Global Ministerial Mental Health Summit - Open Letters Open Letter to the Organisers, Partners and Delegates of the Global Ministerial Mental Health Summit, London9th and 10th October, 2018 The UK government is hosting a Global Ministerial Mental Health Summit in London on the 9th and 10th of October, 2018. The Summit aims to “build momentum on global mental health issues such as early intervention, public health, research, tackling stigma, and promoting access to evidence-based services.” The event is set to culminate with a “global declaration committing to political leadership on mental health.” The Summit will also see the launch of the Lancet Commission into the links between mental health and sustainable development. We the undersigned are concerned about the way in which this event has been organised and about the UK positioning itself as a ‘global leader’ in mental health for the following reasons: The organisation and planning for this event has been a closely guarded secret. Even the full list of countries participating was not released beforehand, which made any possibility of advocacy by civil society organisations in those countries impossible. Significantly, there has been little or no involvement of organisations led by mental health service users, survivors and persons with psychosocial disabilities in the thinking, planning and design of this event. While a few networks were approached to provide ‘experts by experiences’ to attend panels on themes already decided on, there has been no meaningful consultation or involvement of user-led and disabled people’s organisations not already signed up to the ‘Movement for Global Mental Health’ agenda or funding to enable a wide range of representatives to attend. This is in open violation of Article 4 of the UN-Convention for the Rights of Persons with Disabilities (CRPD) which obligates signatories to closely consult with and actively involve persons with disabilities through their representative organisations in decision-making around issues that directly concern persons with disabilities. The UK’s positioning as the leader in the global effort to tackle mental health needs is highly problematic for a variety of reasons. In 2016, an inquiry by the UN Committee on the Rights of Persons with Disabilities found that austerity policies introduced by the UK government had met “the threshold of grave or systematic violations of the rights of persons with disabilities.” The Committee found high levels of poverty as a direct result of welfare and benefit cuts, social isolation, reduced standards of living, segregation in schools of children, lack of support for independent living and a host of other violations. The situation has had a direct impact on people’s mental health with rates of suicide attempts doubling and widespread destitution. In the concluding observations on the initial report of the United Kingdom of Great Britain and Northern Ireland, the Committee raised particular concerns about the insufficient incorporation and uneven implementation of the CRPD across all policy areas and levels within all regions, devolved governments and territories under its jurisdiction and/or control, and about existing laws, regulations and practices that discriminate against persons with disabilities. In the UK, there is a particular situation of discrimination within mental health services that affect its black and minority ethnic communities and migrants from ex-colonial countries and the global south diaspora. Decades of evidence show that they face consistent discriminatory treatment within UK’s mental health services, including high levels of misdiagnosis, compulsory treatment, over-medication, community treatment orders and culturally inappropriate treatment. The inquiry into the death of David Bennett, an African Caribbean man in the care of the state, found the NHS to be institutionally racist. Yet, the UK government has set out to lead the globe in creating inclusive and just societies while continuing to perpetuate a ‘hostile environment’ not only in its health and social care services but in other areas that impact on people’s mental health such as immigration, policing, employment, welfare and so on. The Summit is set to announce the global launch of the anti-stigma programme, Time to Change, with programmes planned in India, Ghana, Nigeria, Uganda and Kenya. Millions of pounds have already been spent on this campaign which claims to have made a positive impact on mental health stigma, while evidence also shows that