Declaration

7-8 October 2016
Moscow, Russia

 

We, the Congress participants, recall that the promotion of mental health and wellbeing is included in the 2030 Agenda for Sustainable Development, as a target and also in the vision, adopted by the government member states of the United Nations in September 2015. We also recall that the protection of people's mental health in the world today is one of the main fields of activity of the World Health Organization (WHO). The WHO Constitution states: "Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity." An important consequence of this definition is the fact that mental health is considered in a positive light and can no longer be considered only as the absence of mental disorders and related disabilities. Mental health is a state of well-being in which the individual realizes his or her abilities, opposes everyday life stresses, works productively and contributes to his or her community. The WHO Constitution states: “Mental health is crucial for our collective and individual ability to think freely, show emotions, communicate with each other, earn a livelihood and enjoy life”. With this in mind, mental health acquires the status of a spiritual value, and its strengthening, protection and restoration are perceived by individuals, communities and commonwealths throughout the world as actions of vital importance.


In our approach to mental health problems, we rely on the relevant resolutions of the World Health Assembly, the WHO Executive Board, the WHO European Regional Committee and the European Union Council. We express our direct commitment to the Athens Declaration on Mental Health and Man-Made Disasters, Stigma and Community Care, Resolution EUR / RC53 / R4, adopted by the WHO European Regional Committee in September 2003; to the European Declaration on Mental Health (Helsinki, Finland, January 12th-15th, 2005), the Minsk Declaration of the WHO international conference “Life-course Approach in the Context of Health-2020” (Minsk, Belarus, October 21st-22nd, 2015). We acknowledge that mental health and mental well-being are the most important prerequisites for a good quality of life and productivity of individuals, their families, local communities and nations as a whole. In this regard, the primary aim of the efforts on mental health protection is to provide a higher level of well-being and daily functioning of people relying on their personal resources and the increase in their resistance to external negative influences, as well as improving and strengthening protective external factors or environmental factors. Further, this goal applies throughout the entire life cycle.


We note that, despite the priority of mental health promotion, prevention of mental disorders, treatment and rehabilitation of persons with mental health problems and care for them, as affirmed by WHO and its Member States, the burden of mental disorders continues to grow and have a noticeable impact on health care systems around the world. This burden is evidenced by recent data. It entails serious consequences for the social sphere, including on human rights and on the economy. The most significant disorders in social terms include depression of various etiologies, bipolar affective disorder, various addictions, schizophrenia, dementia and mental development disorders, including autism spectrum disorders. The number of people who suffer amounts to tens and even hundreds of millions, with the total number of the mentally challenged persons in the world estimated to be up to half a billion. Besides the significant social and economic burden on society caused by mental disorders, the risk for physical ill health is increased.


Unfortunately, health systems of various countries still fail to adequately respond to the urgent and extreme situation. As a result, throughout the world there is a large gap between the need for appropriate treatment and the provision of needed support and services. In low- and middle-income countries, up to 85 percent of patients with mental disorders receive no treatment; in high-income countries, from 35 percent to 50 percent of mentally ill people find themselves in such a situation. Given these data, in 2008, a comprehensive WHO Program of Action was launched to eliminate gaps in the field of mental health, asserting that mental health plays an essential role in providing the best overall health for everyone. The goal of the WHO Action Plan is to improve the mental health of the population in the years 2013-2020, approved by the World Health Assembly in 2013.


We acknowledge that classical individualized one-to-one therapy is not currently the ultimate goal of psychosocial, psychological, and psychiatric care for persons with mental and psychosomatic disorders, but rather, psychosocial rehabilitation and social adaptation. Modern public mental health care systems are increasingly associated with deinstitutionalization and "reliance on the community." These changes are due to the rapid development of biological sciences and neurosciences, psychotherapy and psychology and a number of related disciplines, and also to the rapid development of society and the obvious growth of humanitarian requests.


We emphasize the continuing severity of problems associated with the stigma of persons with mental disorders, professionals working with them, and the disciplines of psychology and psychiatry in general. In this regard, we welcome any valid effort, including on the part of the media, aimed at de-stigmatization of these persons and professions. We also realize that antipsychiatry sentiments arising in virtually every culture and having a negative impact on all kinds of psychosocial and psychiatric care, are deeply rooted both in the history of psychiatry itself and in social history. Thus, their resolution requires an equally in-depth analysis on the basis of equitable sharing of responsibility between psychiatry as an integral sphere of public life and society as a whole.


