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Canada Gairdner Global Health Symposium

by Gita Jaffe


CEThe 2019 Canada Gairdner Global Health Symposium was hosted by the Gairdner Foundation, Grand Challenges Canada, SickKids Centre for Global Child Health and Centre for Addiction and Mental Health (CAMH) on October 23, 2019 in Toronto, Canada. The symposium’s theme, Community-based Health Interventions: From Global to Local highlighted speakers from around the world including: Vikram Patel (2018 Global Alliance Presidential Award Winner); Vandana Gopikumar founder of the Banyan and the Banyan Academy of Leadership in Mental Health; Vicky Stegiopoulos the Physician-in-Chief at CAMH who focusses on the development and evaluation of interventions to address the needs of people who are homeless (including mental health); Abhijit Nadkarni an addictions psychiatrist and global mental health researcher who focusses on developing and evaluating interventions for alcohol use disorders in low resource settings; Takeesha White, Founding Director of the Friendship Benches NYC, Renee Linklater the Director of Shkaabe Makwa, a program that supports First Nations, Inuit and Métis wellness at CAMH and Daisy Singla, one of the youngest winners of a study from the Patient Centred Outcome Research Institute (PCORI) focussing on scaling up evidence-based psychological treatments to enrich the lives of women and their families worldwide. The speakers identified personal pathways towards their current professional efforts.

The various research and programs discussed demonstrated approaches to tackling existing gaps in- and barriers to- behavioral health and wellbeing. Below are a few concepts that were discussed among the panelists:

  • The interface of professional identity with action (locally and abroad) and understanding the opportunity for synergies between action and academy. As barriers to success were discussed around the globe, the consistent understanding was that every country needs to address gaps in achieving wellbeing.
  • The shared goal among stakeholders interested in mental health (and arguably any issue) is critical to finding solutions and encouraging action. Despite differences in approach and opinion, the opportunity to collaborate on a shared vision (wellbeing) is central. 
  • In understanding that increasing access to behavioral health services globally must include non-specialist mental health care, emphasis on cultural context and cross-cultural relevance is required. The engagement of civil society is critical to progress. Finally, solutions are found where policy, culture, practice and academy intersect.

Get Youth and Families Involved

by Deborah Klein Walker

[Recently, Deborah Klein Walker, the Immediate Past President of the Global Alliance and a member of the Forum For Children’s Well-Being, participated in a workshop to discuss dissemination strategies for the newly released report, State of Mental, Emotional, and Behavioral Health (MEB) of Children and Youth in the United States.]


In the last ten year, the evidence-base about the influences of mental, emotional and behavioral (MEB) development has expanded greatly (see report Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda). Despite this, the United States has not fully acted on the information, which has resulted in an increasing number of children and youth with MEB challenges. Currently, 31.9% of children and youth have anxiety; 19.1% have behavioral disorders; 14.3% have depression and 11.4% have substance disorders. Suicide is the second most common cause of death for youth, ages 15 to 24 years, and the third most common for youth, ages 10-14 years.

MEBFamilies and youth must be involved in designing the dissemination strategies for their communities and states to educate the public about MEB development and the major investments needed for MEB promotion, prevention, treatment and maintenance. The leadership of organizations such as the Federation of Families for Children’s Mental Health and Family Voices must be engaged continuously to work with families and youth in designing effective strategies. Similarly, Youth MOVE National, an independent organization of youth leaders across the country, should be engaged in developing programs and policies that affect them. All of these organizations have “chapters” in most of the states that foster family and youth engagement at the local and state levels. Working together, we can create the political will and design social strategies for an agenda to improve MEB health. Unless families and youth are engaged in the process, these efforts will not be effective.

What is Needed to Promote MEB Health of Children and Youth?

by Deborah Klein Walker


 [Recently, Deborah Klein Walker, the Immediate Past President of the Global Alliance and a member of the Forum For Children’s Well-Being, participated in a workshop to discuss dissemination strategies for the newly released report, State of Mental, Emotional, and Behavioral Health (MEB) of Children and Youth in the United States.]


The promotion of mental, emotional and behavioral (MEB) health for children and youth requires action on multiple fronts in multiple sectors (e.g., education, healthcare, childcare, etc.).  No “one single bullet” will work.   Rather, it will take a sustained effort of program and policy interventions combined with public education to achieve the goals and vision laid out in the new consensus study report, entitled Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda.   According to the report, a coordinated effort will require (1) active engagement of all stakeholders, (2) a well-trained workforce, (3) engaged leadership in organizations delivering the interventions, (4) strong community coalitions and (5) a data monitoring system.   The monitoring system to track the quality and outcomes of implementation efforts, as well as barriers and facilitators to successful implementation, will be the most challenging since there currently is no MEB system that provides data at the local, state and national levels.