there has been no improvement in knowledge or behaviour among the general public, nor in user reports of discrimination by mental health professionals. The UN Committee on the Rights of Persons with Disabilities, in its concluding remarks, raised particular concerns about perceptions in society in the UK that stigmatize persons with disabilities as living a life of less value than that of others. It also pointed out that existing anti-discrimination legislation in the UK does not provide comprehensive or appropriate protection, particularly against multiple and intersectional discrimination. Given this scenario, it is objectionable that the UK government continues to fund a programme that aims to address stigma while carrying on with the most stigmatising and discriminatory policies that affect persons with psycho-social disabilities. UK has already taken the lead in exporting the failed paradigm of biomedical psychiatry globally through the ‘Movement for Global Mental Health’. The failure of social contact based anti-stigma programmes to attain any change in structural discrimination and inequalities has not deterred the UK government from supporting the export of another high-cost, low impact programme, with funding from the Foreign and Commonwealth Affairs Office, to the global south. This model of ‘North leading the South’ recreates colonial ‘missions of education,’ significantly impacting on the development of locally relevant, rights-based discourses rooted in the wisdom of CRPD and led by persons with psychosocial disabilities in the global south. Many professionals in the field of mental health both in the global south and in the global north have cautioned against the application and scale up of western models of mental health care worldwide. User/survivor groups in the global south have already objected to importing failed western models of mental health care into their countries and called for full CRPD compliance that will enable full and effective participation of service users, survivors and persons with psychosocial disabilities in all aspects of life. This is significant at a time when the Mental Health Act is under review in England and there has been consistent resistance to moving towards CRPD compliant legislation. Given this scenario, it is hypocritical that the UK government is taking the lead in creating a global declaration on political leadership in mental health. As with the Global Disability Summit this government recently staged, we are seeing an intolerant government posing as the upholder of the rights of persons with psychosocial disabilities. The organisation of the Summit is in opposition to the spirit and terms of the CRPD. We ask the participants and delegates of this Summit to: Reflect upon the issues brought forward in this letter, including existing structural and multiple discrimination against persons with psychosocial disabilities in the UK by its government Demand a clarification from the UK government on its position on the CRPD and the measures it is taking to uphold the CRPD within its own laws and policies Ask the UK government to desist from operating in imperial ways that export failed models and methods to the rest of the world which negatively impact on local innovations and ways of working Campaign to ensure that any declaration created at the Summit is put forward for wide consultation and ratification by the diverse range of user-led and disabled people’s organisations worldwide Insist that if the UK government wishes to promote mental health in the global south, it must: Lead by example by changing its domestic laws, policies and practice that currently threaten the lives of mental health service users and survivors in the UK, including its economic and welfare policies that have widened inequalities, made life intolerable for thousands of disabled people and contributed to their deaths. Acknowledge the knowledge existing within user-led and disabled people’s groups about what works best as well as provide support for user-led services, advocacy and research Examine its own foreign policies in order to lessen north-south disparities in health standards and its own ethical standards in exporting western mental health systems Support local, inclusive innovations in the south to address social and structural determinants of health rather than take over leadership Enable local people to develop services that are for the benefit of the people concerned as subjects rather than objects of development and sustainable without