We meet on the occasion of the 15th anniversary of the Slovakian National Programme for Mental Health (NPMH). It has brought about changes in awareness and practice by overcoming, for instance, the mentality of ‘about us without us’, well known from the former Communist regime.
The NPMH is based on the WHO approach (2002) on mental health promotion and prevention. According to this concept, promotion is the responsibility of society, of families and education systems to foster conditions of healthy development. