for management ofphysical health conditions in severe mental disorders. These products offer guidelines forsupporting not only people struggling with mental and brain health conditions, but also theirfamilies and caregivers.

2.2 Launch of the mhGAP Community Toolkit
Tarun Dua (WHO) and Neerja Chowdhary (WHO) presented the mhGAP Community Toolkit,
a community platform for delivering mental health promotion, prevention, service activities,
and interventions. The toolkit was developed based on a scoping review and consultations at
the 2018 mhGAP Forum. It is written for a wide range of audiences from different
backgrounds and is divided into two main parts. Part 1 is a guide for programme managers andpart 2 is a community provider manual that includes practical and actionable information foranyone in the community who wishes to provide support to people with mental healthconditions.

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Next steps for the toolkit include field-testing for feasibility and acceptability, collecting casestudies, and gathering additional tools and resources to help communities build capacity toprovide mental health care.

2.3 Plenary Discussion on mhGAP Community Toolkit
During the plenary discussion that followed, attendees expressed enthusiasm for theCommunity Toolkit and asked additional questions. WHO explained that the toolkit isdesigned to apply to a broad range of settings and to guide users to adapt it to their local
context. It is currently available only in English, but WHO would be interested in furthertranslations. Attendees were invited to submit case studies, use the toolkit, and provide
feedback on how to contextualize it. A number of important issues were raised including theimportance of community involvement, doctors working collaboratively with the community,
using the toolkit both in LMICs and marginalized communities in HICs; creating community
systems that can manage important issues such as confidentiality and safety; doing robust andsystematic research on the toolkit, and using SDGs as a framework for selecting a set ofoutcomes to assess.

2.4 Upcoming Products from WHO MSD
To conclude Session 2, Dévora Kestel (WHO) briefly reviewed upcoming WHO resources
and tools expected to be released in the coming year. These included:• Quality Rights Training Package• WHO position paper on integrated care for brain health• Other publications in brain health (e.g. dementia-related toolkits, Parkinson’s
discussion paper)• Global scales for early childhood development• Caregiving skills training toolkit• Helping Adolescents Thrive (HAT) guidelines and toolkit• Global report on developmental delays, disorders and disabilities• Advocacy booklet on mental health and neglected tropical diseases.
• e-learning course for mhGAP• Several evidence-based, scalable psychological interventions• EQUIP (Ensuring Quality in Psychological support) training and implementation
platform.
• An updated Mental Health Atlas

LUNCHTIME SEMINAR- Suicide prevention: a month long
campaign.
Kenneth Carswell (WHO) opened the floor reporting statistics concerning suicide andhighlighted world suicide day. Alexandra Fleischman (WHO) stated that 38 countries havesuicide prevention strategies and noting the work needed to reach the SDG targets. Alison
Brunier (Department of Communications at the Office of the Director-General,WHO) described some of the media used around the world on suicide precvention includingSouth China, Brazil, India and the UK, the WHO 40 seconds of action social media campaign
which involved celebrities (e.g. Talinda Bennington) and Facebook Messenger’s set of ‘story
filters’ and “stickers” for World Mental Health Day. WHO released products including a
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resource for pesticide regulators (available in English, French and Spanish), and resources(video and one-pager) for professionals (journalists, police officers, teachers, emergency
responders, employers and prison officers). Partners including United for Global Mental
Health, WFMH and IASP were thanked for their work.
A variety of comments were raised from the floor including the importance of translation.
Lebanon shared some of their campaign activities including putting messages of hope on
cars. Dévora Kestel closed the session by giving thanks to the team and highlighted that while
the current advocacy is welcomed, much more work is needed in the area of suicide
prevention.

SESSION 3: Small Group discussions- Impact throughimplementation: How are WHO tools being used in countries?
Group 1: Implementation of Policy
The aim of the session was to explore how WHO tools are being used in countries toimplement mental health policies, and to discuss impact, successes and challenges in using
these tools. The session was moderated by Martin Vandendyck (WHO).
Simon Njuguna (Director of Mental Health, Ministry of Health, Kenya) reported on therollout of the WHO QualityRights initiative country-wide.
Zipporah Angyu (Mental Health Desk Officer, Federal Ministry of Health, Nigeria) and Mary
Dewan (WHO) outlined some of the key challenges in reforming the national mental healthact, and discussed 2019 efforts to revise the law in line with the WHO standards and the UN
CRPD.
Mani Chandran (Senior Consultant Geriatric Psychiatrist, Hamad Medical Corporation,
Qatar) gave an overview of the development of the National Dementia Action Plan,
highlighted some of the key achievements and lessons learned from the process, and outlined
the aims and key actions of the Plan.
Gonzalo Soto Brandt (Professor, University of Chile) presented the evaluation of theimplementation of mhGAP in Colombia, Belize and Dominican Republic using WHO AIMS,
WHO Atlas and WHO Training report. He gave a brief overview of results of the evaluationand proposed a number of recommendations for future work in this area.
Frances Prescilla Cuevas (Ministry of Health, Philippines) discussed the recently endorsed
National Mental Health Act, described the translation and high level launch of the Filipino
version of the WHO QualityRights e-training platform (including challenges, solutions andlessons learned) and highlighted the importance of this platform in supporting theoperationalization of the new Act.
Dita Protopopová (Coordinator of mental health reform projects, Ministry of Health, Czech
Republic) described the QualityRights assessment which led to the upcoming rollout of
QualityRights e-training nationwide. She described other Mental Health Care Reform efforts
in the country including the development and implementation of the national Mental Health
Action Plan, the National Action Plan for Alzheimer’s disease and related illnesses and the
National Suicide Prevention Action Plan.
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KEY MESSAGES
Challenges to implementation include: fragmented individual initiatives for policy and law
reform that do not lead to buy-in from government health sector, lack of community based
services that promote recovery and human rights and policies and laws that do not align with
the UN Convention on the Rights of Persons with Disabilities (CRPD) and other standards.
Solutions to challenges include: creation of solid partnerships involving government andcivil society with a strong voice of people with lived experience; establish a vision forcommunity based services which reflects national resource contexts, allows for the phasingout of institutions and promotes community inclusion; create national policies, laws andservices that align with the CRPD and other human rights standards.
Recommendations include: participation of a broader range of stakeholders in Special
Initiative actions, in particular the meaningful involvement of people with lived experience;
ensure that commitment to deinstitutionalization and the principles of the CRPD are criteria
for selecting Special Initiative countries and that it is the basis for all action through theInitiative; ensure that the leadership for the Special Initiative in countries is at the highest
possible level and that the Initiative is also supported by local level champions in order toensure maximum visibility and commitment.

3.2 Implementation of Mental Health Interventions to Adult Populations
The objectives of this session were to identify challenges and recommendations on theimplementation of mental health interventions to adult populations. The session wasmoderated by Carmen Martínez (WHO).
Rabih El Chammay (Head of the National Mental Health Programme, Ministry of Public
Health, Lebanon) presented the Mental Health Strategy 2015-2020 in Lebanon, which
included the opening of 12 community mental health centres by 2021, Interpersonal
Psychotherapy (IPT) training, psychiatric emergency training for health care providers
working in emergency, testing (and implementation if effective) a guided digitial Self-Helpintervention, and QualityRights. Key challenges and solutions were discussed.
Hilda Kanaka Fatma Jansen (Interim Mental Health Coordinator, Ministry of Health,Vanuatu) presented mhGAP implementation 2016-2019 in primary care health settings in
Vanuatu after the 2015 tropical cyclone Pam. A multi-sectoral approach was taken. The
mhGAP implementation included training and supervision in clinical and non-clinicalsettings. Key challenges and solutions were discussed.
Jasmine Kalha (Program Manager and Research Fellow, Centre for Mental Health, Law &Policy, India) presented implementation research on mental health and human rights acrosssystems-based and community interventions in Gujara. Activities included building local
capacity, improvements in social environment, introducing family and peer-support groups,
and making improvement plans. Key challenges and solutions were discussed.

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Ashley Nemiro (MHPSS Advisor, The MHPSS Collaborative), presented the implementationof Problem Management plus (PM+) in three settings: Ethiopia, Syria and Honduras. The
case-studies showed PM+ integration into existing mental health and psychosocial support
programs; the use of remote supervision to implement PM+; and the implementation of PM+
with volunteer workforce. Key challenges and solutions were discussed.
KEY MESSAGES
Challenges to implementing adult mental health interventions include: limited resources(financial, human, time and skills/training); lack of buy-in from governments; difficulty
sustaining and scaling-up services.
Solutions include: a structured supervision system; additional mental health coordination
support/resources at district level; pre-service training within academic courses; engagementof community and intersectoral actors.
Recommendations for WHO include: adopting a whole system approach (health, educational,social); provide support for service planning, monitoring and evaluation; address
comorbidities and related conditions such as dementia under mental health services.