dependence on or interference from rich countries in the West. Engage with independent civil society groups and not conform to the wishes of the UK government. Signatories National Survivor User Network, England Recovery in the Bin Mental Health Resistance Network, UK ISPS UK (International Society for Psychological & Social Approaches to Psychosis) Linda Burnip on behalf of Disabled People Against Cuts, UK North East Mad Studies Collective, England Transforming Communities for Inclusion – Asia Pacific (TCI-Asia Pacific) Bapu Trust for Research on Mind and Discourse, India SODIS (Sociedad y Discapacidad), Peru National Coalition for Mental Health Recovery, USA North East Together (NEt), England North East Together (NEt), service user and carer network, UK NTW Service User and Carer Network, England Steve Nash, Co-Chair ReCoCo: Recovery College Collective, England Center for the Human Rights of Users and Survivors of Psychiatry (CHRUSP), USA Activist Research Collective, UK Akiko Hart, Hearing Voices Network, England Akriti Mehta, User-researcher, King's College London, UK Alan Robinson, Artist, Buenos Aires, Argentina Alexandra Reisig, Student (Global Mental Health), UK Alfred Gillham, ISPS UK Alisdair Cameron, Launchpad: by and for mental health service users, UK Anne Cooke, principle Lecturer, Salomons Centre for Applied Psychology, Canterbury Christchurch University Dr Alison Faulkner, Survivor researcher, UK Alvaro Jimenez, University of Chile, Santiago, Chile Dr Amy Chandler, Chancellor's Fellow in Health, through Arts, Design and Humanities, School of Health in Social Science, Edinburgh University Andrea Liliana Cortés, Independent activist in human rights and psychosocial disabilities, Colombia Angela Woods, Durham University Asmae Doukani, London School of Hygiene and Tropical Medicine, UK Ben Glass, Mental Health Patient Bev Oliver, Mental Health Service User Brenda A. LeFrançois, Professor, Memorial University of Newfoundland, Canada Caitlin Walker, Cambridge University, UK Carolyn Asher, Service user of mental health services, UK Catherine Campbell, Professor of social psychology, London School of Economics, UK Dr Cathryn Setz, Associate Visiting Research Fellow, Rothermere American Institute, University of Oxford Che Rosebert, Director – interim external communications, Association of Clinical Psychologists UK Cheryl Prax, Psychiatric survivor, Speak Out Against Psychiatry (SOAP) China Mills, Lecturer, University of Sheffield, UK Chris Hansen, International Peer Support, USA Claudio Maino, Université Paris Descartes, France Colin King, survivor Lecturer Corinne Squire, Professor of social sciences, University of East London, UK Cristian Montenegro, PhD candidate, London School of Economics, UK Dr Daniel Fisher, Co-founder of the National Empowerment Center, USA Darrel Cottle, Service User David Harper, Reader and programme director for the professional doctorate in clinical psychology, University of East London, UK David Orr, Senior lecturer in social work, University of Sussex, UK David Son, individual, UK Derek Summerfield, Honorary senior clinical lecturer, IoPPN, King's College London, UK Diana Rose, Professor, King’s College London, UK Dolly Sen, Writer & Survivor Researcher Dominic Makuvachuma, Co-ordinator, Reigniting the Space Project, England Doreen Joseph, Service user, advocate/researcher/lecturer/writer, UK Dorothy Gould, Researcher, trainer and consultant with lived experience of mental distress, UK Duncan Double, Consultant psychiatrist, Norfolk & Suffolk NHS Foundation Trust, England Eamonn Flynn, ISPS UK Elaine Flores, London School of Hygiene and Tropical Medicine, UK Eleni Chambers, Survivor Researcher, UK Eleni Hatzidimitriadou, UK Emma Ormerod, Survivor Researcher, UK Emily Green, Cambridge University Emmy Charissa, User and Survivor of Psychiatry, Singapore Erica Burman, Professor of Education, University of Manchester, UK Erica Hua Fletcher, Zorich Fellow in Mental Health Policy, Hope and Healing Center & Institute, USA Erick Fabris, Psychiatric survivor; Researcher for the Mad Canada Shadow Report, Canada Dr Erminia Colucci, Senior Lecturer, Middlesex University London, UK Ewen Speed, Senior lecturer in medical sociology, Director of research, School of Health & Human Sciences, University of Essex Farhad Dalal, Psychotherapist, group analyst, and organizational consultant Fee Plumley, Salford, UK & Adelaide, Australia F.E.E.L. - Friends of East End Loonies, UK Felicity Callard, Professor of Psychosocial Studies, Birkbeck, University of London