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The United Nations' draft Sustainable Development Goals (SDGs) only briefly mention mental health. In the context of a growing burden of disease due to mental disorders and psychosocial disabilities, the inclusion of a clear mental health target and indicators in the SDGs will acknowledge the needs and rights of hundreds of millions of people. It will mobilise international funding and policy development, and support other SDGs; it will also strengthen mental health structures, governance and services in low- and middle-income countries. We argue that for a just, sustainable and inclusive post-2015 development agenda, it is vital that the United Nations includes a clear mental health target and indicators in the SDGs.
Thematic papers: International partnerships in psychiatry
Regular appraisal and revalidation are now a routine part of professional life for doctors in the UK. For British-trained psychiatrists working abroad (in either development/humanitarian or academic fields) this is a cause of insecurity, as most of the processes of revalidation are tailored to those working in the standard structures of the National Health Service. This article explores the degree to which a peer group for psychiatrists working abroad has achieved its aim of helping its members to fulfil their revalidation requirements. It gives recommendations for how those considering work abroad can maximise their chances of remaining recognised under the revalidation system.
In this paper we describe the mutual benefits of the bi-directional flows of knowledge and skills from North–South/South–North linkages, on the basis of our personal experiences of clinical and research collaborations between the UK and South Asia.
The International Health Partnership (‘the Link’) between the East London NHS Foundation Trust and Butabika Hospital in Uganda was set up in 2005. It has facilitated staff exchanges and set up many workstreams (e.g. in child and adolescent psychiatry, nursing and psychology) and projects (e.g. a peer support worker project and a violence reduction programme). The Link has been collaborative and mutually beneficial. The authors describe benefits and challenges at individual and organisational levels. Notably, the Link has achieved a commitment to service user involvement and an increasingly central involvement of the Ugandan diaspora working in mental health in the UK.
There is no national mental health law in Germany: the 16 German states are responsible for legislation concerning forced admissions, while the German Civil Code covers non-acute care, in particular for those not able to care for themselves. In forensic psychiatry, both federal and state laws apply. This article describes this situation and provides figures about detentions and other aspects of mental health law in Germany.
The article describes the changes that have taken place in the mental healthcare system in Russia since a new mental health law came into force. The focus is on involuntary hospitalisation and the guarantee of patients' rights.
We studied the rate of participation of psychiatric nurses in mental healthcare in Kenya. A simple questionnaire was delivered to 50 nurses attending a mental health meeting of the National Nursing Alliance of Kenya in April 2012. Of the 40 nurses with psychiatric nursing qualifications, 19 worked specifically as psychiatric nurses; among those employed as general nurses, half their case-loads were mental health patients. Ten per cent of psychiatric nurses had run a private clinic (75% of them general clinics) and 15% were doing private locum work alongside salaried employment. Kenya would need to increase the number of psychiatric nurses 20-fold in order to achieve an internationally recommended ratio (for low-income countries) of 12 psychiatric nurses per 100 000. It appears psychiatric nurses are migrating internally to nursing positions in other areas of healthcare, aggravating the ‘brain drain’ in mental health.
This article describes the rationale and principles for the SUNDAR approach adopted by Sangath, an Indian non-governmental organisation: to use lay people, with appropriate training and supervision, to deliver psychosocial interventions for a range of mental health conditions. This approach has been evaluated in a number of randomised controlled trials and is now being scaled up. At the core of this innovation is revisiting the questions of what constitutes mental healthcare, who provides mental healthcare and where mental healthcare is provided. In doing so, SUNDAR offers a vision for a mental healthcare system which is empowering, inclusive, equitable and effective.