3.3 Implementation of Mental Health and Brain Health Interventions toChildren and AdolescentsThe session was opened by moderator Dan Chisholm (WHO) and organizer Chiara Servili(WHO).
Matias Irarrazaval (Director, Department of Mental Health, Ministry of Health, Chile)
outlined a number of mental health initiatives in Chile, such as “Chile Grows With You”, apolicy that aims to help all children reach their full potential for development; mhGAP
training; WHO Caregiver Skills Training Programme for Families of Children with
Developmental Disorders or Delays; and a training plan for Psychological First Aid (PFA).
Fareed Minhas (Professor of Psychiatry/Director, WHO Collaborating centre - Rawalpindi
Medical College, Pakistan) presented the country’s experiences with technology assisted
task-shifting (e.g. interactive voice response system for identification of cases) using ‘Family
Volunteers’ to Implement mhGAP and the Caregivers Skills Training (CST).
Nikolay Negay (General Director, Republican Scientific and Practical Center of Mental
Health, Ministry of Health, Kazakhstan) presented the country’s work implementing mental
health screening and awareness raising in schools, and training of school staff to recognise
those in need of support. Technology aided implementation of this work (e.g. through online
training, electronic screening). An achievement of the program had been the successful
decrease in adolescent suicide rate. mhGAP implementation was reported to be going well.
Benedict Dossen (Country Program Lead - Mental Health Program, Carter Centre, Liberia),
presented mental health programs in the country: a 6 month post-basic training for clinicians,
mhGAP-HIG, and training teachers and school staff in mental health and brain health. The
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goals of Liberia’s Mental Health Strategic Plan for 2016-2021 were discussed. Challenges toimplementation included lack of mental health knowledge, stigma and lack of resources.
Charlotte Hanlon (WHO Collaborating Centre, Addis Ababa University, Ethiopia) joined
online and presented the field testing of Caregivers Skills Training (CST) for families ofchildren with developmental disorder in Ethiopia. Results suggest that CST was wellreceived during pre-pilot, and it is being integrated and delivered hospitals and training forpsychiatrists and clinical psychologists.
KEY MESSAGES
Challenges to implementation of mental health and brain health interventions for children andadolescents include: inadequate human resource capacity; not enough time for assessment andmanagement of MH conditions at PHC care; sustainability.
Solutions include: training (preservice training, competency-based training, continuous quality
improvement, supervision and monitoring, and the use of digital technologies to support
training); multidisciplinary teams; provide evidence on investment case; schools, which are an
important platform for delivery (but specific strategies may be required for out-of-school
children); the use of family volunteers; innovative financing; whole-government approach.
Recommendations include: Take time to understand the context well (including availability ofhuman resources, and complex heterogeneous needs of children and families); engage
schools; whole government approaches and innovative financing.

3.4 Implementation of Mental Health Interventions in Humanitarian
Settings
The session was organized by Fahmy Hanna (WHO) and Inka Weissbecker (WHO), andmoderated by Florence Baingana (WHO).
Fahmy Hanna provided an overview of new WHO estimates for mental health conditions
following conflict, the scarcity of human resources and WHO MHPSS tools (e.g. IASCMHPSS guidelines, the mhGAP-HIG).
Claire Whitney (Sr. Global Mental Health & Psychosocial Advisor, International Medical
Corps) presented on WHO and UNHCR needs assessment and gave a case study of it applied
to Yemen. Implementation of PM+ in the Middle East was described.
Yutaro Setoya (WHO) presented on humanitarian hazards in the Pacific islands. An overview
of the use of mhGAP, IASC guidelines, and MoH ToTs applied to the 2016 cyclone Winston
in Fiji and the 2018 cyclone Gita in Tonga was given.
Selma Sevkli (Mental Health Technical Advisor, International Medical Corps) outlined theimplementation of mhGAP-HIG (integrated with other tools) in Libya. Initial phases focusedon identifying human resources, followed by development and adaptation of toolkit,
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assessments, implementation and supervision. The presence of a strong local team (especiallythe inclusion of local psychiatrists) was a key asset to the success of the project.
Inka Weissbecker (WHO) showed a video clip of a mhGAP-HIG training programme incollaboration with IMC. It can be accessed from the following link:(https://www.youtube.com/watch?v=B9_Ik_Tf2N8&feature=youtu.be&fbclid=IwAR10l7go2
zDfItWkKcfCLn3ACVkoKcGODlf4_ucshcEQqj231Sw4Y-3U15M).
Joseph Mogga (WHO) described South Sudan’s work with the building back better
framework and Self Help + (SH+). Tools (e.g. mhGAP operations manual) wereoperationalised through the MoH with support of WHO and led to 52 health workers being
trained for the treatment of around 600 people, and the decrease of patients in prison.
Emeka Nwefoh (Mental Health Advisor, CBM) spoke about CBM work in North East
Nigeria. CBM continued an intervention they had begun in November 2018 into December
2021 with funding from the German Ministry of Foreign Affairs. They conducted various
ToTs with focus on supervision, clearer referral pathways, and the rebuilding of healthfacilities.
Alisa Ladyk-Bryzghalova (WHO) presented the Building Back Better (BBB) framework in
Ukraine. Key components of the programme are de-institutionalisation and integration ofmental health within PHC through the use of mhGAP. The overall program aims to haveapproximately 2 million people covered by mhGAP services across the country.
Giovanni Sala (Mental Health Programme Coordinator, COOPI) described the MHPSS
program of COOPI Niger, inspired by BBB framework. The program aims to provide
emergency response through community and public health integration in PHC. Activities
include testing of group PM+ and awareness raising to reduce stigma and ease referrals from
communities (e.g. radio stations, mobile cinemas).
KEY MESSAGES
Challenges to implementing mental health interventions in humanitarian settings included
sustainability, mental health needs of humanitarian workers, and coordination issues(Governments, NGOs).
Solutions proposed were: engagement of humanitarian and development partners towards
common outcome in line with national agenda; integration of MHPSS support forhumanitarian workers; better coordination through MHPSS Technical Working Groups(national partners, authorities, ministries and other decision makers to be engaged).
Recommendations were: Building Back Better- Build capacity using tools such as mhGAP
HIG, Operations Manual, PM+ and others; healthy humanitarian workers are needed for scale
up of MHPSS; and establish MHPSS Technical Working Groups and engage withgovernmental stakeholders.