Fiona Little, MH sufferer, violated for years, UK Francisco Ortega, Professor of collective health, State University of Rio de Janeiro, Brazil Frank Keating, Professor of social work & mental health, Royal Holloway University of London, UK Gary Heydon, Mental Health Service User Giles Tinsley, Hearing Voices Network England Glenn Townsend, Service user of mental health services, UK Hari Sewell, Independent consultant and author, UK He, Ma, Director, Changsha Thanksgiving Mental Health Advocacy Centre Helen Spandler, Professor of mental health, University of Central Lancashire; Editor, Asylum magazine, UK Huang, Xuetao (Alice), Director of Equity and Justice Inititative, China Ian Parker, Emeritus Professor of Management, University of Leicester, UK Iain Brown, Tortured sufferer at the hands of MH team, UK Ilma Molnar, London, UK Jackie Shann, individual James Deane, with lived experience and for DPCA (Disabled People Against the Cuts) Bristol and Southwest Janaka Jayawickrama, PhD, Associate professor in community wellbeing, Department of Health Sciences, University of York, UK Jane Gilbert, Consultant clinical psychologist, UK Janice Cambri, Founder, Psychosocial Disability-Inclusive Philippines (PDIP), Philippines Jacqui Narvaez-Jimenez, Carer bullied by the MH team, UK Jasna Russo, Survivor researcher, Germany Dr Jay Watts, Consultant Clinical Psychologist, Queen Mary, University of London Jayasree Kalathil, Survivor Research, UK Jen Kilyon, ISPS UK Jenifer Dylan, Service user involvement facilitator, Camden and Islington Foundation Trust Jhilmil Breckenridge, Editor, Mad in Asia; Founder, Bhor Foundation, India Dr Jijian voronka, Assistant Professor School of Social Work University of Windsor, Canada John Adlam, Consultant Adult Psychotherapist and Independent Researcher Joyce Kallevik, Director of Wish Julie Gosling, Making Waves, Nottingham Julie Newcombe, individual, UK Justin Karter, MA, PhD student, Counseling Psychology, UMass Boston; Research News Editor, Mad in America Karen Chance, Social Worker Karen Machin, Researcher, UK Katerina Nomidou, mental health and human rights attorney, secretary general of GAMIAN-Europe, Belgium – president of the Greek Federation of mental health organisations POSOPSI, Greece Kate Swaffer, Chair, CEO and Co-ordinator of Dementia Alliance International Katherine Runswick-Cole, Professor of education, University of Sheffield, UK Laura J Welti, (consultant and trainer in Disability Rights and Inclusion), Bristol Disability Equality Forum Lavanya Seshasayee, Psychiatric survivor; Founder, Global Women’s Recovery Movement, Bangalore, Indi Leah M. Ashe, Ph.D., Reilly Center for Science, Technology, and Values, University of Notre Dame (USA) and victim of UK psychiatry Leo McIntyre, Chairperson, Balance Aotearoa, New Zealand Liam Kirk, Member of the service user group of Brent, Wandsworth and Westminster Mind, UK Lisa Cosgrove, Professor of counselling and school psychology, College of Education and Human Development, University of Massachusetts, Boston, USA Lisa K Samoto, Someone with lived experience, UK Liz Brosnan, Survivor researcher Luciana Caliman, Professor of psychology, Universidade Federal do Espírito Santo, Vitória, Brazil Lucy Costa, Deputy executive director, Empowerment Council: A Voice for the Clients of CAMH, Toronto, Canada Lynn Tang, Assistant Professor, Tung Wah College, Hong Kong Magda McQueen, human being with rights, UK Margaret Turner, Secretary, Soteria Network UK Margerita Reygan, Mother/Carer of mental health service survivor, UK Mari Yamamoto, User of psychiatry, Japan María Isabel Canton Rodriguez, Rompiendo la Etiqueta, Nicaragua Maria Nelson, Service User Mark Allan, HVN England and North East Mad Studies Collective, England Melissa Raven, Postdoctoral fellow, Critical and Ethical Mental Health research group (CEMH), University of Adelaide, Australia Merry Cross, Chair Berks Disabled People Against Cuts Michael Ashman, Survivor of psychiatry, UK Michael Njenga, Executive Director, Users and Survivors of Psychiatry in Kenya, Kenya Michelle Baharier, Director of Fruit Cake Creatives and founder of CoolTan Arts Mick McKeown, University of Central Lancashire, UK Mike Steel, Service User Researcher, University of BristolMohan Rao, Professor (retired), Centre of Social Medicine and Community Health, Jawaharlal Nehru University, India Myles Cook, mental health service user Naomi Salisbury, Director, Self injury Support Nat Fonnesu: psychiatry survivor and activist, co-founder of F.E.E.L. - Friends of East End