Good afternoon, ladies and gentlemen. Thank you very much for coming to this session. We do appreciate that this is really a very full program and people may have to choose and find that what would be of their interest. But on behalf of World Psychiatric Association, I welcome you all to this session and we are thankful to you for your interest in the WPA and in particular to this particular session. This session is primarily to highlight some of the work of WPA and to generate some discussions about our future plans and future activities. I'm pleased that four of our executive committee members are present in this session. Three of them will be presenting with me and we do hope that all of us will be available for any questions, queries or anything that you may like to know or explore about the WPA. So with this remark, I'll just start with my presentation and I will be giving a general overview of the action plan that was approved in 2020 when the current triennium started and when the current executive committee started its term. What happens in each general assembly, we present a sketch of the program that we intend to carry on during the next three years and then go on reviewing and revising so that we keep ourselves on the track and also get feedback from our membership about any changes or any additions or deletions. This is my disclosure and I will cover generally about WPA's actions, objectives and also about some of the salient features of the action plan. Edmund, can you help me because I can't move the slides here. So just to sort of give you a general introduction of World Psychiatric Association, this is an association of national psychiatric societies and we have got 145 member societies from 122 countries and the membership of these member societies make the membership of WPA which is more than 250,000 all over the globe. It is a professional organization without any political agenda and the basic objective of this organization is to provide a platform to the professional colleagues coming from different parts of the world to exchange their ideas, to talk about mutual interests and overall to work to improve the services, the delivery of services, the teaching training and other related issues in terms of the practice in most of the countries within the limit of WPA. Generally, these are the salient features of WPA's agenda which derives its strength from the feedback and from the support of other member societies. And these general objectives range from promotion of mental health to capacity building, encourage professional collaboration to work with other organizations and to foster a sense of mutual collaboration and support to each other. So I was just mentioning about how we prepare, formulate and then come to the practice of the action plan different ideas. So based on those recommendations, we had these six main areas of work that we thought that we will concentrate during this triennium. And these proposed areas of work were changeable, were interactional with each other areas and were primarily based on having a global touch to our future work. The guiding principles for this triennium's work were that we wanted to promote that from lack of access to improved care for treatment, prevention and promotion, from stigma to acceptance, from exclusion to inclusion, from hospital to community and from lack of engagement to all stakeholders. So these were the general guiding principles for this work. Because of the time limitations, I will very quickly go for some of the priority areas, but more details are available on our website. So to start with capacity building and educational plans, we have to be mindful that around 70 to 80% of our member societies come from low and middle income countries where excellent teaching and training programs are not considered as privileges. So we thought that we will try to improve the educational programs in such a way that it fulfills the requirement of most of these countries. Unfortunately, during the start of our term, we were stuck by COVID-19 and we had to modify many of our training programs and move to virtual type of training rather than in-person specified teaching and training programs. So we started by building our educational portal on our website, which is now running very successfully the last plus two years. This is a free access. People have to only enter and put their email as entering point and then they are accessible to all the educational programs. And I'll just very briefly give you an idea of those courses and modules. We also started having webinars and it was almost one or two webinars every two months. And during this two and a half years period, we have organized more than 30 webinars, which have been attended by a big number of audiences. These are some of the topics that we covered and we were privileged of having experts and specialists who were really presented with the state of the art in their respective fields. So this is just a list and all these webinars, recorded webinars are available on our website. Then in addition to the webinars, we also requested many experts to prepare educational modules. And I'm really pleased that some of the authors of the modules are present in the audience. And we also tried to translate some of these modules in different languages, especially Spanish. So these are the lists of modules which are available on our website with accreditation from the WPA. And we are still continuing with these webinars and modules. Tomorrow morning, we are having a webinar in collaboration with patients and carers group, which is on human rights of our patients. And this is a list that will give the trainees a rough idea about the contents of the modules. We also helped our membership by organizing courses on ICD-11. I know ICD-11 is not that frequently used in this part of the world, but in majority of the countries in Europe, Africa, and Asia, ICD-11 is the official classification. Keeping in view the need for updating our American colleagues, during this March and April, we also conducted a Spanish version. And most of these courses were attended by 300 to 400 people from different parts of the world. WPA also issues position statements on topics which are relevant and more important for use for the policymakers. I'm really pleased that we usually revise all the position statements every three years. So when we took the charge, we commissioned those position statements for a revision. And all these position statements are also available on our website. This certainly gives a lot of support to our membership if they have to go and speak to