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SESSION 4: WHO Special Initiative: Suggestions from the field
4.1 Introduction
Dévora Kestel opened the session and introduced Mark van Ommeren (WHO) and Alison
Schafer (WHO).
Mark van Ommeren (WHO) introduced the aim of the Special Initiative project, “By 2023
universal health coverage (UHC) ensures access to quality and affordable care for mental
health conditions in 12 priority countries to 100 million more people.” This will be done
through 2 strategic actions: 1) Advancing mental health policy, advocacy and human rights,
and 2) Scaling up interventions and services across community-based, general health andspecialist settings. By make substantial investments for 5 years in 12 priority countries theaim is to have enough structure in country to sustain the services. Most of the money for the
project will be spent in countries and a better balance will be created in distribution oftechnical staff in WHO country, regional and HQ offices. The aim is to have implementing
staff in country offices. Selection of countries is still underway.
Alison Schafer (WHO) introduced a small activity for participants. She asked all participants
to write down their ideas and thoughts to answer the following sentence:“My one suggestion for WHO’s Special Initiative for Mental Health (2019-2023): Universal
Health Coverage for Mental Health is…”
The top three themes were:
1. Working at a community level (involvement of community health workers, schools,
faith centres) was the most common suggestion (n=23)
2. A focus on research and quality of services (using scientific evidence, M & E,
research, inclusion of academia, publishing results) (n=12)
3. Integration of mental health across levels, services and populations (engaging
different sectors, using a system change approach) (n=10).
Additional themes submitted by five or more people were:
1.
2.
3.
4.
5.
6.
7.

getting government buy-in (n=9)
running awareness campaigns (n=8)
involving people with lived experience (n=8)
engaging in advocacy (n=6)
focus on children and adolescents (n=6)
involvement of other health sectors (e.g. family medicine, PHC) (n=5)
involvement of vulnerable populations (e.g. refugees, migrants, people withdisabilities) (n=5)
8. supervision systems in place (n=5)
9. tackling stigma (n=5).

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4.2 Summary of small group discussions and country presentations on
mental health system reform
Summaries of small group discussions can be found in “Key messages” boxes in Session 3
above.

4.3 Country presentations on mental health system reform
Rabih el Chammay (Head of the National Mental Health Programme, Ministry of Public
Health, Lebanon) described the reform of the Lebanese mental health system. The importanceof leadership governance and inter-sectoral policy work was emphasised. Main challenges
were (i) building all the blocks of the system at the same time and (ii) funding.
Recommendations to overcome these included (i) having a road map (Mental Healthstrategy), having a highly skilled team centrally and leveraging other agendas (e.g. UHC,
NCDs,), and (ii) use humanitarian funding for system strengthening, create a collaborative
governance model and to identify actors willing to invest in system strengthening.
Jacob Bernard (Federal Coordinator of the Belgian mental health care reforms, Federal PublicService – Health, Belgium) described the mental health reform in Belgium, which focused on
the integration of psychiatric care into existing community networks and resources. For
healthcare systems reform, a global approach is needed with consensus at all political levels,and links with employment, justice, and education system. A lot of time was also needed (atleast 10 years in Belgium). It is important to have stakeholders involved, a strong national
strategic plan that is in line with regional plans and having a regional coordinator.
Yuri Cutipe (Director of Mental Health, Ministry of Health, Peru), outlined the mental healthreform in Peru, which started in 2011 and focused on providing care through community
mental health centers. In 2015 a finance program for mental health was created. By 2021 theaim is to have increased coverage from 10% to 28%. Key lessons learnt were: in addition toa legal mechanism for the operationalization of policies permanent intersectoral, national andregional buy-in is key; political advocacy and technical assistance of the national andinternational organizations is important; the need for partners in health and human rights
reform; and the need for political support for community mental health policy from othersectors of the State and social actors. Having concrete financing mechanisms is essential increating sustainability.

4.3 Plenary Discussion
Dévora Kestel closed the session by thanking all the presenters. She acknowledged thateveryone has contributed a lot to these projects, the results are rewarding and that leadershipis essential in making things happen.