MEBMoreover, the recommendation to implement a public education campaign to combat stigma and promote MEB health in children and youth will require large investments of public and private dollars to develop and maintain.   As we learned in the tobacco control and prevention work in the 1990s and beyond, media campaigns are instrumental to changing attitudes and behavior, but extremely expensive to implement at the level needed to “move the needle” on public opinion.  Let’s hope we can generate the resources for a major public campaign that will create the political will to invest in promotion of MEB health for children and youth.

New NASEM Report Presents Opportunity to Improve MEB in Children and Youth

by Deborah Klein Walker


[Recently, Deborah Klein Walker, the Immediate Past President of the Global Alliance and a member of the Forum For Children’s Well-Being, participated in a workshop to discuss dissemination strategies for the newly released report, State of Mental, Emotional, and Behavioral Health (MEB) of Children and Youth in the United States.]


The Global Alliance is a sponsor of the Forum for Children’s Well-being, an activity of the Board on Children, Youth and Families of the National Academies of Sciences, Engineering and Medicine.  Last week, the Forum met to discuss dissemination strategies for the new consensus study report -- Fostering Healthy Mental, Emotional, and Behavioral Development in Children and Youth: A National Agenda. This report, which follows the 2009 consensus study (Preventing Mental, Emotional and Behavioral Disorders Among Young People) presents more evidence for programs and policies that promote mental, emotional and behavioral (MEB) development and prevent MEB disorders. It is important to note that the first consensus report (Reducing Risks of Mental Disorder) published 25 years ago in 1994 did not discuss promotion of MEB health and had very little discussion of prevention of MEB disorders. Although much still needs to be done to assure full implementation of treatment and maintenance of MEB disorders, the emerging evidence for promotion and prevention interventions is especially encouraging.

MEBThe report “urges the creation of a broad-based effort to improve MEB health for children and youth, organized under the rubric Decade of Children and Youth, led by the Department of Health and Human Services. The initiative would build awareness of the social and economic gains associated with healthy child development and engage multiple sectors of society in working toward the goal.” How can this effort be supported by individuals, families, communities, states, faith-based organizations, private businesses, and others to assure that it is successful? The time has come to invest in evidence-based solutions to improve MEB health for children and youth.

GA at the UN: Wrap-Up

by Gita Jaffe

WUAs I reflect on the process leading up to, and experience at the UN HLM and UNGA side events I feel hopeful that the progress made in NYC this past week is significant. It provides the necessary framework to act and amplify our voice. The meetings and events highlighted successes to date and presented glaring gaps that need to be addressed in order to achieve the SDGs and UHC in the years to come. The commitment is a long process, for each community and country. To be accountable the global community must move forward with tangible targets. For the Global Alliance our next steps include:

  • continuing to advocate and inform policy and research on pertinent issues UN
    surrounding the inclusion of mental health and behavioral health services as part of UHC, through channels such as written statements, policy resolutions and multi-stakeholder meetings;
  • develop and share good information about the intersection of behavioral health and social justice issues; and
  • complete an environmental scan to identify gaps in policy and research as well as potential partners engaged in global mental health advocacy and education.

This week, people from around the world shared common goals on this important stage. It was a great privilege to represent the Global Alliance in advocating for our shared values. #GA4UHC #SDGs #globalgoals


GA at the UN: Civil Society Engagement Mechanism

by Gita Jaffe

CSE

The Civil Society Engagement Mechanism for UHC 2030 (CSEM), which the Global Alliance is a member of, held an interactive session this morning titled Post-HLM Civil Society Strategy. The focus was to discuss an overview of the HLM on UHC and its outcomes from the lens of civil society and discuss next steps for action. For civil society, there were 4 key priorities leading into the HLM: (1) increase public health financing and financial protection (2) leave no one behind (3) focus on health workers (paid and unpaid) to grow the health force and (4) engage civil society and community in UHC implementation to ensure accountability.  To frame the conversation today, the achievement of consensus on the political declaration was recognized as a success, understanding that it provides a framework for post-HLM advocacy.  The language of the declaration did not regress, despite contentious issues surrounding migration and sexual rights and reproductive health. Member states all agreed to, and can be held to account for important concepts introduced and reiterated through language such as the right to health, the requirement for inclusion throughout the life course (such as promotion and prevention), recognizing the role of civil society and community and the need for meaningful partnerships. There were notable omissions in the HLM surrounding key populations and a lack of focus on specific targets for accountability, monitoring and tracking purposes (particularly needed for 2023 to assess progress). However, this platform provides a basis for which we, as civil society members will move forward. As we discussed pivotal lessons learned from past health-related HLMs we agreed that we must collectively break CSEdown siloed efforts and work together as civil society for coordinated leadership despite the varied and complex health-related priorities each organization has, ensure we collect disaggregated data for financing and accountability, and assist in developing country specific national plans with concrete targets. Although it is recognized achieving UHC is far in the distance, the fact that 'seeds have been planted' suggest the process has begun. #cspostHLM #GA4MH