the policymakers, to their health departments, or even to their universities for emphasizing the importance of these particular topics. One of the salient features regarding the capacity building during this triennium was developing a group who works with the medical students. We feel that we will never ever have enough psychiatrists. So the best way forward would be to sensitize our medical students who may not become psychiatrists or who may not come to psychiatry as a specialist to have some expo here. So what we have done is that we are identifying various areas for promoting psychiatry as a career among medical students. We have identified different organizations, centers, and universities where we are approaching the medical students and giving lectures, webinars, and providing them with educational modules. And also to ensure that medical students are given a priority when they are receiving their undergraduate medical education, especially in the field of mental health. So these were some of the activities which we did. And a couple of initiatives which attracted medical students in a big way that we started travel fellowships to the medical students to attend our World Congresses. We started last year with our World Congress in Bangkok. We launched a competition of essay on stigma. And interestingly, we received more than 150 essays from 40 countries. These were medical students. And we gave one travel fellowship of $2,000 to a medical student who won the competition. We also took the first 16 essays and we have published this book, Stigma and Mental Health, Global Medical Students' Perspective. This is also available in PDF and is loaded on our website. Similarly, we are doing another competition for our this year's World Congress being held in Vienna. And to my surprise, the group told me yesterday that they have received 600 essays from medical students. I think this is a future perspective, how can we promote psychiatry and popularize it among the medical students. Then, we also thought that, especially looking at the experience from the COVID, that there are many other areas in psychiatry, in mental health, which are beyond the drug treatment. And that's why we established a group on public mental health to look at what should be the priorities in different areas of mental health for incorporating prevention, promotion, and public mental health interventions that could be helpful to us. This is just a summary of some of the papers, publications that our public mental health group published during the last two years. And we were really pleased that these publications appeared in very high index journals like World Psychiatry, Social Psychiatry, and many other regional journals. We also felt that promotion of early intervention in mental health should be a priority. And to achieve that, our working group did a thematic Congress last year on early intervention in psychiatry across the lifespan. This was attended and participated by a big number of participants, especially the trainees who were interested to update their knowledge in this area. While we were passing through COVID, we were also mindful that we have to work and formulate some of our guidelines, recommendations in this particular area. I'm pleased that our Action Plan group has decently prepared a very impressive document on COVID care for patients with, people with mental illnesses. This is also being added to our website and will be available for all of our professional colleagues. You have seen yesterday the protest against psychiatry. And I always say that psychiatry is the only specialty where you find anti-psychiatry. There is no anti-cardiology, no anti-diabetology. And I think the fault or the reason lies with us. We have not been able to bring patients, users, and carers on board. So our group on this particular topic has been very active. And we invited and involved representatives of patients, carers, users, and families. And as I mentioned, tomorrow we will be having a webinar on this particular topic. And in addition to that, based on the feedback from patients and their families, we also set up a group on coercion. And a very comprehensive statement has been prepared. And also some of its summary has been published in World Psychiatry. That will give a guide to our colleagues who work in this area. So in summary, there are many other groups which you can always find on WPA. I have just given you a short glimpse of some of the group's activities. WPA, I'm really pleased that despite having a number of adversities during the last two years, we have been able to continue to work towards improving the image of psychiatry and psychiatrists. And we have been a strong advocate to tell the policymakers that we need accessible, affordable, and acceptable services, whether you are working in a developed country or a less resourced country. What WPA promotes and has been promoting, that mental health needs to be evaluated on evidence, not on perception. And changes in our services should be based on needs. And change in policies should be as per burden of disease. Look at the burden of disease with the mental health problems. Are we getting our due share in our delivery of services? So dear friends, I, on behalf of my executive committee and the zonal board, I would request you that please stand by WPA to dispel negative views, to enhance the perception of psychiatrists. One of the major issues at the moment we are facing is image of psychiatry and image of psychiatrists. And of course, when we improve the perception of psychiatry, we will definitely improve the image of our profession and of our psychiatrists. WPA needs your assistance. And we really want to play an active role, irrespective of the place, country, or the group that we are going to target for that. I welcome you all to our next World Congress in Vienna. And I hope that you will not only have an experience of great hospitality by your colleagues from Australia, but also a rich scientific program, as well as a social program which will be remembered by you for coming years. I thank once again. And now, I will move to our second speaker, Professor Danuta Wasserman, who is the president-elect of WPA. And she will be speaking about another important area that is really one of the need and opportunities for mental health for the coming years. We will have discussions and question-answers at the end, if that is OK with you. Please, Danuta, over to you. Thank you. Thank you very much for inviting us to beautiful San Francisco and the APA meeting and giving us the opportunity to speak about the World Psychiatric