SAMHSA Addresses Global Burden of Mental Illness
The burden of mental illness on health and productivity
in the United States and throughout the world has long
According to a Global Burden of Disease study
by the World Health Organization (WHO), Harvard University,
and the World Bank, mental illness—including suicide—accounts
for more than 15 percent of the burden of disease in
countries with established market economies. This is
more than the disease burden caused by all cancers.
To help address this public health challenge, SAMHSA
is working at home and abroad to identify what needs
to be done to effect change.
Around the world, the goal is to investigate and explore
all available methods to create flexible, accessible,
and sustainable mental health care systems. SAMHSA has
met with public health officials from many countries—including
England, Afghanistan, Iraq, Russia, New Zealand, Australia,
Italy, and countries affected by the tsunami in South
Asia—to share information and gain insight on how
to address the global mental health crisis.
The Agency is working to find common ground and partner
with the international community to move initiatives
forward, map out plans for advanced training for care
providers, strategize funding possibilities, and prepare
to respond to natural disasters and to terrorism as well
as to the needs of countries in post-conflict recovery.
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SAMHSA’s international efforts include:
Work with Post-Conflict Countries
Project 1 Billion is an effort that convenes meetings
with post-conflict countries to enable them to work together
to address the mental health needs of their peoples.
In December 2004, SAMHSA Administrator Charles G. Curie,
M.A., A.C.S.W., addressed attendees in Rome, Italy, at
Project 1 Billion: International Congress of Ministers
of Health for Mental Health and Post-Conflict Recovery.
Calling the project “an excellent roadmap for
our work on global mental health issues,” Mr. Curie
emphasized how collaboration “will help to define
our roles as leaders who have a genuine desire to work
together to help recovery around the globe.”
At this 2004 meeting, participants endorsed a mental
health action plan and distributed Project 1 Billion
Book of Best Practices: Trauma and the Role of Mental
Health in Post-Conflict Recovery.
In Rome, Italy, SAMHSA Administrator
Charles G. Curie and James Lavelle, LICSW, of the Harvard
Program in Refugee Trauma joined with other leaders from
around the world at the 2004 Project 1 Billion conference.
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Mental Health Leadership
SAMHSA is actively supporting Afghanistan and Iraq to
re-establish mental health services in their countries,
where decades of conflict have destroyed most of the
mental health care system and deeply affected the populations.
Currently, SAMHSA chairs the Planning Group on Iraq
Mental Health. At a meeting in December 2004 (see SAMHSA
News, January/February 2005), the Planning Group—including
Dr. Sabah Sadik, Iraq’s National Mental Health
Advisor—developed plans for the Action Planning
Conference on Iraq Mental Health. That conference convened
March 14 to 18, 2005, in Amman, Jordan, as part of an
ongoing effort to help rebuild Iraq’s mental health
care system. (SAMHSA News will report on this
conference in an upcoming issue.)
Other Agency efforts include the International Initiative
for Mental Health Leadership (IIMHL), a joint endeavor
of SAMHSA, the National Institute for Mental Health in
England, and the Ministry of Health New Zealand. Mr.
Curie serves as a founding member.
The IIMHL developed from a worldwide effort to share
best practices and provide support and collaborative
opportunities for global leaders in mental health services
from developed countries. The group holds annual conferences
and leadership exchanges hosted by member countries on
a rotating basis.
When the United States hosted the Second IIMHL conference
in 2004, SAMHSA played a key role in the preparations.
The agenda focused on consumer involvement in the mental
health system, reducing the use of seclusion and restraint,
and on the transformation of mental health services from
institutional services to community-based, consumer-driven
SAMHSA also participated in the 2005 conference in Wellington,
SAMHSA has joined in collaborations with the World Health
Organization, the World Federation for Mental Health,
the Clifford Beers Foundation, the Carter Center, and
others. The focus of these efforts is to promote mental
health and decrease the incidence and disease burden
of mental and behavioral disorders worldwide, principally
through establishing the Global Consortium for the Worldwide
Advancement of Promotion and Prevention in Mental Health
(GCAPP) as an international resource.
While in New Zealand in September 2004 at a meeting
of the GCAPP, Mr. Curie participated in the International
Alliance for Child and Adolescent Mental Health and Schools
(Intercamhs). SAMHSA has provided the seed money to launch
Intercamhs, which advances the idea that schools have
a part to play in promoting and protecting the mental
health of the community.
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Training and Support
Functional mental health care systems require trained
mental health care providers. SAMHSA is helping to plan
programs for mental health professionals from developing
nations to receive training in the United States and
For example, SAMHSA provided support for Afghan representatives
to attend a pilot meeting of Ministers of Health of post-conflict
countries, held in Sarajevo.
SAMHSA also supported representatives from mental health
systems in Afghanistan and Iraq to attend Masterclasses
in Refugee Trauma and Treatment provided by the Harvard
Project on Refugee Trauma.
Other efforts to strengthen mental health systems abroad
have included a collaboration with the State Department
to develop a two-part project on substance abuse prevention
for use in Russia. The project provided support for a
substance abuse prevention curriculum based on the evidence-based
Life Skills model in every grade in Russian schools.
In addition, the project offered a training curriculum
for all health care workers on prevention screening for
substance abuse, based on SAMHSA’s Treatment Improvement
Protocol 24, A Guide to Substance Abuse Services
for Primary Care Clinicians.
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For more information about international relief
efforts by the U.S. Department of Health and Human
Services (HHS), visit www.globalhealth.gov.
Other international initiatives and programs for
mental health include:
Project 1 Billion: International Congress
of Ministers of Health for Mental Health and
Post-Conflict Recovery at www.project1billion.org.
International Initiative for Mental Health
Leadership (IIMHL) at www.iimhl.com.
Global Consortium for the Advancement of Promotion
and Prevention in Mental Health (GCAPP) at
International Alliance for Child and Adolescent
Mental Health and Schools (Intercamhs) at www.intercamhs.org.
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Tsunami Disaster Relief
SAMHSA is supporting U.S. Department of Health and Human
Services (HHS) efforts to help countries in South Asia
devastated by the December 26, 2004, tsunami. The HHS
Mental Health Team, which includes SAMHSA staff, is supporting
efforts of the United Nations and non-governmental organizations
to address mental health issues in the communities along
the west coast of Sumatra, Indonesia.
For example, 50 HHS staff (including staff from SAMHSA)
traveled on the USNS Mercy to the Indian Ocean in January
to provide assistance.
In addition, SAMHSA’s National Center on Child
Traumatic Stress prepared information on children and
trauma for distribution to humanitarian aid workers and
victims of the tsunami.
Also, in a partnership with the Centers for Disease
Control and Prevention (CDC), SAMHSA enhanced the mental
health and substance abuse elements of CDC’s disaster
response, and the two agencies are collaborating to make
more online information available on the psychological
impact of disasters.
SAMHSA is currently exploring other ways to provide
specific support to the area.
For more information, visit www.samhsa.gov.
In January, the USNS Mercy set
sail for the Indian Ocean to provide support and assistance
to those affected by the Asian tsunami. The HHS Mental
Health Team included SAMHSA staff. (Official
US Navy photo)
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