Future challenges for Mental Health

Pirkko Lahti, World Federation for Mental Health
Beirut, 9/2001

Understanding the concept "mental health" is both an acute and a future challenge. It is important to notice that mental health is not only psychiatry; it includes also economic, social, psychological, medical and environmental elements. Mental health is too often in discussions reduced to only psychiatry or mental illnesses. It is important to notice also the fact that as long as mental illness is labeling in the society, talking about this matter and being labeled as a patient are avoided as long as possible. Because of that, customers at the European and international level prefer emphasizing names, such as a person being rehabilitated, a user, a survivor etc. However, the word patient has originally included care and concern. Especially these qualities are at the moment lacking in mental health work.

The second general observation is that evidence based medicine is a fairly popular concept at the moment. Evidence based is not at all easy to prove in mental health work or mental disturbances. Mental disturbances are quite often subjective experiences and strict search for evidence is not easy. So, the only alternative left is to discuss how a subjective experience is included in evidence based medicine and how the whole concept "mental health and rehabilitation" is extended. The situation is exactly the same in rehabilitation: rehabilitation itself seldom provides clear, medically measurable evidence about improvement of a person's physical condition, whereas the person being rehabilitated may have a fairly positive subjective experience.

Thirdly I would like to emphasize that mental health is not living without problems; it is rather living from a crisis to another. Crises make people stronger, the basis of life becomes stronger and we do not need to be so sensitive to what kind of impression other people get of us and what they think of us. It is quite often wise to find - for example for counseling - people, who have had some kind of crises in their own life. Then their own understanding for people suffering from mental crises extends and makes it easier for them to understand other people.

Fourthly I would like to emphasize everyone's own personal program for coping or "surviving". In crises we often emphasize the fact that people should be able to talk, eat, take physical exercise and sleep sufficiently well - and of course to take medicine when necessary. In any case, it is essential that people have a certain program to keep them "going" and this way to maintain their hold on realities.

Coping is made easier by basic starting points relating to living, working and economic subsistence which are provided by the society and which help people to keep their balance. The second factor, which makes coping easier, is of course the support network of friends and near relatives, which at its best helps to get over a crisis. Thirdly, it is important to notice that as a child each of us learns at home certain patterns of coping. Thus, as basic capital, every parent gives his or her own children patterns of coping which often are repeated in the same way in later phases of life.

Finally I would like to emphasize that it is important that people have confidence in themselves: the ability to learn new things, to listen and to meet other people. When we are uncertain, we too easily know too much, we try to protect ourselves by attacking and we stop listening to other people. This concerns both professional and voluntary helpers. It is important to stop to listen in order to be able to know.

The World Federation for Mental Health, where I act as president at the moment, is represented in about 130 countries. We have nine regions, each of them having a vice president or a regional president. The World Federation for Mental Health works in co-operation with the United Nations, the World Health Organization WHO, Unesco and the labour organization ILO. The Federation emphasizes increasing general knowledge on mental health, improving health, preventing mental problems and receiving better services when necessary.

The World Federation for Mental Health is willing to co-operate with international organizations. For example, Rehabilitation International is an organization, which we think would profit from co-operation with us; at least we would profit from co-operating with it.