Association activities. I am coming from Stockholm Karolinska Institute, which you probably know from the Nobel Prize, which is awarded each year for the most important scientific discovery in medicine or physiology. And I will speak. You probably already said that we are present in 121 countries in 145 psychiatric associations. And we have 70, or maybe more, scientific sections under the presidency of Professor Thomas Schulze sitting here. And we have more than 250,000 psychiatrists. What is important to realize is that of those 250,000 psychiatrists, maybe only 4,000 or 5,000 are coming to different annual meetings, congresses, et cetera, and usually the same persons. So we have probably 200 or even more psychiatrists around the globe who are not traveling and who need to have access to education, development, other sorts, et cetera. So I will come back to that, the question of communication. Probably many of you recognize the World Health Organization diagram about mental health. And what is mental health is to cope with life stresses and realize our own abilities and disabilities and to contribute to our communities. How we can do it? We, of course, need to connect through positive relationships, through communication with the communities. We need to function. It means to apply our cognitive skills, gain new ones, gain education, et cetera, et cetera, to cope and to thrive. Not only live in the misery. The global prevalence of mental disorders comprises, according to WHO, 13% of the global population, which means that 970 million people are living with mental disorders. 5% more females than males. But the numbers are almost equal. 8% of children and 14% of adolescents live with a mental disorder. But only 2% of health expenditure goes to mental health. It is really striking discrepancy between the needs and between the funding given to the topic. And of course, it is like that, that in the countries with high income, here in the diagram in the middle, in the blue line, and the low income countries, there are discrepancies about access to health care, et cetera, et cetera. But still, those discrepancies are not so big, as we would suppose, because different countries are using different strategies to utilize psychiatric care and mental health care and possibilities to improve mental health in the population. Put the attention to the numbers as well. Among those 970 million people, 31% have anxiety, almost 29% depression. And then the numbers are lowering from 11% developmental disorders to 1.5% eating disorders, bipolar conduct disorders 4%, schizophrenia 2.5%. Why I am pointing at that? Because we as psychiatrists are working mainly with those lower numbers in our psychiatric clinics. But we still have 31% of people who have anxiety, which are very often leading to mental problems and mental disorders. And we have depression, which means that we need to broaden the scope of our activities from our clinics to the communities and into public mental health. Global burden of mental disorders and mental disorders are the leading cause of years lived with disability. And mainly due to depression and anxiety again. People with severe mental health conditions die 10 to 20 years earlier than the general population. And of course, for those numbers, suicide is a responsible phenomenon. We know that suicide rates for males are more than double than for females. We know also that suicide is underestimated due to different monitoring and registration methods, as well as due to cultural biases and the question of stigma. We know also that suicide globally is decreasing, the green line on this diagram, but not in your country, not in the United States. It is the red line, which is going upwards. And there is the gap between suicide numbers and figures in the United States and globally. Suicide in the United States, I will not go to the diagnosis, but I would like to show you how it is distributed in different ethnic groups. And as you can see at the bottom, which means they are the highest numbers of suicides, are Indian and Native Americans, above them white population. And the lowest numbers are in Asian, following by Hispanic and black population. During the years before the pandemics, there were declines in suicide in the United States. Small ones, you have seen it on the previous diagram. But afterwards, there was increase again, and increase by 26% among American Indian and Alaska natives, 19% by black or African American persons, 7% among Hispanic persons, but for the white persons, luckily, suicide decreased in the United States. But it speaks this epidemiology a little bit about what we need to do and how it is. And of course, the problem is the gap in treatment everywhere around the globe. And in high income countries, we have usually more robust mental health infrastructure and higher numbers of mental health professionals per capita. But access to care can be limited for certain populations, and probably for those populations which have increasing numbers of mental health problems and suicide. There are great needs and opportunities everywhere on the globe. Access to care, to give culturally sensitive care, to be aware about mental health and about stigma reduction. And this project, which Professor Afsar-Shabed mentioned, the PR activities among medical students are extremely important, because they are writing about stigma. And they will come to the clinical services with, hopefully, a new view on mental health problems. But we need to increase those activities to psychology students, to social workers, to nurses, et cetera, et cetera, to start early. Prevention needs to start very early. Here we speak about education, so we need to start also to do it among other groups. And of course, we need to integrate our mental health services into primary care that everybody agrees on. But I think personally that the community care is the key. We need to collaborate much more with the community care and be tutors for people who are working with mental health problems in the communities. We need to focus on prevention. If we start early to teach children, adolescents, people in the bloom of the age, and elderly people about healthy lifestyles, about physical activities, about diet, sleep hygiene, coping skills, and resilience, I think that we can have an excellent advance to our excellent scientifically-based treatment methods, independently if they are pharmacological or psychological. We need to have collaborative care models. I already mentioned it. Much more with the community services. We need to develop policy together with policy developers