What role can/should the College and its members play in the World Psychiatric Association?

Last year the World Psychiatric Association (WPA) celebrated its 50th Anniversary with a Jubilee conference in Paris. The Grand Amphitheatre of the Sorbonne, where the WPA was launched in 1950 with a conference organised by Henri Ey, was also the site of the Jubilee opening ceremony last June.

The College and the WPA are combining in July this year to create a major international scientific conference, which will be both the Annual General Meeting of the College and a European Regional Meeting of the WPA. It therefore seems to be an apt time to update the wider College membership of the many developments and activities of the WPA of recent years, its part in the facilitation of the development of psychiatry around the world and its important role in creating a responsible worldwide community of psychiatric organisations (membership of the WPA is mainly through organisations: currently there are 116 member organisations from 100 countries).

The activities of the WPA

The WPA emerged out of the human decimation caused by the Second World War and the accompanying breakdown of international communication. It arose in the context of the Cold War between East and West in the 1950s, and a war in Korea. After the first successful WPA conferences, evolving structures emerged within which remarkable developments have occurred.

Ethical standards

The most prominent of these developments have been the ethical stands that the WPA has taken, especially concerning the abuse of psychiatry in the former Soviet Union. Denis Leigh, of the College, was secretary-general during these important times. Currently the WPA is being asked to consider the alleged use of psychiatric internment by the Chinese Government of members of the Falun Gong movement. The ethical guidelines for psychiatric care have evolved from the Hawaii Declaration of 1977, its amendment in Vienna in 1983 and then the Madrid Declaration of 1996, with guidelines concerning the behaviour of psychiatrists in general and in specific situations such as transplantation, euthanasia, torture and the death penalty. There are other guidelines on genetic research, relationships with the mass media and ethnic discrimination.

An important ethical, political and social issue that the UK is involved in, but which is rarely debated with any seriousness, relates to the migration of psychiatrists. In areas of Asia and Africa, where there may be only one psychiatrist per 500 000 population, over half of the countries' graduate psychiatrists migrate to other countries. Southern Asia has a population of 4.5 billion and only a few more psychiatrists than there are in the UK!

Congresses

Congresses fulfil a multitude of important roles — perhaps most importantly they provide settings in which psychiatrists of different backgrounds and experiences can meet one another and gain greater human understanding of different mental health cultures, perspectives, solutions and problems. In the 3 years between 1996 and 1999 there were over 50 WPA organised or cosponsored conferences, attracting some 40 000 psychiatrists (there are about 150 000 psychiatrists in the world). Our meeting that will be held in London in July 2001 will contain a wide range of excellent speakers from many European countries, each of whom brings some special expertise in an area where we will have something to learn (http://www.rcpsych.ac.uk/2001/index.htm).

The XII World Congress of Psychiatry will be held in Yokohama, near Tokyo, in August 2002 and it is important to be aware of the various deadlines for submissions. The theme is the very important one of ‘Partnerships for Mental Health’ (http://wpa2002yokohama.org).

Scientific sections

The WPA now has a very large number of active scientific sections, which reflect the considerable range of psychosocial, clinical, education and research concerns of psychiatrists throughout the world. Some sections now have their own scientific journals and the many WPA congresses throughout the world are important means through which developments and new ideas can readily be shared, discussed and disseminated. Psychiatrists who are members of the College are encouraged to go to the WPA website and find the sections that match their interests and note the contact details (http://www.wpanet.org).

Educational activities

The WPA has developed a wide range of educational activities. Its teaching modules on depression, which are available to teachers in the UK, are of a very high standard. These contain easy guides for teachers, as well as slides. There is also the International Classification of Diseases training kit, social phobia package, the core curriculum in psychiatry for undergraduate and postgraduate students and an educational programme on mental health in mental retardation. A most important current preoccupation is with the high profile WPA ‘global programme to reduce the stigma and discrimination because of schizophrenia’ (http://www.openthedoors.com).

Publications

Evidence and Experience in Psychiatry is the overall title for the WPA Series edited by Maj & Sartorius (1999a, b, c, d). The books have an original format in that extensive reviews on aspects of the topic covered are commented on by a wide range of people representing many different views.

Current Opinion in Psychiatry carries the WPA logo and is a bimonthly journal carrying authoritative reviews of current advances in the various fields of psychiatry, and pointers to the best of the current and past literature. An outstanding article and series of comments recently appeared on culture, spirituality and psychiatry. In this, the anomaly of the secular credo of international psychiatry was discussed and the need to find a place again for personal and cultural meaning systems within diagnostic systems (Fabrega, 2000).

Images in Psychiatry (Nakane & Radford, 1999) is to be a series of books that intend to portray past and present images of psychiatry as practised within different cultural and linguistic contexts. It is particularly apt that the first volume published should be on Japan, where the next WPA World Congress will be held.

Organisational development

To have developed so rapidly and to be effective in so many ways requires organisational effectiveness and in this aspect the transformation in the WPA has been remarkable during the past decade. The organisational calibre of the executive and the development of transparent structures that underpin their work and provide the framework of carrying out their complex transnational tasks are admirable. Excellent links have been forged with the United Nations, the World Health Organization and the World Federation for Mental Health, and more recently the World Medical Association, where the revision of the Declaration of Helsinki (an international agreement on research ethics) was agreed with much subsequent publicity. The WPA delegation of responsibility down to zones is proving effective in harnessing energy and talent. The recently upgraded WPA website has a wealth of information about WPA activities and carries the WPA Newsletter (www.wpanet.org).

Perhaps some of the zone developments are more obvious in Latin America and Asia. In some of the zones of Europe it has been less easy to put one's finger on tangible evidence of active cooperation between member organisations. One exception is clearly the Northern European Zone, which includes the Scandinavian countries and the newly independent Baltic States, where remarkable cooperation is being achieved in helping the latter achieve educational objectives. This is not to say there is not a great deal of activity and movement of individual experts between the UK and European countries and very considerable contributions of individual senior members of the College to activities of the WPA. The College has a rich vein of communication with other Commonwealth countries and this continues to play a bigger part in many ways, perhaps, than our contributions to European developments.

The College and the WPA

It is hoped that the conference in July in London will provide an excellent opportunity for College members to meet with their colleagues in other WPA countries and become fully acquainted with international and other national developments. I am convinced that we have both much to learn and much to offer. For my own part I have been deeply impressed with the major differences from our prevailing culture in the early and continuing treatment of people with schizophrenia that permeate parts of Scandinavia (and which will be reported on at the Friday of this July congress). This links with the easier and more natural integration of psychotherapeutic approaches in psychiatry in the practice of some of our near neighbouring countries. I would encourage those who attend the conference to use correspondence pages in our journals to note their observations of similarities and differences, as well as learning points.

The WPA/College meeting will be preceded by a WPA initiated meeting of presidents of many of the 50 WPA European psychiatric organisations, together with their representatives to the European Union Medical Speciality of Psychiatry. Possibilities for organisational development and future cooperation will be the focus of the workshop-style meeting.

The Bulletin and the College website are the natural sites of information about psychiatric organisations outside of the UK. It is pleasing that the Bulletin will encourage regular submissions and announcements on such international activities of the profession. This will allow the broad membership of UK psychiatrists greater opportunities to influence and be influenced by international developments and concerns and to be familiar with and learn from the strengths and difficulties of psychiatric practice in other settings.