minas nimh leadership and capacity building 2011.03.24

Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011

1 | Collaborating Centre

CIMH

Leadership Training and Mental Health System Capacity Building

Harry Minas Director, Centre for International Mental Health Melbourne School of Population Health Presented at “Building Research Capacity and Collaboration in Global Mental Health” NIMH, Bethesda, Maryland, 24-25 March 2011



CIMH

Mental Health systems in low and middle-income countries

Context and ‘Governance’ Poorly developed and disconnected system elements

Outputs and outcomes

Governments, educators, researchers   Low capacity in policy development and implementation (services, training, research)   MH is a low priority - weak drive for MH system development Population   Low ‘mental health literacy’   Low demand for mental health services

  Weak investment. Shortage of everything – skilled workers, facilities, drugs, etc.   Undeveloped information systems to support planning   Geographic maldistribution of available workforce   Disciplinary imbalance: doctor and nurse dominated   Hospital-centred   Poorly organised and marginalised consumers, carers, civil society

  Narrow population coverage   Very wide gap between best and worst MH services   Low access (geographic, economic, linguistic, cultural)   Stigma, discrimination, social exclusion   Mental health training is unattractive for most disciplines   Inadequate protection of rights   Lack of locally relevant evidence for policy and practice



CIMH

CIMH approach to Mental health System Capacity Building

Mental Health System Capacity Building •  Governance •  Legislation •  Policy •  Financing •  Workforce •  MH system design •  Advocacy •  Human Rights •  Research •  Communication

Leadership

Knowledge Exchange

Research

Education •  Collaboration •  Partnerships



CIMH

Leadership Training

  There is no sustained development without effective leadership

  Leadership perspectives and skills are best taught alongside teaching on mental health system development / capacity building

  Effective leadership is learned by doing, with continuing support and mentoring

  Collaborative programs of activity (in policy development, service design and implementation, research - particularly mental health system research, education and training, and consumer, carer and civil society engagement) are the most effective way to develop effective leadership skills.

  Leadership training without sustained and productive engagement is probably of doubtful value



CIMH

International Mental Health Leadership Program

  Commenced in 2001   Initiative of CIMH and Department of Social

Medicine, Harvard Medical School   Sustained input from London School of Hygiene

and Tropical Medicine, University of Queensland and University of Sydney

  Intended to contribute to leadership for mental health system development, primarily in low and middle-income and post-conflict countries

  >140 graduates from 18 countries

  iMHLP alumni are our key collaborators in:   research and mental health system

development programs in Asia and   the establishment of the International

Observatory on Mental Health Systems

TEACHING AND LEARNING

COLLABORATIVE ACTION

KNOWLEDGE EXCHANGE

OUTCOMES



CIMH


Week 1 Week 2 Week 3 Week 4 Mental Health Legislation, Policy and Financing

Human Resources for Mental Health

Mental Health Advocacy and Human Rights

Mental Health System Design

Leadership for Mental Health System Development: Theory and skills Mental health project development

  Held in Melbourne annually   iMHLP 2011: 5-30 September

  International faculty (changes from year to year)   Usually about 15 participants from several countries   Most participants are active in a collaborative MHS development

project with CIMH



CIMH


INDONESIA   Largest number of alumni   Most extensive program of collaboration   Active program of mental health system

development   National Taskforce on Mental Health System

Development in Indonesia   Leadership for Mental Health System

Development In Indonesia training program   New Indonesian Association for Mental

Health (Consumer and carer association)   Active mental health and human rights

program of activity (esp. in Aceh)

  Most of those who are leading MH system development programs in Indonesia are iMHLP alumni

  Leadership training produces results



KNOWLEDGE EXCHANGE

OUTCOMES

iMHLP alumni 2001-2010



CIMH


  Education programs following on from iMHLP   Master of International Mental Health, University of Melbourne   Other leadership training programs

  International focus: In-country programs   Leadership for Mental Health, Goa, India   Leadership for Mental Health System Development in Indonesia,

Jakarta, Indonesia   Leadership and Advocacy Training Program,

Ibadan, Nigeria   Leadership for Mental Health System Development in Vietnam

  Australian focus   Australian Mental Health Leadership Program   Leadership and Management Workshop for Advanced Psychiatry Trainees