and the decision makers to allocate resources. You remember this discrepancy, 2% of the budgets, and so big burden of mental health in each society around the globe. And we need to make research and innovation addressing the unique needs of different populations and cultural factors. My agenda as the president of the World Psychiatric Association, when I will start my term in Vienna, I welcome you to Vienna on behalf of organizing committee and Professor Johannes van Kata sitting here. Vienna is the beautiful city in the heart of Europe with a rich culture, eastward, westward, north, and south, and with excellent minds, among others of Freud. And I start my mandate there in this beautiful city on the 1st of October, 2023. And I thought a lot by myself, with my staff at Karolinska, and with my planning committee at the WPA, what we can, how we can move forward. Because we know we have excellent treatments already. We need more, of course. But we have already excellent treatments. We know a lot. We will develop a few. But they will be still for this fragment of population, which you remember from my slides, which is among 4% to 10%. But 20% more have also mental health problems. And I would like to base my agenda on the United Nations sustainable development goal for better future of our planet. Do not laugh. I still believe in the common institution on the Earth, even if they are not working. We know what kind of problems all global institutions have, including our one, WPA. Because of different views, cultures, backgrounds, experiences, religions. But still, those international forum are the only one when we can meet, discuss, and to see our differences and similarities, and to start from that. And even if you are very well aware that those 17 goals will be not obtained by 2030, due to many reasons, economical reasons, discrepancy in the conception how to go forward. But still, it is some kind of frame on which almost all countries agreed many years ago to push forward. And among those goals, I wanted to have a frame for my work, a theoretical frame for my work. And within those goals, we had goals which are touching upon mental health. The goal number three is about good health and well-being. I remember I was fighting to include mental health there. Because these goals went through different governments, WHO, and I am the director of the collaborating center. But I understood that the health is both somatic and mental health. And there is no mental health without somatic health. And there is no good somatic health without mental health. So we vote this argument, and I think it is a very good one. Then the goal number four is quality of education, gender equality, to reduce huge inequalities we have within each country on the globe. And of course, partnership for goals. So, on the focus will be to work with lifestyles, to work with policy makers, with WHO, United Nations, UNICEF, and other policy makers, to promote research and innovation and communication. I don't want to have everything in English, or in French, or in Spanish. We are 144 association in 122 countries, 250,000 people, 5,000 of them coming to the congresses and listening to English. But 200 maybe would like, would prefer to read something in their own languages. Let's start with the six official languages of the WHO. And to translate our own policy statements, documents, educational materials to those languages. You have also many languages in one and the same country. And it will be a very big challenge for national psychiatric associations to choose what to translate, and also to choose how to further promote to everyone who works in psychiatry and mental health in each country. And then I will continue with beautiful activities of Helen Herman, who was predecessor to Afzal Avjet, and your activities, Afzal. Promoting healthy lifestyles is important, not only for general population. They are motivated more than psychiatric populations, and they understand maybe more. But it is very important to promote healthy lifestyles in psychiatric populations, and also for us, psychiatrists, which have very sedentary behaviors, and a lot of strains, with poor diet, poor physical activity, not enough fresh air and sun. And this kind of activities will also help to equalize our status with our patients and our staff, if we maybe can perform them a few minutes each day. Because even a few minutes is very important to do it with our patients. So on this figure, you can see physical activity, you can see eating habits, you can see sleeping habits. But what is also important to think about work environment, so we need to look at the mental health in working places. Both of managers and the people who are employed, both of doctors and the persons who are steering our work. We need to promote working conditions in schools, and not only mental health of children, adolescents, but also of teachers. And we have already a lot of materials, which can be adapted, but they need to be communicated, translated, and promoted. What we also need to do is to work with the climate change, and it is a topic for the European Psychiatric Association. They will work quite a lot, so we maybe can link to the work they will do in the European Psychiatric Association. But we need to influence builders, policy makers, to build parks, green spaces, good spaces for children to play, and good places for us to thrive in. We cannot forget how important it is. I am not a green piece or flower power, but we have evidence, hard evidence, how those environmental factors are influencing our well-being and our mental health. And we need to communicate about it everywhere. And lastly, we have a wonderful committee, which is called Advisory Committee on Response to Emergency in the WPA, which was launched in March 2020 as a response to the COVID-19 pandemic. And this group, which works in this committee, is fostering education, information collection, develop strategies, local, national, and international, how to cope with the mental health consequences in emergencies. And, of course, there is a mutual help of countries, association, who have more resources to help countries who have less of those resources in this particular moment. And, sorry, and ACRE Committee, both World Psychiatric Association and European Psychiatric Association is working now very hardly to support Ukrainian psychiatrists, which are organized into psychiatric associations, to provide humanitarian and medical aid, but also intellectual aid through WPA member societies and European Psychiatric Association member societies. And we collaborate very closely, EPA