SESSION 5: Small Group Discussions
5.1 Consultation: Strategies to scale up WHO QualityRights in and acrossCountries
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The session was moderated by Sarah Kline, Deputy CEO, United for Global Mental Health.
Natalie Drew Bold (WHO) shared information on the the large scale implementation andevaluation of QualityRights in India. The momentum of scale-up has been encouraging forthe team which has on-going collaborations with 10 countries.
The participants in the room represented around 8 countries which led to an intensive andconcrete discussion on the possible ways to scale-up QualityRights: within countries andacross countries.
Some of the strategies to scale-up included:- Setting-up an implementing committee- Having a mixed stakeholder group, policy makers, professionals, diverse civil society
groups- Establishing a group of national champions and video messages promoting the etraining through social media- Involving ministers, people with lived experience, civil society reps, well known
national personalities in the national launch event of QR e-training initiative- High level participation- all stakeholder groups- Social media strategy by national expert for ongoing rollout- Complementary QR face to face training (ToT) for super coaches to feed forum
discussions and respond to feedback- QR assessment and improvement/transformation of mental health and social services
The session included questions on the feasibility of the intervention, where QualityRights had
introduced and included updates on various innovative strategies being used across countries
to implement QualityRights.

KEY MESSAGES
Suggestions for in-country strategies included integration of QualityRights into a number ofareas (e.g. professional development curriculum, workplace settings, UN staff, in countries).
Suggestions for strategies across countries included: engaging national human rights
institutions; challenging power hierarchies through representation from inter-sectoral partners
such as education, social justice, social welfare and others, to ensure no group dominates;building mental health leadership within countries; demonstrating how countries can use
QualityRights to achieve SDG 3.4; include QualityRights as an approach for donor funding incountries, in line with Article 32 of the UN CRPD.

5.2 Consultation: The development and implementation of a Minimum
Services Package for mental health and psychosocial support inhumanitarian settings
This session was led by Inka Weissbecker (WHO) and Zeinab Hijazi (Mental Health andPsychosocial Support Specialist, UNICEF).

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Inka Weissbecker summarised the aims of the three year Minimum Services Package (MSP)
project: to create a package of priority actions and interventions carried out by humanitarian
actors to improve availability and quality of care in humanitarian settings. It will support
coordinated MHPSS through integration across the sectors of health, child protection, andeducation and will be co-led by WHO and UNICEF with the support of UNHCR.
Zeinab Hijazi explained that the MSP focusses initially on child protection, education andhealth, with future focus on different aspects (e.g. GBV, disabilities).
Peter Ventevogel (Senior Mental Health Expert, UNHCR), used the Rohingya crisis as an
example, to outline the need for the MSP to provide a more predictable, faster and credible
response for humanitarian crisis.
Koen Sevenants, (UNICEF) outlined the need for the MSP to support organisations toorganise and co-ordinate responses, in particular for enhancing services in child protection.
Sarah Harrison, (Global MHPSS Technical Advisor, International Federation of Red Cross
and Red Crescent Societies) highlighted the absence of existing data on financial costs (perchild or person in need) of MHPSS in humanitarian crises. It is hoped that the MSP will fillthis gap. The need for the MSP was emphasised, using Ebola response in DRC as a caseexample.
Margi Bhatt (Coordinator, Education Policy, Inter-Agency network for Education in
Emergencies), highlighted the need for MHPSS to be integrated in education. Linking to acase study in Syria, challenges included linking child protection and education, no clear way
to co-ordinate the response, being unsure of the costs involved. The MSP can help overcome
these challenges.
Discussion from the floor included the support for more transparent costing to allow for
better coordination (although this will not be easy); the importance of having different entry
points for MHPSS (e.g. child protection, health); localisation and adaptation of MSP; andensuring the MSP is simple and accessible.
KEY MESSAGES
There is the need to better integrate MHPSS services, care and pathways across sectors,
including health and child services.
A Minimum Service Package for MHPSS may allow for better coordination between donors;
include tools that can be used for advocacy within organizations and with partners; include
elements related to disability, child protection and nutrition; enhance accountability andresearch.
Challenges for the MSP include difficulties producing cost estimates; ensuring that thelanguage is simple and understandable; identifying who should be responsible for MHPSS(i.e. which actors and sectors); including people with complex mental health needs.
The importance of ensuring that MHPSS is aligned with global guidelines in health and childprotection, and is being recognized at the policy level.

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5.3 Consultation: Integrated approach to Brain Health
The objective of this session was to discuss and obtain feedback on WHO’s integrated
approach to brain health. The session was moderated by Dan Chisholm (WHO).
Tarun Dua (WHO) introduced WHO’s vision for an integrated approach to brain health (seeFigure 1).
Figure 1. WHO’s integrated approach to brain health.

Kate Swaffer (Chair, CEO and co-founder, Dementia Alliance International) highlighted theneed for brain health education across the life-course, starting with children. She also stressed
the importance of a rehabilitative, rights-based approach focusing on mental, physical andemotional health.
Alla Guekht (Director, Moscow Research and Clinical Center for Neuropsychiatry, RussianFederation) emphasized the importance of personalized and multidisciplinary care,coordinating health care professions such as neurology, psychiatry, psychology andphysiology, amongst others.
Raoul Bermejo (Coordinator, Care, UNICEF), introduced the Nurturing Care framework(WHO, UNICEF and others), and indicated that the pregnancy period, early development andadolescent years are important times to promote brain health, emphasizing that brain
development can be nurtured.