KNOWLEDGE EXCHANGE

OUTCOMES



CIMH

Leadership for Mental Health Goa, India

  Course Director, Vikram Patel

  Collaborators   Sangath (Mental Health NGO Goa)   London School of Hygiene and Tropical

Medicine   SCARF (Schizophrenia Research

Foundation, Chennai)   CIMH, University of Melbourne

  2-week program in Goa

  Participants from developing and developed countries



CIMH

Leadership for Mental Health System Development in Indonesia

  Course Directors: Harry Minas, Vita Diatri

  2-week seminar, Jakarta, March 2009

  Partners: National Taskforce on Mental Health System Development, CIMH, MoH, WHO, Universitas Indonesia

  Funded by AusAID, CBM

  30 participants from 8 provinces, all MH disciplines, and Indonesian Human Rights Commission

  15 projects will be completed by the end of 2009, supervision by program faculty:

  Research, medical school curriculum, and service development projects



CIMH

MH Leadership and Advocacy Training Ibadan, Nigeria

  Course Director, Oye Gureje

  Collaborators   Department of Psychiatry, College

of Medicine, Ibadan   CIMH   CBM

  2 week program in Ibadan

  30 participants each year from Nigeria, Sierra Leone, Ghana, Gambia

  Funding from AusAID



CIMH

Leadership for Mental Health System Development in Vietnam

  Course Directors: Tran Huong (HMU), Ritz Kakuma (CIMH)

  2-week seminar, Da Nang, 2011

  Partners: National Taskforce on Mental Health System Development in Vietnam, CIMH, Hanoi Medical University, MoH, WHO

  Funded by Atlantic Philanthropies

  30 participants per year from all parts of Vietnam

Leadership for Mental Health System Development in Vietnam



CIMH

Australian Mental Health Leadership Program Melbourne, Sydney, Brisbane, Geelong

  Program Director: Harry Minas   Commenced in 2005   Four 3-day seminars, over 6

months, and completion seminar   Collaborators

  CIMH, University of Melbourne   Deakin University, Geelong   University of Sydney   University of Queensland   University of the Sunshine Coast

  Focus: Australian mental health system reform



CIMH


  Collaborative action   Mental health system

development and research projects in Indonesia, Malaysia, Sri Lanka, Vietnam, ….

  International Observatory on Mental Health Systems will be the main platform for collaborative research and development action

  Focus on Asia and the Pacific   Expansion to Central and

Southeast Europe



KNOWLEDGE EXCHANGE

OUTCOMES



CIMH


  Information dissemination

  Commenced publication in 2007

  Distinguished International Advisory Board

  Peer reviewed, open access

  Authors from Africa, Asia, Australia, Europe, Middle East, North and South America

  www.ijmhs.com



KNOWLEDGE EXCHANGE

OUTCOMES



CIMH

International Mental Health Leadership Program TEACHING AND

LEARNING COLLABORATIVE ACTION

KNOWLEDGE EXCHANGE

OUTCOMES

  7th International Mental Health System Development Conference “Mental Health in Sri Lanka” Melbourne, October 2010

  Review of progress, planning of Mental Health for the North project

  Previous conferences held in Beijing, Hong Kong, Thailand, etc.



CIMH

Mental health System Capacity Building Mental Health for the South: Sri Lanka

Mental Health Southern Province Sri Lanka

2005: No mental health service except inpatient unit in Galle city. There is now a functioning community-focused mental health service with good population coverage in all three districts

CSOs MOMHs Diploma in Psychiatry Community Mental Health Nurses

New NIMH Colombo Child mental health project Suicide prevention project

Impact of CSOs project Services information system

7th International Mental Health System Development Conference: Mental Health in Sri Lanka (Melbourne Oct 2010) Sri Lanka College of Psychiatrists conference, March 2011 Journal papers from evaluation, 2011 Mental Health for the North, Sri Lanka

iMHLP 2006-2009 Key participants from SL MoH, College of Psychiatrists and from Southern Province Learning with iMHLP participants from many countries

Leadership

Knowledge Exchange

•  Collaboration •  Partnerships

Education

Research

MoH SL WHO SL WVA CIMH



CIMH

Sri Lanka



CIMH

Dili, East Timor

Thank you for your attention

[email protected] www.cimh.unimelb.edu.au

minas nimh leadership and capacity building 2011.03.24

Health & Medicine