and WPA, on this issue. And there is possibility to donate money because Ukrainians need money. They are planning now to have a new mental health program, both for psychiatric and community treatments, both for psychiatric patients and mental health problems. And this program will be run under the patronage of the First Lady of Ukraine, Olga Zelensky. So I really hope, and I know that American Psychiatric Association was also very generous to contribute with donations, but we have also examples of individual donations. Thank you very much for your attention. Thank you. Thank you very much, Danuta. And I'm sure that this really gives a broad aspect of our future work, especially looking at the current adversities and disasters. May I now request our third speaker, Professor Paul Subhagrat, who is our Executive Secretary for Finance. And he has been, he told us that he won't be using the slides, but I'm sure that he will be able to deliver without the technology. So I wanna keep my remarks brief so we can get to questions and answers with the audience, which I think will be very important. And obviously, following both of these presentations, they've really covered, both Professor Javed and Professor Wasserman have covered so much about what WPA is doing and will be doing in the future, and it will be hard to add to that. I guess I wanna just make a few kind of general comments. First of all, I wanna welcome everyone who's visiting from outside the United States to this APA meeting. As a past president of the APA, our relationship with the WPA and our relationship with psychiatrists and others across the world is extremely important. And so the sponsorship of this is, and the relationship with the WPA is critical. There are things that only the WPA can do because it really is a neutral convener, like the United Nations, like the World Health Organization. It is a place where we have countries that may not always like each other in their day-to-day existences, talking with one another and working together and psychiatrists working together. We have the capacity to interact with other governmental organizations. So I think it's very critical that, as we think about the challenges that we all face as psychiatrists, and frankly, even more importantly, the challenges that we face, the challenges that our patients and families face and our communities face, that we think about how we interface with these various other organizations. I wanna just start with a brief story. So many, many years ago, it seems like now, when I was first beginning my academic career, my first chief of psychiatry, chair of psychiatry at Mass General Hospital and Harvard Medical School was a man named Tom Hackett. And Tom died very young. He died at 59, impossibly young, it seems to me now. But he was a polymath. He was one of these people who, at the age of 13, he had grown up in Cincinnati, Ohio, and he was just, you know, he was just one of these people who knew, at the age of 13, he was the director of hepatology for the Cincinnati Natural History Museum and a world expert on snakes and birds and eggs and all sorts of other things. And that expertise continued throughout his life. And he helped me think about, as I was thinking about things I wanted to work on academically, I had been a history major, I was interested in political kinds of things, and he directed me to investigate further. There was a guy named Alan Gregg who had been the medical director of the Rockefeller Foundation. Now, the Rockefeller Foundation has done a lot of good. It's also been involved in some complicated areas like eugenics, you know, nobody and nothing is perfect. But Gregg was the medical director of the Rockefeller Foundation, and part of what he did was bring an enormous amount of resources to bear an attention to the issue of mental health in the United States in the late 1920s and early 1930s. Now, again, if we kind of dial back where we are now, right now there are something like 40,000 psychiatrists in the United States, 50,000, it depends on where you look at the numbers. In 1974, there were probably 16,000 psychiatrists in the United States, and another 30 or 40,000 mental health practitioners. Right now there's 40 or 50,000, and there's about almost a million mental health practitioners. One can argue whether that's made us healthier or happier or safer or better, or what things would be like without all of those folks, but that's where we are. But in 1929, there were 1,600 members of the American Psychiatric Association, not 40,000. 94% of the beds in 1934 were sitting in state mental hospitals or Veterans Administration hospitals. There were almost no psychiatric services that were available in general hospitals. People had psychiatric illness. People were presented with psychiatric illness. They were seen by other doctors, they were seen often by neurologists, but it didn't mean that there were people who were attending to or paying attention to them. And Greg, and I only learned this in the last couple of years, others on the board of the Rockefeller Foundation decided that they needed to make an investment in mental health, both academically and in terms of clinical services. Now, part of the story that I only learned in recent years was that this wasn't a dispassionate and unselfinterested decision. Several members of the board of the Rockefeller Foundation, including John D. Rockefeller Jr., who had had recurrent episodes of depression, and two other members of the board, one had had the, and they were all men in that era, one man had a wife who had severe bipolar illness who killed herself and her two children in the midst of some type of manic or manic-depressive episode, not really clear what, but a very public case. And another individual had a spouse who ended up in a state mental hospital or a hospital of some type and eventually died due to severe psychiatric illness. And they could have, like many people do, hide, run away, move in a different direction, ignore, but they decided that they needed to move towards this area and part of their thinking was, and again, it's hard to talk about this now in a post-pandemic period, but part of their thinking was, Greg was an infectious disease physician, had worked as a public health physician in Brazil, and his view was that as acute infectious diseases diminished in the aggregate, not pandemics, but in the aggregate, the importance of non-communicable diseases, and particularly the importance of psychiatric illness would come to the fore within countries and cultures. And I think as Danuta showed us in her slides, the burden