Implementing the WPA Action Plan 2017‐2020: community orientation for learning, research and practice
Authors: Helen Herrman
Journal: World Psychiatry (2019)

With each new term of Presidency at WPA, an Action Plan is implemented that builds on our preceding work. Our 2017-2020 Plan1, 2 strengthens the community orientation of our profession. It addresses the contribution of psychiatrists to responses to conflicts, emergencies and adversities, and provides a targeted strategy for reaching young women and men who face adversity and disadvantage and associated mental ill health or risks. In March 2018, we took the first major steps toward executing this strategy, when WPA representatives met with leaders from citiesRISE, the Juan José López-Ibor Foundation and senior psychiatrists from the Colombian city of Bogotá3. We were joined by experts from the Department of Mental Health and Substance Abuse of the World Health Organization and the International Medical Corps. We talked about how, through collective efforts, we can link local action with global networks to accelerate the uptake of best practices and models and support psychiatrists to contribute to community-based work in practical, creative ways. We considered how WPA and partners might best develop tools and strategies to support those at high risk of developing mental health problems (for any reason) and those who are already experiencing these problems, as well as ways to promote mental health for the wider population. We have now established the WPA-citiesRISE partnership. The WPA is a founding partner of the citiesRISE platform4 and has been instrumental in shaping its strategy and collective action program, implemented initially in five cities and focussed on the mental health of young people. The program is supported by a range of philanthropic and industry funders. The WPA has participated in collective action workshops in Chennai and Nairobi, as well as supporting foundational work in Bogotá. Existing initiatives in these cities, many of them led by small grassroots entities, are examples of what community orientation in mental health looks like in practice. The WPA is helping to stimulate productive exchanges between people who rarely have an opportunity to talk to one another. In Nairobi, for example, there have been joint meetings with senior psychiatrists, the national directorate of mental health, researchers, civil society leaders and young people such as participants in Amazing Minds (a creative network of students dedicated to reaching zero stigma for mental health and increasing help seeking among campus students). These kinds of encounters are characteristic of the WPA-citiesRISE partnership. They are an exciting way to support mutual understanding between diverse organizations as they join the global program. As well as supporting citiesRISE by access to the best available technical and conceptual evidence and experience, the WPA will lead specific programs. Psychiatry will contribute to better community capacity to respond to the mental health needs of children and young people in emergencies and adversities. Across the cities we will work towards: a) improved perinatal mental health, and b) support for prevention programs that reduce the prevalence of depression, anxiety and suicidal behaviour among young people. The recent announce-ment of the Lancet-WPA Commission “Reducing the global burden of depression”5 is a further step in this direction. The work will consolidate the perception and role of psychiatrists as members of a profession with a community orientation. It will demonstrate the practice of psychiatry within a framework of community care and multi-sector collaboration across low-, medium- and high-income settings. It will show how sustained support can be achieved for networks of psychiatrists engaged in community-based work and for psychiatrists working in community development related to the improvement of mental health. The WPA-citiesRISE partnership gains life from the committed leadership of psychiatrists in each of the engaged cities. In the first phase, WPA is appointing a global task force to guide the development of the partnership activities. We are also identifying interested psychiatrists in each city. They will be encouraged to form local representative groups positioned to assist the work of citiesRISE and develop the community-oriented work of psychiatrists in their country of operation. Each group will ideally include diverse practitioners, drawn from a range of backgrounds and from different points in their careers. The WPA is appointing psychiatrists as program leaders. They will have multi-faceted roles that include facilitating the development of the local representative groups and the interaction between them and the global task force. They will take a lead in developing the tools and guidelines for the planned activities. We are actively pursuing other activities. These include support for best practice in working between practitioners, people with lived experience of mental ill health and family carers3, 6. The WPA Executive Committee has approved the establishment of a service user and fam-ily carer consulting group to advise on new initiatives, including reviewing and improving the participation of service users and family carers in our congresses. This work is a priority in the new WPA meetings policy. Examples of best practice will be gathered as the WPA-citiesRISE partnership work proceeds, and will be disseminated through the newly launched WPA website7 and other channels. The WPA participated in preparation and launch of the Lancet Commission on Global Mental Health8, a landmark document in the field. We are concerned with quality of care and human rights in psychiatry. Consequently, we are designing a project with a member society to examine how to create conditions in mental health services that are free from violence and abuse and that minimize coercion. To conclude, I am pleased to report these developments in implementing the WPA Action Plan. Other activities under the Action Plan have been and will be described in detail on other occasions. There are major changes underway in the WPA meetings program, in the work of the Early Career Psychiatrists programs, and in WPA communications. A global survey of psychiatry is being developed in conjunction with a survey of training programs, and other programs are detailed separately by our active of-ficers9-11. My fellow officers and I are above all encouraged by the active engagement and support of the WPA Secretariat, our Member Societies, Scientific Sections, hard-working Standing Committees and all components of the Association.