GA at the UN: A Decade of Action

by Gita Jaffe
UNPathfinders hosted the evening A Decade of Action: Accelerating Action to build Peaceful, Just and Inclusive Societies which are Free from Fear and Violence, based on SDG16+ which includes SDG 16 Peace, Justice and Strong Institutions and 24 targets from seven other goals that directly measure an aspect of peace, justice, and inclusion. The evening had three themes of discussion.  The first set of presenters were distinguished political guests sharing tangible examples of actions taken in their countries since the launch of SDGs and practical next steps.  Sierra Leone’s Attorney General and Minister of Justice Priscilla Schwartz shared a significant number of accountable actions they have already taken in areas such as civil registration (identity), technology and corruption.  The second set of presenters represented examples from civil society including Ms. Jhody Polk, Founder of the Legal Empowerment and Advocacy Hub, who emphasized that access to justice is a human right, and we must ensure access for all, including to incarcerated populations.  The final theme of the evening sharedUN examples of collaboration to accelerate action on SDG16+ from private and public stakeholders. The conclusion and common understanding throughout the evening was that without peace, justice and strong institutions no SDGs can be achieved. Investment in SDG16+ must be made by all, and collectively we must accelerate data-driven innovations and people-centred approaches.

GA at the UN: Turning the Tables

by Gita Jaffe
UNTurning the Tables: Patient Perspectives on Universal Health Coverage focussed on the importance of meaningfully engaging in patient-centred care.  It was acknowledged that there is a chasm between the political declaration and what occurs in communities. The speakers each shared their personal and professional lived experience to encourage patient knowledge in developing strategies that include collecting evidence to support efforts in moving forward in programming and policy.

GA at the UN: Global Action Plan for Healthy Lives and Wellbeing

by Gita Jaffe


The Launch of the Global Action Plan for Healthy Lives and Wellbeing was introduced by the three initial champions of the strategy, German Chancellor Angela Merkel, Norwegian Prime Minister Erna Solberg and the President of Ghana Nana Akufo-Addo. Stronger Collaboration, Better Health: Global Action Plan for Healthy Lives and Well-being for All brings together 12 multilateral health, development and humanitarian agencies to better support countries to UNaccelerate progress towards the health-related SDGs. Angela Nguku, Executive Director for the White Ribbon Alliance in Kenya, spoke for Civil Society and argued that a13th partner should be recognized as the voice of all people. This meeting was strongly based on the premise that SDG 3, to ensure healthy lives and promote well-being for all at all ages, is the docking station for the SDGs. Therefore, engaging countries and communities to identify their priorities, accelerating progress, aligning support of countries and reviewing and sharing lessons to ensure accountability were the highlighted steps of action. As selected individuals shared their commitments to collaboration, the Colombian and Ugandan representatives both raised the critically importantUN issue of migrants and refugees and their health as a human right. 

GA at the UN: Children & Youth

by Gita Jaffe


The meeting, From 2011 to 2019: Global NCD Progress for Children and Youth focussed on (1) sharing global programs for NCDs (2) developing new opportunities at the global level particularly in the context of UHC and (3) to inspire young people to speak out and in support UNof NCDs. In order to 'walk the talk' they had 2 youth moderators Dr. Marie Hauerslev and Dr. George Msengi. In discussing the largest changes the NCDs community has observed, Sir George Alleyne explained (1) the shift to fundamentally listening to youth as opposed to the tokenism of inclusion previously and (2) the flow of information. Dr. Stefan Peterson, the Associate Director of the Program Division and Chief of Health for Unicef, discussed some of the current frustrations for adolescents and NCDs in the context of UHC including that collectively the community is still at the advocacy stage, partially due to the lack of mobilized resources. However, it is encouraging that Unicef has moved towards programming and have developed new guidelines on community-based mental health and psychosocial support. Her Royal Highness Princess Dina Mired focused on a transformative (and progressive) systems approach to achieve UHC, by finding efficiencies, communicating messages clearly and ensuring that 'nothing for us without us'. These concepts were supported by the panel and emphasized with action steps forward to (1) learn from shared experience, particularly through political entrepreneurs and champions and (2) link NCDs and UHC with human capital in messaging. #youthNCDs #youth4health #SDG3

UN

GA at the UN: The Overall Experience

by Gita Jaffe


I have been asked, what is it like at the meetings? My initial response is that it is a unique experience that I feel fortunate to have the opportunity to attend. Having been engaged in national and regional UN meetings in sub-Saharan Africa some time ago, I can say that the environment and energy is different here.

