Maailman terveysjärjestön paneelikeskustelu mielenterveydestä: pysyvän edustajan sijaisen Janne Taalaksen puhe New Yorkissa 16.9.2010
Ladies and Gentlemen,
I welcome this occasion to discuss the opportunities and challenges experienced by bilateral development agencies in integrating mental health into the development agenda.
Mental health is both a contributor and consequence of poverty and inequality. It should therefore be part of the core business of bilateral development agencies. Disappointingly, the prevailing global attitude towards mental health issues in development has been one of exclusion rather than inclusion and reform. This is a serious problem.
Finland has aimed at addressing this for several decades by integrating mental health considerations into its development agenda. The promotion of the rights of vulnerable groups remains one of the cornerstones of Finland's development policy.
On the basis of our long experience, I would like to mention three themes in which the work of bilateral development agencies can include and benefit persons with mental disabilities. These are 1) mental health in emergency situations, 2) mainstreaming mental health, and 3) advocacy.
Firstly: emergency situations. Development agencies are routinely involved in post-emergency relief and reconstruction. Mental health issues are central to this work, not only in terms of psychosocial recovery, but also in terms of developing long-term mental health policies and systems.
Let me give you an example from Finland's experience. Following the short term mental health and social support following the 2004 tsunami, the Sri Lankan government initiated a longer-term policy-development process for mental health. Finland worked with the Sri Lankan Ministry of Health, the World Health Organization and other bilateral and multilateral partners. We provided funding for and assistance in the reconfiguration of mental health services. The aim was to ensure that care would be locally available in all districts of the country.
This involved establishing or strengthening the acute inpatient facility in each district as well as creating outpatient clinics to reach more people in more places. Finland also supported the training of multidisciplinary mental health workers.
The policy has had a beneficial effect, allowing people to maintain employment and participate in civic life. The Sri Lankan experience shows how development agencies can play a significant role in mitigating the vulnerability of persons with mental disabilities. Failure to address this may have serious adverse effects.
The second theme I want to highlight is the importance of mainstreaming mental health. Among Finland’s experiences, a successful example is been our partnership with Egypt. Finland worked closely with the Egyptian Ministry of Health from 2002 to 2007. The partnership led to the integration of mental health into primary care, strengthening of the referral system, facilitation of evidence-based training and professional development in mental health. For the first time in Egypt, public education campaigns on mental health were run. The outcomes were also set in the context of legislative reform and policy development, guided by WHO.
The Egyptian Ministry of Health continued to run this programme after 2007. A firm and sustainable infrastructure had been established through our bilateral partnership and Finland and Egypt continue to cooperate on mental health issues.
Even though we’ve had successes, there is clearly a need to expand the scope of mainstreaming. We recognise that mental health issues need to be better integrated into our development programmes more generally.
Finally, I want to draw your attention to advocacy. We in the community of international development agencies have an influential voice in advocacy. We can encourage our partner countries to adopt policies and plans that include mental health considerations. We must also ensure that the needs of people with mental health conditions are no longer ignored when planning programmes and allocating resources.
We can also advocate for the promotion of mental health. Health promotion is an effective strategy to improve the quality of life and reduce inequities and poverty. We need programmes and agendas that attach importance to psychological well-being in development outcomes.
Effective advocacy will only be achieved by working closely with persons with mental disabilities. As the UN Convention on the Rights of Persons with Disabilities obliges us, international cooperation must be inclusive of and accessible to persons with disabilities.
In conclusion, I want to stress that the 'failure to notice' must end. The exclusion and disempowerment of people with mental health needs in a development context must be put behind us. Bilateral development agencies have a crucial role in targeting these people as a vulnerable group.
I believe that Finland's health in all policies framework and our focus on addressing vulnerability through development has been valuable in framing our work. We must continue to build on our commitment to these principles in our advocacy, planning and implementation work.
We need all embrace new opportunities to reach a vulnerable and often voiceless group of people through targeted development. In doing so, we can also increase the effectiveness of rights-based development efforts. WHO's Mental Health and Development Report, launched today, provides us with concrete tools and strategies for commonly addressing this world-wide problem and giving mental health the recognition and investment it deserves in the international development agenda.