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Paper presented at the NIMH workshop on capacity building for global mental health development in March 2011
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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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
2 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
3 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
4 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
5 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
6 | Collaborating Centre
CIMH
International Mental Health Leadership Program
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
7 | Collaborating Centre
CIMH
International Mental Health Leadership Program
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
TEACHING AND LEARNING
COLLABORATIVE ACTION
KNOWLEDGE EXCHANGE
OUTCOMES
iMHLP alumni 2001-2010
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
8 | Collaborating Centre
CIMH
International Mental Health Leadership Program
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
TEACHING AND LEARNING
COLLABORATIVE ACTION
KNOWLEDGE EXCHANGE
OUTCOMES
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
9 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
10 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
11 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
12 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
13 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
14 | Collaborating Centre
CIMH
International Mental Health Leadership Program
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
TEACHING AND LEARNING
COLLABORATIVE ACTION
KNOWLEDGE EXCHANGE
OUTCOMES
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
15 | Collaborating Centre
CIMH
International Mental Health Leadership Program
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
TEACHING AND LEARNING
COLLABORATIVE ACTION
KNOWLEDGE EXCHANGE
OUTCOMES
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
16 | Collaborating Centre
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.
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
17 | Collaborating Centre
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
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
18 | Collaborating Centre
CIMH
Sri Lanka
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
19 | Collaborating Centre
CIMH
Sri Lanka
Minas: Leadership training and mental health system capacity building NIMH, Washington 24 March 2011
20 | Collaborating Centre
CIMH
Dili, East Timor
Thank you for your attention
h.minas@unimelb.edu.au www.cimh.unimelb.edu.au
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