Presentation on theme: "World Federation for Mental Health Conference October 29, 2007"— Presentation transcript:
1 PREVENTION of PSYCHOLOGICAL DISTRESS and PROMOTION of WELL-BEING: A GLOBAL PERSPECTIVE World Federation for Mental Health ConferenceOctober 29, 2007John L. Romano, Ph.D.University of Minnesota
2 QUESTIONWhat are the major social issues that impact the mental health and well-being of people in your country or region of the world?
3 QUESTIONWhat is done to prevent or reduce the incidence of psychological, physical, and social distress in your country or region of the world?
4 QUESTIONHow might psychology and mental health professions work to promote the emotional, physical, and social well-being of people?
5 World Health Organization Defines Health as “ World Health Organization Defines Health as “. . . a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity” endorsed by WHO’s 191 member states
6 WHO Defines Mental Health State of Well-Being: Cope with normal stressors, work productively, and contribute to communityMental Health Promotion: Strategies that have a positive effect on mental health, including improvements in socio-economic environments
7 Mental Health Promotion Mental Health Promotion requires multi-sector action including government and non-government agencies/services (e.g. faith communities, schools) working in partnership
9 Global Mental HealthMental health problems increasing and dramatically adding to the global burden of disease and disability world wideMental disorders account for about 14% (2007) of global burden of disease: depression, alcohol/drug abuse, psychosesMany mental health disorders go untreated due to stigma and lack of understandingMiddle and low-income countries devote less than 1% of health expenditures to mental health
11 Groups at risk include children and adolescents, elderly, displaced persons, abused women, indigenous personsWorld has realized dramatic improvements in physical health, but only limited improvement in mental health
12 Noncommunicable Diseases (NCD) Rapid rise of NCD, e. g. heart disease, cancer, diabetes, strokeIn 1998 NCD contributed to about 60% of deaths and 43% of global burden of disease. By 2020 estimates are 73% and 60% (respectively)
13 Cancer, cardiovascular disease, diabetes, and pulmonary disease related to life style behaviors: tobacco use, poor nutrition, physical inactivityMuch is known about the prevention of NCDDepression + NCD Reduces Overall Health
14 Health Japan 21To Promote Healthier Citizens, e.g. reduce smoking, improve nutritionSmoking rates: Males-53% (1997) to 43% (2002), Females-steady 10-12%Raise Awareness of Health/Tobacco LinkSupport Smoking Cessation Programs
15 Other ExamplesScotland: Raise awareness of mental illness and promote mental health. Reduce stigma.Finland: Promoting children’s mental health. Promoting parent/child interaction. Early identification of risk factors.United States: Healthy People Increase quality and years of healthy life and reduce health disparities
16 Mental Health Resources in the World WHO reports (2001) 32% countries reported no government budget for mental healthOf countries with a budget, 36% spent less than 1% of total health budget on mental healthPercentage of total health budget on mental health from less than 2% (low income countries) to 7% (high income)
17 National mental health policies and budgets need to address broad issues affecting the mental health of all sectors of society(e. g. refugees, socially alienated, poor, elderly, children)
18 Mental Health and the Elderly Increase number of elderly in the world (by 2025, 1.2 billion elderly, and nearly 75% in developing world)WHO's global movement on active agingActive, healthy older person as a community and economic resource
21 Prevention Gordon (1987) and Institute of Medicine (1994) Universal SelectedIndicated
22 Prevention Romano and Hage (2000) Stops Problem from Occurring Delays Onset of ProblemReduces Impact of Existing ProblemPromotes Emotional and Physical Well-BeingSupports Institutional and Community Policies that Promote Well-Being
23 Social, Environmental, and Economic Determinants of Mental Health Risk Factors: Drugs/alcohol, lack of education, poor nutrition, poverty, racial injustice, violence/delinquency, war, work stress, unemploymentProtective Factors: Social participation, social services, ethnic minority integration, social networks__________WHO: Prevention of Mental Disorders, Geneva.
27 Schools Start early Involve parents and community Age appropriate Repeat oftenComprehensiveSystemic improvements
28 Student Well-BeingDevelopment of knowledge, skills, behaviors, and attitudes that maximize students' functioning in settings where they live and workPromote personal development through (a) knowledge, (b) skills, (c)behaviors, (d) attitudesDomains of academic, inter-and intra-personal, and physical and emotional healthIn school, home, communityJ. L. Romano (1999)
29 WHO’s child friendly schools' initiative to promote positive psychosocial environment in school (e. g. cooperation, tolerance, support, family/school connections)
30 Work Life and Employment Some countries 35-45% of employee absenteeism due to mental health problemsIncrease employer awareness ofmental health issuesPsychosocial climate in work placeSocial skills trainingCounselingUnemployment (especially of youth)
31 Prevention Project What is the Need Who and What is the Focus Identify StakeholdersStakeholders meet to planConduct Needs AssessmentWhat is Being Prevented and Promoted
32 Prevention Project Project Goals Project Activities Who will Implement the ProjectWho are the RecipientsDeliver the Project InterventionEvaluate the interventionReport back to StakeholdersPlan Future Projects
33 Prevention Best Practices Prevent Human Suffering throughProactive InterventionsPrevention for Individual and Systemic ChangeReduce Risks & Promote StrengthsEngage in Political and Social Advocacy___________Hage, Romano, Conyne, Kenny, Matthews, Schwartz, Waldo: Best PracticeGuidelines on Prevention Practice, Research, Training, and Social Advocacy forPsychologists (The Counseling Psychologist, 2007)
34 Best Practices Culturally Relevant Prevention Practices Ethical Issues in PreventionPrevention Addresses Individual as well as Systemic FactorsPrevention Based on Theory and ResearchDevelop Prevention Competencies
35 Future ChallengesTensions between Professional Training and MarketplaceStudent ExpectationsTraining Program AdjustmentsMultidisciplinary CollaborationsResearch and Funding
36 Future HopesBring Prevention perspectives, concepts, skills into the mainstream of psychology, mental health and human developmentPromote the importance of multidisciplinary partnerships to impact societal problemsFocus on strengths and protective factorsGreater attention to political, institutional and systemic barriers to the promotion of mental health in all environments