Loonies, UK Nathan Dowling, Clinical Psychologist, UK Neil Caton, ISPS UK Nev Jones PhD, University of South Florida, USA Nikolas Rose, Professor of sociology, King’s College London, UK Norha Vera, King’s College London, UK Noel Hunter, heral square Psychology New York, USA Ohyong Kweon, secretary General, Korean Alliance for Mobilizing Inclusion, South Korea Ontario Peer Development Initiative, Ontario, Canada Paola Debellis Alvarez, Universidad de la Republica, Uruguay; CCC PhD-Forum, Geneva, Switzerland Patrick Bracken, Consultant psychiatrist, Co Cork, Ireland Patrick Coll, Associate Professor, Psychiatry, University of Calgary, Canada Paula Peters, Bromley DPAC (Disabled People Against Cuts), England Peter Bartlett, Professor of Mental Health Law, University of Nottingham, UK Peter Beresford, Mental health service user/survivor, Shaping Our Lives, UK Peter Coleman, A family carer for son currently subject to restriction, UK Phil Ruthen, Survivors Poetry, UK Philip Thomas, Writer; Formerly consultant psychiatrist and academic, UK Pia Noël, PhD Candidate in Social Anthropology, University of Edinburgh Premila Trivedi, mental health service user trainer & advisor Radoslaw Stupak, PhD student in Psychology, Jagiellonian University, Poland Raúl Silva, Doctoral student, UCL Belgium/Ecuador Reima Ana Maglajlic, Senior lecturer in social work, University of Sussex Reshma Valliappan, The Red Door, India Dr Rich Moth, Senior Lecturer in Social Work, Liverpool Hope University UK Robyn Timoclea, Survivor researcher & Activist, UK Dr Ron Roberts, Honorary Lecturer in Psychology, Kingston University Roy Moodley, Associate professor and director of Centre for Counselling & Psychotherapy, University of Toronto, Canada Ruth Silverleaf, User-researcher, Kings College London, UK Sami Timimi, Consultant child and adolescent psychiatrist, Lincolnshire Partnership NHS Foundation Trust, England Sara Haq, Artist Dr Sarah Carr, Acting Chair, National Survivor User Network, England Sarah Yiannoullou, National Survivor User Network, Managing Director Sebastian Lawson-Thorp, UK Shireen Gaur, Clinical psychologist and psychotherapist, UK Sofía Bowen, PhD candidate, King’s College London, UK Stan Papoulias, Assistant director, Service User Research Enterprise, Kings College London, UK Stephen Jeffreys, Someone with lived experience, UK Sue Bott, Deputy chief executive, Disability Rights UK Suman Fernando, Retired psychiatrist, writer and campaigner, UK Sumeet Jain, Senior lecturer in social work, The University of Edinburgh, UK Susan Wolfe, Social historian, UK Sushrut Jadhav, Consultant psychiatrist and clinical senior lecturer in cross-cultural psychiatry, University College London, UK Steph de la Haye, Mental Health & ME survivor, Chair / founder Survivors of Depression in Transition (SODIT) Susan Bevis, Psychoatric Survivor Syeda Akther, Research Assistant, University College London, UK Dr. Tarek Younis, PhD/PsyD, Clinical Psychology, British Academy Fellow, Division of Psychiatry, University College London Teisi Tamming, Estonia Tiago Pires Marques, historian and researcher at the Centre of Social Studies (University of Coimbra), working on the field of mental health Dr Timothy Buescher, Lecturer in mental health, University of Hull, UK Timothy Swann, trainee Clinical Psychologist, University of Hertfordshire Tish Marrable, Senior lecturer in social work, University of Sussex, UK Tracey Lazard: CEO: on behalf of Inclusion London Will Hall, Host, Madness Radio; PhD candidate, Maastricht University School of Mental Health and Neuroscience, Netherlands Yang, Chouniu (Linus): individual self-advocate, maintainer of www.madinasia.org Yi, Xinru, Chairman, Changsha Thanksgiving Mental Health Advocacy Zhuang, Chao (Frank): director of a program for depression, Xintu Collective for community mental health, Shanghai Zoe Kirby, founder SWADS, Wales' largest mental health peer support group, UK Zsófia Szlamka, Youth activist, Hungary If you would like to add your support to the letter please email [email protected] In another letter a number of service user/survivor led organisations and networks have raised concerns regarding the planning and organisation of the event, feeling that user led collectives are being excluded. This letter calls for 'service users and our experiential, non-medical knowledge to be supported and for our autonomous organisations to be enabled to join the debate on equal and inclusive terms that fully address diversity and challenge our continued exclusion'. Download the letter here.