We agree that professional activity is an important sphere of human life, and professional identity almost universally serves as the basis of personal identity, defining the hierarchy of needs and spiritual meanings of each individual and the entire society. Professional status of the individual and the level of professional competence and performance, heavily influence self-esteem and one’s subjective evaluation of the social significance. In this regard, we consider two essentially interrelated problems, namely, (1) lack of employment and decent work, for persons with mental disorders, and (2) mental health challenges in the workplace. The first problem, unemployment, negatively impacts quality of life and determines the highest level of social adaptation that can be attained by persons suffering from mental disorders in the process of rehabilitation. The second problem underscores the need for programs of primary prevention of mental disorders to be made available for professionally employed and originally mentally healthy people. In one approach in the work site, what is called a “workstation” brings together mentally ill and mentally healthy people. In addition, the prevention of mental disorders in the workplace and the psychosocial rehabilitation of persons suffering from mental disorders, requires multidisciplinary and inter-agency cooperation and collaboration, engagement of a wide range of both mental health professionals and specialists from other fields of knowledge and practice, participation of business, non-profit and voluntary organizations, representatives of culture and sports, all sectors of society and government.


FIELD OF APPLICATION

 

  • We believe that the solution to the problems related to mental health protection in modern society today should be based on a systems approach with interdisciplinary, inter-institutional and inter-sectoral collaboration and cooperation.
  • The efforts of professionals alone - psychiatrists, psychotherapists, psychologists, counselors, mental health nurses - are clearly insufficient and fail to meet the growing demands of the population for quality care and solutions to the problems of mental health treatment. Training and supplemental staff must be provided. However, these professionals should be more active when solving these problems directly related to their professional competence.
  • Addressing the issues of public mental health requires the involvement of the widest public and community resources; this entails, above all, the private sector consisting of corporations, business entities and others; public-and-private partnership; non-profit organizations (NPOs), non-governmental organizations (NGOs) and other civil society groups; educational institutions; the rapidly expanding volunteer movement; and other stakeholders
  • The media can and should play a major role in the protection and promotion of people's mental health and wellbeing, by informing and educating the population, and by communicating positive messages from policy set by the state and by professional groups in the field of mental health.
  • In light of currently developing trends in the field of mental health, as well as the spiritual and valuable aspects of this concept and practice, active participation of people of culture and sports in the discussion and resolution of relevant issues regarding mental health and wellbeing is necessary, constructive, and promising.

 

OUR PRIORITY TASKS


Taking into consideration the above, we believe that our priority tasks should be as follows, to:

 

  • promote the widest possible dialogue on mental health protection among all stakeholders, organizations and communities, both professional and non-professional;
  • promote awareness and understanding of the importance of mental health and well-being in all sections of the population and society;
  • develop and implement comprehensive treatment-and-rehabilitation and prevention programs aimed at the recovery of the mental health of individuals - throughout the entire life cycle - and of the population as a whole,
  • ensure a structure of efficient, effective and evidence-based mental health systems integrated into primary health care that rely on the resources of state and public organizations, professional and other communities;
  • provide resources for the needs for a competent workforce, capable of effective work in the field of mental health;
  • contribute to the development of the volunteer movement in the field of mental health, provided with adequate training, to provide added human capital to mental health care;
  • use the experience of users of mental health services and their caregivers as a basis for planning and development of such services;
  • carry out joint efforts to fight stigma, discrimination, marginalization and social exclusion of persons with mental disorders and their families, including countering attitudes against any form of treatment that hinder the integration of such services in the protection of mental health and society as a whole;
  • contribute to the development of inclusive education and sports for all persons with mental conditions, including autism spectrum disorders and other forms of mental and developmental disabilities - throughout the entire life cycle;
  • develop programs of primary prevention of mental disorders in the workplace and promote the effective solution of employment issues of persons with mental disorders;
  • promote the development of art therapeutic communities, clubs, theaters and other studios, engaging the society-enriching creative activity of people with mental disorders, and thereby contributing to their social adaptation.
  • advocate for policy supportive of mental health services, and respect for those with mental health challenges, from government and all other relevant agencies and organizations 
  • encourage increased funding for mental health services, including from government and private sector sources. 