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Alarcos Cieza (WHO) shared WHO’s rehabilitation perspective, which includes a focus onfunctioning, rehabilitation and action. The importance of measuring functioning, in addition
to mortality and morbidity, was highlighted.
Benedict Dossen, (Country Program Lead - Mental Health Program, The Carter Centre,
Liberia), spoke about the national assessment on mental health needs in young people carriedout by the Government of Liberia in 2009, and subsequent training for teachers to raiseawareness of brain health, which resulted in reduced stigma, reduced physical abuse, theestablishment of referral routes to mental health clinicians.
Raad Shakir (Professor Neurology, European Academy of Neurology) emphasized theimportance of considering issues such as stroke within the purview of neurological disorders,and highlighted the need for WHO to better engage neurologists and neurosurgeons.
Peter Yaro (Executive Director, Basic Needs- Ghana) highlighted the need to train andinclude traditional healers in order to overcome health human resource constraints in lowand middle-income countries. In Ghana this represented a key step to promoting epilepsycare, and there are now registers for traditional healers in both Ghana and South Africa.
KEY MESSAGES
There is a need to focus on: conceptual issues regarding brain health and mental health; aholistic approach to brain health that is evidence-based across the life-course; prevention,
treatment, care and rehabilitation (including optimal functioning)
A systemic approach is required, which considers family dimensions, traditional healers,essential medicines, NCDs and assistive technologies.
There is the need to address social determinants of health and stigma.
It is important to respect societal and personal perspectives as well as country context.
There is an opportunity to mainstream brain health into universal health coverage andprimary health care; and a need to integrate two pillars, or brain health paradigms: healthpromotion and disease-specific prevention, management and interventions.

Lunchtime Seminar: Promoting Human rights and Recoveryoriented Services and Supports for Persons with Psychosocial
Disabilities.
The seminar, moderated by Alison Brunier (WHO) opened with a brief introduction byMichelle Funk (WHO) who highlighted the importance of creating community services that
operate without coercion, support recovery and promote autonomy and inclusion. She thendescribed the work currently underway to generate WHO good practice guidance in this area.
Seminar speakers Michael Njenga (CEO, Users and Survivors of Psychiatry in Kenya),
Thurayya Zreik (Field Manager, QualityRights, National Mental Health Program, Ministry ofPage 20 of 26

Public Health, Lebanon) and Arturo Cannarozzo (organizer of the International Activities, La
Collina Social Cooperative, Italy), gave powerful testimonies about their lived experience ofmental health and using mental health services. Each presenter spoke about initiatives they are
undertaking to promote services that respect human rights and promote recovery.
Highlights of the seminar included Thurayya Zreik’s vivid account of the positive changes she
witnessed within a service after it had implemented QualityRights, Michael Njenga’s strong
call to end coercive practices, respect legal capacity and promote peer support as an essential
part of the service package, and Arturo Cannarozzo’s important reminder that all services havea duty to look at the whole life of the person, not just focusing on their symptoms, and tosupport them in achieving their goals and aspirations.

SESSION 5: Small Group Discussions (part 2)
5.4 Consultation: Implications of ICD 11 for health care practice andtraining
The objective of the session was to consult on the implications of ICD-11 for health carepractices and training. The session was moderated by Jose Luis Ayuso-Mateos (Professor of
Psychiatry, Universidad Autónoma de Madrid, Spain).
Geoffrey Reed (Professor of Medical Psychology, Global Mental Health Program, Columbia
University, USA) outlined the major changes to ICD-11 (approved in May 2019, which comeinto effect January 2022)(i)
Elimination of mind-body dualism (e.g. new unified classifications of sleep-wakedisorders which was previously divided into ‘organic’ and ‘non-organic’)(ii)
Move towards dimensional classification (stronger focus on current presentation,
moving away from stable diagnoses)(iii) Disorders due to Substance Use corresponds to global public health needs(iv)
Gender Identity disorders now called “gender incongruence” and moved to the
new chapter on sexual health, no longer considered a mental disorder.
Raad Shakir (European Academy of Neurology) described how the changes in the ICD 11
would improve neurology. For example, stroke is classified as a brain disease in its own rightin the ICD 11 (previously was under three classifications), leading to improved clarity andclinical usefulness.
Mariana Pinto da Costa (Chair, Early Career Psychiatrists, World Psychiatric Association)
presented views of early career psychiatrists on International Classification Systems. For
example, out of 202 early career psychiatrists 55% stated they were “very interested” in the
ICD-11 and 37.6% were “very interested” in the DSM 5.

