Paper presented at the NIMH workshop on capacity building for global mental health development in March 2011

1. 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
CIMH
Collaborating Centre

2. Mental Health systems in
low and middle-income countries
Context and ‘Governance’ Poorly developed and Outputs and outcomes
disconnected system
elements
Governments, educators,  Weak investment. Shortage of  Narrow population coverage
researchers everything – skilled workers,  Very wide gap between best and
 Low capacity in policy facilities, drugs, etc. worst MH services
development and  Undeveloped information  Low access (geographic,
implementation (services, systems to support planning economic, linguistic, cultural)
training, research)  Geographic maldistribution of  Stigma, discrimination, social
 MH is a low priority - weak available workforce exclusion
drive for MH system  Disciplinary imbalance: doctor
development  Mental health training is
and nurse dominated unattractive for most disciplines
Population  Hospital-centred  Inadequate protection of rights
 Low ‘mental health literacy’  Poorly organised and  Lack of locally relevant evidence for
 Low demand for mental marginalised consumers, carers, policy and practice
health services civil society
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

3. CIMH approach to
Mental health System Capacity Building
Mental Health
Research System Capacity
Building
• Governance
• Legislation
Education • Collaboration • Policy
Leadership • Partnerships • Financing
• Workforce
• MH system design
• Advocacy
Knowledge • Human Rights
Exchange • Research
• Communication
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

4. 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
CIMH
Collaborating Centre

5. International Mental Health Leadership Program
TEACHING AND
COLLABORATIVE
KNOWLEDGE OUTCOMES
LEARNING
ACTION
EXCHANGE
 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
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

6. International Mental Health Leadership Program
Week 1 Week 2 Week 3 Week 4
Mental Health Human Resources Mental Health Mental Health
Legislation, Policy for Mental Health Advocacy and System Design
and Financing Human Rights
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
CIMH
Collaborating Centre

7. International Mental Health Leadership Program
TEACHING AND
COLLABORATIVE
KNOWLEDGE OUTCOMES
LEARNING
ACTION
EXCHANGE
INDONESIA
iMHLP alumni 2001-2010
 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
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

8. International Mental Health Leadership Program
TEACHING AND
COLLABORATIVE
KNOWLEDGE OUTCOMES
LEARNING
ACTION
EXCHANGE
 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
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

9. 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
CIMH
Collaborating Centre

10. 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
CIMH
Collaborating Centre

11. 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
CIMH
Collaborating Centre

12. Leadership for Mental Health System
Development in Vietnam
Leadership for Mental Health System  Course Directors: Tran Huong
Development in Vietnam
(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
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

13. 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
CIMH
Collaborating Centre

14. International Mental Health Leadership Program
TEACHING AND
COLLABORATIVE
KNOWLEDGE OUTCOMES
LEARNING
ACTION
EXCHANGE
 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
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

15. International Mental Health Leadership Program
TEACHING AND
COLLABORATIVE
KNOWLEDGE OUTCOMES
LEARNING
ACTION
EXCHANGE
 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
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

16. International Mental Health Leadership Program
TEACHING AND
COLLABORATIVE
KNOWLEDGE OUTCOMES
LEARNING
ACTION
EXCHANGE
 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
CIMH
Collaborating Centre

17. Mental health System Capacity Building
Mental Health for the South: Sri Lanka
New NIMH Colombo iMHLP 2006-2009
Child mental health project Key participants from SL MoH,
Suicide prevention project College of Psychiatrists
Impact of CSOs project and from Southern Province
Services information system Learning with iMHLP participants Mental Health
from many countries Southern Province
Research
Sri Lanka
2005: No mental health
service except inpatient
Education • Collaboration
Leadership • Partnerships
unit in Galle city.
MoH SL There is now a
WHO SL functioning community-
WVA focused mental health
Knowledge CIMH service with good
population coverage in all
Exchange
7th International Mental Health System three districts
Development Conference: Mental Health
CSOs in Sri Lanka (Melbourne Oct 2010)
MOMHs Sri Lanka College of Psychiatrists conference, March 2011
Diploma in Psychiatry Journal papers from evaluation, 2011
Community Mental Health Nurses Mental Health for the North, Sri Lanka
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

18. Sri Lanka
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

19. Sri Lanka
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre

20. Dili, East Timor
Thank you for your attention
h.minas@unimelb.edu.au
www.cimh.unimelb.edu.au
| Minas: Leadership training and mental health system capacity building
NIMH, Washington 24 March 2011
CIMH
Collaborating Centre