of mental disease is extraordinary, not just disability, but also suicide. And remember, when young people die by suicide, you're losing 50, 60, 70 years of life. It's, the burden of this is to say nothing of the impact on other members of families. So they invested what was then something like, I don't know, 10, $12 million, now it's probably closer to $200 million US dollars in building out psychiatric services and academic institutions, research and investment, investment in training, investment in training of other physicians. But in part did this because of their own direct and personal experience with severe psychiatric illness. And we may argue about what's at the boundaries of psychiatry, is certain problems that people have. All of us go through anguish, suffering, loss. I mean, my teachers, when I was training in Zen Buddhism, in 1972, would have called it Dukkha in the Pali language. It's existential suffering, all of us suffer, all of us get old, all of us get decrepit and all of us will die. But there is also illness that I think most, if not all people would recognize as being something somewhat discontinuous with the experiences of everyday life. So my thought and what I wanted to say was that as the WPA evolves this very robust and highly continuous agenda from Helen Herman to Professor Javed, who by the way was just honored with a very high civil award by the President of Pakistan for his leadership and his commitment both to Pakistan and to mental health internationally. And to Danuta Wasserman for her leadership that we also think about how we as psychiatric organizations throughout the world, people who are in contact with governments, foundations, organizations and how we at WPA can work with other groups like the UN, like the World Bank, like other world federations, world medical foundations to have the kind of forthright plan for investment. Now it's true that, it's true if you look at countries that have developed like China and India, their burden of infectious disease has gone down. Yes, it's hard to talk about that in a post-COVID environment, although COVID's had a lot of other impacts on mental health as well. And likely we're not done with pandemics given what's happening ecologically to our world. But at the same time, the burden of non-communicable disease, the burden of mental health will only increase. And so I think we really need to reach out to the people who can affect this, both within our organizations and externally, to see what we can do to invest and to come up with a roadmap or to build on the roadmaps which have been developed by the World Bank the WPA, World Health Organization and others to really think about what comes next for global investment in mental health so that we're not at 2% of the expenditures when we represent at least 15% or 20% of the burden of disease, to say nothing of the anguish and loss that's associated with suicide. So thank you very much. Thank you very much, Paul. Before we go for question and answer session, may I request Professor Edmund Pai, who is our Executive Secretary for Scientific Meetings, for his remarks. Thank you. Since I'm from California, I want to welcome all the colleagues from the world. All right, welcome and thank you for attending the APA annual meeting. And as my last name is P, I only two alphabets, I'm gonna make my discussion very brief. Very brief. So, and thank you for all the presentation by President Javad and the President-Elect, Professor Wasserman and then also our Secretary for Finance, Professor Samargran. Did I say Professor Javad? Yeah, I make sure I say that clearly. And so we heard about the WPA's action plan for the current triennium, that's from 2020 to 2023. And now we also heard about the psychiatry around the globe needs an opportunity. That just opened our mind, opened our vision, opened our, we know how much we have to do. But here, the only simple message from my heart is that we are the world and we are one world and one family. And regardless what, from high, middle, or low-income country, the membership from all these countries, we're one world, one family. So by working together, that's the key message, that we are, we can achieve these goals as it was delineated by our President and President-Elect of WPA. So by working together, we can achieve a lot of things. And then, and so what are those things and we already know what are the goals and objectives. So we should hold together our collegial relationship among all the member societies. And by doing that, we can define and shape the future of psychiatry in our profession, also provide the best care, treatment deliver system for the people who are in need of psychiatric care. So thank you very much. I stop here, as we leave plenty of time for Q&A from the audience globally. Thank you, Edmund. So we have got some time for questions and answers or comments. Any? Hello. My name is Chandrasa. I'm a medical student in Halifax, Canada. Thank you so much for your talk today. My question was regarding something that was said early in the presentation, being that the APA is an apolitical organization. I was wondering if you could speak more about that, given that psychiatry is really influenced by the social determinants of health, which I think are very related to politics and policy. So I'm wondering how you kind of toe the line between being an apolitical organization and being effective advocates for psychiatry. Well, I think the issue about this particular demarcation is very difficult to comment when you are speaking on behalf of the professional organization, that what are the boundaries between when the professional boundaries finish or when the political boundaries start. But mental health is unique in that sense that the psychosocial determinants of health have got a great influence, not only on causation, but also on the outcome. So we cannot stay outside this domain. And we have to really pass on this message to everyone that if we look at the mental health in a broader perspective, what should we really do and what should we really concentrate? And I fully agree with you that the psychosocial determinants of health are not only important, but also very pertinent in terms of sharing with our patients, with our carers, with our users, so that they should also get this idea that the pills or the drugs are not the only answer. There are so many other options that should be available. But at the same time, we have to also train our own professional colleagues that they have to really keep all these things in mind when they are treating or managing their patients. And we