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KEY MESSAGESClinical description and diagnostic guidelines (CDDG) are the best tool for training;
therefore a priority should be set on the translation, publication and widespreaddissemination of these guidelines.
There is a need to capacity build activities that incorporate novel technologies for healtheducation.
There is a need to involve professional societies and national health authorities to identify
the required activities for the adoption and implementation of ICD 11.
The incorporation of ICD 11 changes into undergraduate and graduate education should befacilitated and promoted.
The need and scope for a primary care version should be assessed and articulated, and an
appropriate product developed, consistent with mhGAP and other recommendations from
WHO’s Mental Health and Substance Use Department.

5.5 Consultation: Planned EQUIP (Ensuring Quality in Psychological
Support) training materials including training guidance and foundational
skills training
Alison Schafer (WHO) opened the session by introducing the EQUIP (Ensuring Quality in
Psychological Support) project. Jennifer Hall (WHO) facilitated an icebreaker to prepare thegroup for an interactive session, followed by Sarah Watts (WHO) who introduced the training
package and competencies developed within the EQUIP project.
A participatory group activity followed, moderated by Jennifer Hall (WHO), Edith van’t Hof(WHO), Sarah Watts (WHO) and Alison Schafer (WHO), to gather ideas from the group ofactivities for training pre-selected competencies. The EQUIP team selected 4 corecompetencies for the exercise on training activities: 1) Promotion of realistic hope for change,
2) Rapport building and self-disclosure, 3) Exploration, interpretation and normalisation offeelings, 4) Demonstration of empathy, warmth and genuineness. The consultation was very
interactive and all groups gave valuable ideas on activities.
Main issues raised in the discussion were around the use of competency assessment tool
ENACT, the link between competency based training and client outcomes, how to use the
EQUIP tools in different contexts..

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KEY MESSAGES
Competency based training can improve quality of training provided.
Consideration needs to be given to implementation of competency -based training, to ensure
it can be used in different contexts, and a safe learning environment is maintained,
Suggestions for training competencies included role plays, group reflections and teaching thegroup mindfulness skills.

5.6 Consultation: The role of mental health and psychosocial support inemergency preparedness, climate change and disaster risk reduction
The objectives of this session were to consult on the role of mental health and psychosocial
support in emergency preparedness, climate change and disaster risk reduction. The session
was moderated by Brandon Gray (WHO).
Fahmy Hanna (WHO) highlighted the importance of MHPSS preparedness through a casestudy of a hurricane affecting the Bahamas. MHPSS preparedness can be linked to disasterrisk reduction (DRR). The Sendai Framework for Disaster Risk Reduction also highlightsthat MHPSS needs to be a component of disaster risk management programming (DRM).
Jostacio Lapitan (WHO) highlighted the need for political commitment in order to have publichealth services that promote dignity, strengthen resilience, make scalable psychologicalinterventions available and provide mental health integrated with general health care.
Elena Villalobos-Prats (WHO) stated that climate change has been defined as the publichealth risk of the century and explained links between climate change and public health, suchas i increased air pollution, extreme weather, and poverty.
Kasi Sekar (Professor and Registrar, National Institute of Mental Health and Neurosciences NIMHANS, India) outlined the importance of a multi-sectoral MPHSS response throughdescribing a project (implemented by National Institute of Mental Health and Neuroscienceand UNDP funded by USAID) which aimed to develop community resilience in disasterprone areas in India. Preliminary studies showed that these materials were effective.
Martin Vandendyck (WHO) described how working with the MoH to provide psychologicalsupport, using a Building Back Better (BBB) approach, supported responses to two
emergencies in the Western Pacific region last year (an earthquake in Papua New Guinea andflash-floods in Laos PDR, first national emergency in Laos).
Maria Ziegler (Operations Officer, Gender and Development, Caribbean Development Bank)
outlined efforts to support DRR in the Caribbean, in particular in response to hurricanes,
through raising awareness, community campaigns, capacity building (mhGAP-HIG, PFA) andcreating a regional roster of mental health professionals available for mobilisation in case of
emergency.

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Anva Ratzon (protection coordinator and DRR countenance, IsrAID) summarised IsraAID
approach to DRR, and highlighted the basis of the programme in Moshe Farchi’s model toreduce acute stress reactions. Anva proceeded to describe a series of projects conducted in
Guatemala and in other countries to integrate DRR and MHPSS in 31 schools.
Julian Eaton (Mental Health Director, CBM) presented on the work conducted in the Ebola
crisis in Sierra Leone. Preparedness work previously conducted in Sierra Leone, such as
capacity building for nurses, supporting front line workers, focus on children and persons withdisabilities and set up of MHPSS systems, greatly helped Ebola response.
Brandon Gray (WHO) discussed a draft framework by the IASC MHPSS Reference Group thathas been developed for integrating MHPSS into DRR and vice-versa. The framework will
include practical tools (such as checklists on preparedness, tools on how to integrate MHPSS
into DRR), a guidance note to understand how the IASC framework can be used on the groundand operationalised, and lessons learnt.
Maria Baena Álvarez (WHO) stated that more research is needed in the field of mental healthand climate change, on both acute weather event and long-term implications of climate change.
Fiona Charlson (Senior Research Fellow, Queensland Centre for Mental Health Research,
Australia) described the impact that climate change is having in Australia and in the Pacificand stated that that literature on climate change and mental health is largely restricted to
discussion papers of proposed causal pathways and cultural impacts using qualitative research.
Future research is needed.