UNThe process has been intensive with a pre-registration and selection process for each event, multi-step ticketing pick up while in New York and security check points for any event within UNHQ. The streets are often blocked off for security, while motorcades for heads of state and other officials travel to the meetings. Among the champions of mental health the urgency is clear, there is no chance to achieve the SDG without its inclusion. Inside, and particularly at smaller-scale meetings, high level officials UNembrace speaking to champions of UHC. Together we hope to overcome the general lack of focus on behavioural health in order to influence and strengthen the inclusion of mental health and behavioural health services in UHC. #GA4UHC 

GA at the UN: Mental Health for All

by Gita Jaffe


Mental Health for All: An Evening for Action brought together leaders, distinguished guests, champions of mental health and advocates with lived experience from around the world.    James Chau, WHO Goodwill Ambassador for SDG and Health, introduced the evening acknowledging the historic event from today, as the UN welcomed the ‘most comprehensive agreement ever on global health’. Messages were consistent from speakers that included UNGA President Tijjani Muhammad-Bande, Queen Mathilde of Belgium (a trained psychologist and UNSDG advocate) and WHO Director General Dr. Tedros, that mental health is the least talked about issue, yet presents some of the largest barriers to achieving the SDG, and that the time to invest must be now.  However, it was in a passionate speech by Amina J. Mohammed, the Deputy Secretary General of the UN, that clearly articulated one of the greatest challenges to achieving UHC, that even on this platform of the UNHLM, ‘not up to 5 ministers put mental health in their speech’.  Despite this sobering statement, the launch of Speak Your Mind a new global civil society campaign, organized by United for Global Mental Health was supported with hope and excitement, as they call on everyone to take 40 seconds to raise your voice with an aim of catalyzing action. #40seconds #speakyourmind

mh4 mh4
Amina Mohammed Jazz Thornton from Voices
of Hope (New Zealand) and
Victor Hugo  (Nigeria)
organizations  leading the
Speak your Mind Teams
and campaigns

GA at the UN:UHC

by Evelyn Tomaszewski


 The Global Alliance for Behavioral Health and Social Justice applauds Secretary Azar (U.S. Health and Human Services) for recognizing – during a presentation at today’s UN High Level Meeting on Universal Health Care - that access to primary care is critical (part of universal health care), and that primary care must be integrated into and with behavioral health services, including the use of community health workers.     As stressed in the Global Alliance’s statement submitted during the UN HLM – UHC Interactive Hearing, the integrative and accessible programs and services must include resources for trained, supported (including supervision) and resourced behavioral health providers in the overall planning for human resources for health.  To read the Global Alliance letter to UN member states, click here.

GA at the UN: Day 1

by Gita Jaffe


In preparation for the United Nations High Level Meeting on Universal Health Care (UN HLM-UHC), I had the UNopportunity to attend a side-event on behalf of the Global Alliance for Behavioral Health and Social Justice: "A World at Risk: Accelerating Global Preparedness for Health Emergencies”.  The Global Preparedness Monitoring Board (which is co-convened by the WHO and the World Bank Group) released a ‘how to’ guide with clearly described recommendations of actions that leaders ought to take in order to better prepare the world for health emergencies, as serious gaps persist. The report can be downloaded here. The panelists all agreed that in regard to disaster preparedness, ‘no one is safe, until everyone is safe’, comprehensive community involvement is necessary (particularly for building trust) and that preparedness cannot be siloed, particularly in regard to UNUHC and the SDGs.  Ms. Kitty van der Heijden, the Vice Minister for Foreign Trade and Development, Netherlands stressed the importance of including mental health and psychosocial support within health emergencies and mentioned an upcoming conference the International Conference on Mental Health and Psychosocial Support in Crisis Situations in October. 

GA at the UN: Modern Slavery

by Gita Jaffe 



UN
The Freedom Fund and Walk Free hosted the session Unlocking What Works to End Modern Slavery.  Releasing their Evidence in Practice report Unlocking what works: How Community-Based Interventions are Ending Bonded Labour in India.  The premise of the discussion was to convene and collaborate ideas, particularly focusing on promising practice. Acknowledging the shared theoretical values that drive efforts to end modern slavery, three guiding principles were outlined: (1) to concentrate resources, (2) to organize for collective action (social movements) and (3) to commit for the long-term.   Co-Founder of Walk Free, Grace Forrest, referenced the Global Slavery Index for new data and emphasized the importance that all stakeholders (including but not limited to individuals, CEO's and elected officials) have in ending modern slavery.