were really pleased that I think this was last year or the previous year, the APA's theme of the work was the social determinants of mental health, which have really made a big difference in terms of highlighting the importance of this particular theme. Thank you. Anyone else wants to comment? Paul, do you want to say anything? Yes. Thank you very much for your question. I will answer to the last one. There is a huge work by the World Health Organization and we are collaborating very closely with World Health Organization, which is called Mental Health Gap. And it is an excellent manual which can be used also in high-income countries to connect and to teach community service people addressing those questions. Of course, we need to use this high technology you mentioned. It is not used yet there. But the materials are there and very well validated and used in the field. And I think Professor Cesar Alfonso, you are a part of the program that is developing those modules on psychotherapy. I mean, this is the future that although we learned it more during the COVID period that tele-psychiatry, virtual psychiatry, and all these tools need to be really prioritized in our practice. And task shifting is, of course, we will have to consider that in a set of more priority areas. Yes, sir. Hi, I'm Alexander Moreira Almeida from Brazil. First, I'd like to congratulate you all from the WPA for the wonderful work that you have done. Talking about the global mental health crisis, we have emphasized very much the social determinants and also the necessity of improving and expanding the mental health care. However, in the last decades, despite all problems, we have improved in the world as a whole in decreasing the poverty and also even increasing the mental health coverage in many countries. However, despite that, we are having a decrease of mental health in the population. We can see, for example, this in the US, in Brazil, in many other countries. Of course, not neglecting the importance of social determinants and also of improving mental health care, but I was wondering if we are not neglecting, for example, the resilience. Perhaps what we can see nowadays is a kind of decrease in resilience in the population as in the definition of WHO of health, the ability to cope with the normal stress of life. So perhaps we are missing a bit this about of the attitude of people and patients regarding the life stressors, like Vito Frankl and Carl Jaspers proposed. I just would like to raise this idea and to hear your thoughts about the importance of this in dealing with the crisis in mental health. Thank you. So first of all, congratulations on your new book. I think it's an important question. And again, it's not to, I worry a lot about, at the margins, at the boundaries, over-medicalizing human experience. I think there's a risk of that. Again, as I pointed out, there were 1,800 psychiatrists in the United States in 1929. There were 17,000. There's 40,000 plus now. There's literally hundreds of thousands of other people who do mental health care. I think that's been very important, and it's been very important to be able to have people come out of the shadows and to also have many, many other different and new treatments. But in some ways, I'm not sure that we can replace the grandmother's bench. I certainly know I can't replace my grandmother's. And so I think there are elements of community, of communal life that get fractured. I mean, why is the suicide and the death rate in the United States going up? Well, if you look, if you stratify the data, it's not going up everywhere. It's going up in certain parts of the United States that may be experiencing certain cultural or economic circumstances. So again, I do think that being reasonably focused and humble about what we can accomplish is very important and doesn't mean to ignore other things. But the reality is when people are dying of severe psychiatric illness, those are people dying years younger, years earlier than they might otherwise, or from overdoses, or from suicide, or from what are called overdoses but are actually suicide. We have to think through also where do we impact and who do we impact the most, especially because of the early age of onset of our conditions. Again, we have conditions that start in early childhood up through adolescence, early adulthood. So the trajectory and the burden is really through this very active and productive period of life. Congratulations to all of you for your lucid, crisp, and very comprehensive presentation to all those in the podium, the stalwarts. Myself, Dr. Ranjan, representing from India. So as we know that in the LAMIC countries, the mental health treatment gap can be as high as 80% to 85%. And as Professor Zerved has rightly mentioned about the need for the UG sensitization, in recently on the 16th April this year, we have conducted the WPA regional congress in Kolkata. And you'll be amazed to know that around 1,000 undergraduate students were there and they have been sensitized. In the initial part of the program, when we asked them how many of you are keen to get the psychiatry as PG subject, only a handful of them, 10 to 15, have raised their hands. But we ended the program of 90-minute durations. Around 70% of the UG students are quite impressed because the brilliant brains are willing to join this subject. Previously, we have been taught about the brainless psychiatry and the mindless neurology. This controversy had been there. So as Professor Zerved mentioned about the need for UG sensitization, myself being in the faculty of the post-graduation training, I have found that though the American Psychiatric Association is holding their 178th annual meeting here and American Medical Association is lagging three years behind, but we have found that the other disciplines are marching much ahead of us. So we get the 25 faculties as PG in the discipline of medicine, but we get only four faculties for the PG in our discipline. So my request for the WPA advocacy group, the incoming president, madam, and Professor Zerved, sir, as well, to need to sensitize the national commissions. We have the National Medical Commission to conduct the post-graduate medical education examination and to trust on the PG education and increasing the seats for the PG discipline in psychiatry. I think you're absolutely right. And thank you very much for organizing that event for promoting psychiatry among medical students. This is something which we would really like our member societies to use WPA's platform to convince the policymakers. And of course, all of us will be available to