The <scp>WPA</scp> Action Plan 2023‐2026
Authors: Danuta Wasserman
Journal: World Psychiatry (2024)

Building on the Association's foundational activities, the WPA Action Plan 2023-2026 aspires to enhance the mental and physical well-being of psychiatric patients, psychiatric staff, and the broader public. The staggering statistic that one in every eight individuals globally grapples with a mental disorder1 warrants continuous improvement in preventing and treating these disorders. Alarmingly, despite the magnitude of this issue, public expenditure on mental health remains disproportionately low2, 3, underscoring the urgent need for intervention and reform. An umbrella review and meta-analytic evaluation of 102 meta-analyses, including 3,782 randomized controlled trials and 650,514 adult patients who received psychotherapies or pharmacotherapies for the treatment of the most prevalent psychiatric disorders, showed that the effect sizes of treatments appear to be low and have plateaued, hinting at a potential ceiling effect in current research modalities4. This calls for a paradigmatic shift in research methodologies as well as identifying new methods to improve mental health by treatment and prevention. However, finding, developing and getting approval for new treatments and preventive methods takes a long time. In the meantime, we must concentrate on implementing existing evidence-based treatments and preventive methods that show relatively good efficacy. To accomplish this goal, the WPA Action Plan 2023-2026 prioritizes the following actions: implementation of evidence-based therapies, prevention and adoption of healthy lifestyles, research, and communication. Here we focus on implementation of evidence-based therapies, prevention and adoption of healthy lifestyles. Evidence-based treatments are available for all psychiatric disorders. Some psychotherapies and pharmacotherapies, as well as their combinations with psychosocial measures, are proven to improve mental health of patients with various disorders. Research papers, while invaluable in advancing medical knowledge, often present a challenge for clinicians: their technical nature can make them inaccessible to those who are on the front lines of patient care and are pressed for time. It is imperative to bridge this gap between academic research and clinical practice. We must develop a system that consistently updates clinicians about the latest findings, enabling them to discern and adopt the best practices. Such a system would ensure that patients receive care based on the most recent and relevant evidence, enhancing the overall quality of care. To systematically implement these existing treatments, along with emerging ones, the WPA is introducing a "Specialist Corner: Advances of sciences and their application in clinical practice". This Corner will serve as a hub to summarize advancements in clinical psychiatry, public mental health and ethics, while fostering diversity and inclusiveness. This platform, dedicated to clinicians, will feature online webinars where expert specialists present, in an accessible way, state-of-the-art treatments and best practices for daily psychiatric work. Within this Corner, insights on diagnosing, treating and rehabilitating patients with various mental disorders – including psychosis, affective disorders, substance use disorders, attention-deficit/hyperactivity disorder, autism, and eating disorders – will be presented. Topics such as mental health during crises, practical applications of digital psychiatry, and ethical considerations in everyday scenarios will also be covered. The lead specialists for each mental disorder, responsible for each webinar or series of webinars, will appoint a group of colleagues from all continents to present the topic from different perspectives, showing gaps in research, availability of studies, and adaptation of existing materials to different cultural contexts. Outcomes from these webinars will be summarized for easy comprehension, intended as educational resources for patients, their families, and clinical staff. This approach aims to foster treatment adherence and the application of best practices. All webinars, along with their associated materials, will be available on the WPA website. Preventing psychiatric disorders is essential for promoting mental well-being and reducing risk of relapses, and necessitates systematic implementation at both local and national levels5. Evidence-based preventive strategies, when adopted early in life, can significantly enhance mental health outcomes6, 7. Through coordinated efforts, we can foster more resilient communities and reduce the overall burden of psychiatric disorders. While there is evidence that healthy lifestyles boost general health, there is also growing proof of their impact on mental health across different populations. Activities such as physical exercise, a balanced diet, and consistent sleep hygiene all have positive effects on mental well-being8-10. Consistent sleep hygiene practices significantly enhance mental well-being by ensuring restorative rest and maintaining circadian rhythms11. Proper nutrition, characterized by a diet rich in essential nutrients, is crucial for brain health and overall mental wellness9. Engaging in regular physical activity has been consistently linked to improved mood, reduced anxiety, and cognitive benefits8. Integrating these healthy lifestyle practices can supplement and amplify the effects of existing pharmacotherapies and psychotherapies. The public has increasingly recognized the importance of healthy living. A growing number of individuals now participate in regular physical activity and consciously strive to make healthier lifestyle choices. While the broader public acknowledges the benefits of a healthy lifestyle, its full potential in psychiatry remains untapped12-15. This disconnect often stems from patients' lack of knowledge about adopting and sustaining healthy habits. Many do not have tangible examples or role models from their homes or schools that illustrate the effective incorporation of physical activity, proper nutrition, and sleep hygiene into daily routines. Thus, the WPA Action Plan 2023-2026 is geared towards enhancing the emphasis on physical activity, nutrition, and sleep hygiene among psychiatric patients and staff. Three videos have been produced to guide psychiatric staff and patients on the significance of daily physical activity and good nutrition habits. Developed at Karolinska Institutet in Stockholm, these videos provide guidelines and recommendations for incorporating exercises of varying intensity into daily routines for 3-5 min. Engaging both psychiatric staff and patients in joint physical activities can strengthen connections, promoting shared experiences, improved communication, increased empathy, reduced hierarchy, and overall enhanced physical and mental well-being. The University of Campania in Naples has produced three videos on nutrition, specifically tailored for adolescents and young adults. They showcase dialogues that promote awareness of healthy dietary choices and include a 2-min summary offering advice on dietary habits that support mental well-being. The videos produced will be hosted on the WPA website as part of a library on healthy lifestyles, making them accessible to colleagues worldwide. These resources can be downloaded for inspiration and application in daily psychiatric practice. We also encourage members from all continents to share short videos highlighting their initiatives in promoting healthy lifestyles among psychiatric patients. This initiative aims to enhance collaboration, cultural awareness, and inclusivity among all WPA Member Societies. In 2015, the United Nations introduced the Sustainable Development Goals as a global blueprint to ensure prosperity, environmental sustainability, and peace by 2030. The WPA Action Plan 2023-2026 seeks to uplift the mental health of the global community by making significant strides in psychiatry and public mental health in the upcoming years. The Plan underscores the importance of integrating mental well-being across all fields of society, including education, clean water and sanitation, affordable and clean energy, good work environments, and reduced inequalities. The WPA is determined to gain traction and lead the way to foster a worldwide community in which mental health advancements are not just limited to medical and psychiatric contexts, but are ingrained in the very fabric of society. The Association aims to inspire other sectors for intersectional collaboration, emphasizing the pivotal role of mental health as the foundation for harmonious relations, thriving communities, improved outcomes in all our endeavours, and a brighter future for all.