 

OUR ACTION


We support the statement that mental health is an essential component of the human, social and economic potential of nations; and therefore, mental health protection and promotion should be regarded as a necessary component of social policy in various areas of society, including the protection of human rights, social security, education, professional practice and creativity. In this context, we affirm the need to do the following:

 

  • adhere to the interdisciplinary, cross-sectoral system and cluster approaches to the organization of mental health protection services, as well as to research and practical implementation of the results from various fields of knowledge associated with the subject of mental health and wellbeing;
  • consider the mental health of each individual continuously throughout the life cycle, while respecting individual mental development at different ages, e.g., from childhood, adolescent, and youth, through to maturity, and again, in different statuses of intellectual and developmental abilities, and in different cultures and contexts;
  • continue to concentrate efforts on combating socially significant mental illness, depression and bipolar affective disorder, chemical and non-chemical addictions, schizophrenia, dementia, as well as impaired mental development, including the development of comprehensive measures aimed at the prevention of these disorders and their development into serious stages, e.g., suicide or accompanying diseases and physical illnesses;
  • support the development of a preventive field in the system of public mental health, focusing on the one hand, on the issues of primary prevention of mental disorders and, on the other hand, on issues of psychosocial rehabilitation of persons with mental disorders, psychosomatic diseases and other general health problems;
  •  maintain active interaction with users of mental health services, their families and persons engaged in their care, as well as a variety of their associations;
  • carry out extensive cooperation with government and business entities for the employment of persons with mental disorders and the preservation of mental health in the workplace;
  • cooperate with people of culture, representatives of religious denominations, non-profit and volunteer organizations on psychosocial and creative rehabilitation of persons suffering from mental disorders;
  • cooperate with sports entities to maximize the benefits of this discipline is positive mental health and wellbeing;
  • cooperate with media in order to fully inform the public, in a timely fashion, about events taking place in the field of mental health; raise public awareness on various issues related to mental health; and create a positive attitude on the part of individuals and the population as a whole towards relevant professional agencies and communities;
  • develop international cooperation to identify and resolve pressing problems in the field of mental health and exchange best practices between the relevant national and supranational organizations and services.
  • advocate with local, national and international delegates and entities to further the above-outlined agenda;
  • conduct regular meetings including the II Congress on Mental Health: Meeting the Needs of the XXI Century (19-21 October 2018, Moscow, Russia) and the III Congress on Mental Health: Meeting the Needs of the XXI Century in partnership with the IX World Congress for Psychotherapy (26-29 June 2020, Moscow, Russia) to follow the above-outline Action Plan.

 

OUR COMMITMENT


We, the Congress participants, in our further actions, commit to:

 

  • base actions on the principle of the priority of conserving mental health, and a good quality and healthy way of life for ourselves, families, partners, communities, customers and patients when performing our professional duties;
  • abide by the principles of informed consent, freedom of choice and respect for individual rights in the provision of services to users of mental health services;
  • continuously carry out extensive cooperation with international, state, local, commercial and public, including volunteer, organizations for the protection of mental health of individuals and the population as a whole on a single goal-oriented and organizational platform;
  • develop innovative approaches to the diagnosis, treatment, prevention and rehabilitation of mental disorders, throughout the entire life cycle of each individual;
  • promote the employment of persons with mental disorders, their wider access to and inclusion in education, art and sports;
  • promote mental health improvement in educational institutions, the workplace, local communities and other relevant settings and locations by increasing collaboration between organizations and agencies responsible for health care, mental health and other sectors of the economy and society as a whole;
  • facilitate the elimination of stigma, marginalization, and discrimination, and strengthen the social integration, of persons suffering from mental disorders or facing corresponding risks, by enhancing their rights and opportunities, as well as raising awareness on mental health protection;
  • oppose the development of anti-psychiatric attitudes in society by raising public awareness about mental health care and include use of the media to promote potential, permanent active positive interaction with users of mental health services, their families and persons engaged in their care, as well as a variety of their associations.