provide any guidance or any support. And that is why I said that many a time, some of the position documents of the WPA may be helpful in reaching to those people who are really sitting at the helm of affairs. Hi. Congratulations for your presentation. For those of you who don't remember me, I am Aldo Suarez from Mexico. And well, in the last maybe 15 years, I've been working in the area of mental health of mental health professionals. It's not comfortable for many of us to hear about our mental health. In the last two weeks in our country, five psychiatrists under 40 years died. Some of them died of autoimmune diseases. Two of them are supposed to die because of suicidal behavior. So I am still very, very concerned about what happens in our population because I think there are not enough efforts in order to attend, to look up what is happening among us. I always tell when I talk about this that psychiatry is a risk profession. And I've been trying to work in the past years to promote mental health among us in several ways. I would like to ask Dr. Wasserman if there is any effort now in order to know more about mental health of other psychiatrists, and especially if there's something for psychiatry trainees. Thank you. From which country are you? Colombia. I'm from Mexico. Mexico. Mexico. And he said that we can't remember him. We do remember him. He organized and helped us for the WPA Congress. Yes, yes. Thank you very much. It's extremely important, you know, and also the question you raised. We work with the individual patients, but everybody is influenced by social, political, economical factors. And those are helping us, or those are hindrance for us, yes, in all aspects. I mean, we cannot treat homelessness, et cetera, but we need to influence opinions and decision makers. If we are not doing that, we will not succeed with our professional deeds. And it is the same about the mental health. It's a normal stigma, not only among psychiatrists, but also in the police forces or other forces among politicians. You cannot say, even if we have examples, good examples, of people saying, like Harlan Brutrand, who was the general secretary for the WHO, when her son committed suicide. She came to the office of WHO and asked, what do you have? And there was almost nothing about it. So I know that it was really a very massive effort from Brazil, Professor Jose Bertolotte, who is now back in Brazil, to collect different sources, to do different materials. And now, WHO have a lot of resources to help suicide. I think it should be the same for mental health of different professionals. One prime minister of Norway, he said, came out and said, I have depression. And now, we do a lot about it in the Nordic and Scandinavian countries. So we need to have more examples for people coming forward, and also to there, because it is a lot of substance use, misuse, depression, anxiety, and even violence within our profession. And we don't speak so much about it. So when I say mental health in working places, I mean all working places, also hospitals, not only factories, and also our health. And when I say we need to have physical activity, we need to sleep better, we need to eat better, it's also about our health. We need, really, to show examples to our patients. It will be my agenda, the global public health agenda. And I hope that many of you can help in raising different awareness on different levels about it. Thank you very much. We have got a question. Please. Thank you, all of you, for beautiful presentations. And thank you, Professor Javed, for excellent tenure, in fact, regarding on the scientific area, whatever you promoted. It is really great. Not only helpful to the developing countries, all of the psychiatrists will get the materials from WPA now. In fact, in the last WPA regional conference at Calcutta, we have done wonderful scientific work as per your suggestions. And also, thank you, madam, for your vision in the coming WPA actions. But what I am telling you, sir, most of the things we are doing beyond our four walls. We are not going beyond our four walls of conference. Something we are restricted to are the psychiatrists. As we have done in the mental health work, as you are present there, in the recent regional conference, almost more than 1,000 people worked together. And the slogan was, no health without mental health. And it was big things. And I think something like that from WPA, if we organize, that every member of society can report what they are doing. We should reach to the society at large, not only beyond ourselves. Yes, we are also important. Our mental health, as well as physical health, is important. But until we reach the society at large, then the stigma and all things will be there in the society. We should take some planning or anything which we can report to the WPA head office that from India, we are doing all these things. During the COVID period, we have done lots of work. There are lots of psychiatrists who directly go to the society at large and to the people who are suffered. And mental health is a problem. In fact, there are so much of negative points during the COVID period. There are also positive periods, like we can reach to the people. There are lots of improvement in the tele-psychiatry and all. And number two, sir, during the lifestyle modification, from WPA, this year also, under the leadership of you, we have done a course on the yoga. And that is also a very good thing. I think we should mention that it is a really good thing. Well, thank you very much, Dr. Saha. I think that was an exceptional way of promoting mental health by organizing a walk by the mental health professionals during the Congress. I do hope that we will encourage our future Congresses. Actually, that walk was, there were about 1,000 mental health professionals on the streets of Kolkata, just raising voice for the mentally ill. So probably that could be a sort of a real example, which we can recommend to all of our future Congresses. Thank you, sir. And with your advice also, you have taken a decision. Every year, we do such a walk from office. So I think we are just approaching to the close of this session. Any last-minute comment or any question? If not, many, many thanks. Thanks to all my colleagues. And also to all of you for listening to us. Thank you very much.

World Psychiatric Association

mental health promotion

capacity building

professional collaboration

educational programs

ICD-11 training

early intervention

non-communicable diseases

UN Sustainable Development Goals

resilience education

global audience

cultural adaptations