Professor Andrea Winkler, Director of the CGH welcomed all the participants to the first seminar of this kind at the University of Oslo and underlined the need of prioritising mental health in the global health perspective.
Professor Ingunn Engebretsen from the Centre of International Health at the University of Bergen talked about global mental health research and services by focusing on children’s mental health. Worldwide, around 10-20 % children and adolescents experience mental disorders. Neuropsychiatric conditions are leading causes of disability in these young people, influencing their development, their potential to live fulfilling and productive lives, and carry with them a stigma. Professor Engebretsen discussed the Sustainable Development Goals and treatment gaps, and raised important questions regarding the use of instruments developed in the ‘Global North’ in assessing mental health in the ‘Global South’. She also provided a critical perspective on the WHO Mental Health Gap Action Programme (mhGPA) for children, which, she said, needs some adaptations.
Ann Færden, a senior psychiatrist at Oslo University Hospital and research coordinator at the Department of Acute Psychiatry Division of Mental Health and Addiction, gave a presentation on mental health in Malawi. She focused on the challenges of forming collaborations for improving the mental health situation in a country of 15 million people, where there is virtually not a single psychiatrist. All psychiatric services are, thus, run by nurses and non-specialist medical doctors. Currently, Malawi is one of the five top priority countries for Norwegian aid. In 2013, Malawi received 222 million NOK from Norway, which was mainly targeted to be spent on maternal and child health. Other collaborations exist between University Hospitals in Oslo and Bergen with the Kamuzu Central Hospital in Malawi in surgery. However, in mental health, despite several attempts, collaboration has not been possible and one of the reasons is that there are several external partners doing collaborative works.
Edvard Hauff, Professor of Transcultural Psychiatry at the University of Oslo spoke about his experiences of collaboration in research with South Sudan. Professor Hauff has broad experience from working and collaborating with several countries in Asia and Africa. As part of a 5-year project between 2007-2012 on capacity building in mental health in South Sudan, two community studies of mental health were conducted in the province of Bahr el Ghazal. The main collaborating partners were the University of Bahr el Ghazal and the University of Oslo. Ahfad University for Women in Sudan, Stellenbosch University in South Africa and SINTEF Health in Norway also participated in the project. Scholarships for a psychiatric resident, for PhD-, master- and bachelor students, in-service training for clinical and administrative staff and research seminars were also included. The studies revealed frequent and complex mental health problems in this severely traumatized population. He concluded by underlining the need of not only the Global North-South institutional collaboration but also South-South collaboration.
Suraj Thapa, Associate Professor at the University of Oslo and leader of the Transcultural Psychiatry Board at the Norwegian Psychiatric Association talked about the mental health situation in Nepal, which appears somewhat better than many African countries. However, considering the past history of political unrests, civil war and recent earthquakes in Nepal, there is still a huge scarcity of human resources in mental health services. He illustrated some of the ongoing collaboration between Nepal and Norway at the academic and research levels, and highlighted the opportunities for more collaboration in research, education and services.
Senior consultant psychiatrist Wolfgang Krahl from IsarAmper Clinic, Munich, Germany had an interesting presentation on developing mental health services in low-income countries with focus on Mozambique. He emphasized that mental health is one of the several neglected health areas in low- and middle- income countries, and criticized the Millenium Development Goals for not including mental health. Neglecting mental illness will be very costly in the long run, said Professor Krahl. Some recommendations from the talk included: training of health care professionals, educating public on mental health, giving care in the community, making policy and plans, training more human resources and including other partners. Professor Krahl then talked about Catholic University of Mozambique (UCM, 1996) in Beira, which was founded as a direct result of the Rome General Peace Accords in 1992. The UCM medical faculty has access to local hospital psychiatry services for training, but they are of poor quality and may have a demotivating impact on students.
Lars Lien, head of the National Centre for Substance Abuse and Mental Illness, Sanderud Hospital, Professor at the Hedmark University College and researcher at the University of Oslo, shared his experiences from his sabbatical leave visiting and working at the University of Namibia. This country has HIV/AIDS prevalence of over 13% and life expectancy of 63.6 years. Alcohol misuse is high in Namibia. Professor Lien said that he was engaged in lecturing and supervising medical, master and PhD students. He encouraged other clinicians and researchers to spend their sabbatical leave in a similar manner.