KEY MESSAGESIt is important to be ready to respond and not waiting for an emergency to happen
The identification of links between disaster risk reduction and MHPSS.
The impact of climate change on mental health, and how these can be integrated in a holisticmanner.

SESSION 6: Plenary Discussion and Close
6.1 Reports from small groups
Each small group consultation presented two to three key messages, summarising the mainlearning points from each session. These have been summarised as ‘Key Messages’
throughout this document.

6.2 Updates from WHO Regional Advisors
Florence Baingana (Consultant, WHO AFRO) provided updates from the AFRO region. She
described the context: suicide and substance use are the main areas of burden, and thePage 24 of 26

majority of countries do not have mental health policies or plans. Challenges in reducing thetreatment gap include: low prioritization of mental health, insufficient funding, weak healthsystems, lack of health information systems, lack of resource (health care workers, facilities,
medicines) and poor quality of care. There were many achievements, including QualityRights
support in Kenya, legislation review support in Nigeria and support for developing mental
health strategic plan in South Sudan. Plans for 2020/2021 include: regional programmemanagers’ meeting with all 47 Member States, regional dementia meeting for 20 Member
States; implementing QualityRights in francophone countries, mental health capacity building
for WHO country offices and national ministries of health.
Dan Chisolm and Alisa Ladyk-Bryzghalova (WHO) provided updates from the EUROregion. More than 25 out of 50 Member States in EURO have explicitly included mental
health in their work plan, however there continues to be an overdependence on
institutionalized health. Challenges include meeting the needs of so many Member States.
There are two strategic directions: (i) the promotion and protection of mental health and brain
health over the life-course, including advocacy and mental health in old age and (ii) policy.
Achievements include dementia policy and planning workshop in Malta, suicide prevention
and mhGAP in central Asia (e.g. Tajikstan) and QualityRights implementation (e.g. in
Latvia).
Alisa Ladyk-Bryzghalova provided an overview of Ukraine country-level activities, including
support for developing a national mental health policy and action plan, financing for mental
health , implementing mhGAP and QualityRights in Ukraine.
Carmen Martinez (WHO) provided updates from the AMRO region. These included
developing mental health policies,; mhGAP and PM+; de-institutionalization of services;
implementation of QualityRights; economic investment cases to develop evidence; caregiverskills training (CST) for families of children with developmental delays; suicide prevention
strategies and plans; and aiming to develop a regional observatory for mental health by 2020;
Martin Vandendyck (WHO) outlined activities in the WPRO region. Key priorities included:
noncommunicable diseases and ageing, health security, climate change and environment –mental health and dementia are included under all three priorities. 19 of 27 Member States
requested support on mental health. China, the Philippines and Vietnam are currently
developing national dementia plans. WPRO adopts a tailored support approach for theWestern Pacific.

6.3. Evaluation of the Forum
Kenneth Carswell (WHO) led participants through an online evaluation of the Mental HealthForum 2019 in real time. Key results are shown below.
Suggestions made for making products easier to implement and use included:- more accessible products (shorter, easier to read; n=25)- Operational guidance, implementation workshops and training and supervision (n=19)- Ensuring local adaptation and contextualisation and relevance to field (n=13)
29% stated they found the forum “extremely useful”, 45% “very useful”, 40 % “useful” and
4% “not useful”
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88% stated that WHO should continue with the WHO MH Forum “more or less as it is”
Suggestions for improving the forum included:- More time for discussion and interaction, less presentations, more group work,
different talk formats, more question time, more participation from participants(n=56)- Smaller sessions and smaller groups for group-work (n= 14)- More service users and carers involvement (and possibly paying for their attendance)(n=13)

6.4. Conclusions and close
Dévora Kestel (WHO) expressed her gratitude to the Mental Health and Substance Abuse
Department team for organizing the Mental Health Forum 2019, and also recognized thework of the photographers. Recognition was expressed to participating governments,
nongovernmental organizations and other agencies. The Mental Health Forum 2019represented an opportunity to learn about activities being undertaken at country-level. Dévora
expressed that it is rewarding to witness progress unfolding but that there still remains muchto accomplish. She thanked donors and partners for their intentions to support this agenda
moving forward. Dévora mentioned that WHO will reflect on the feedback shared byparticipants during the Mental Health Forum 2019 and encouraged participants to collaborate
in an ongoing manner. To close the session, Dévora indicated that WHO will continue towork hard to ensure that people with mental health needs receive the care and respect they
deserve.

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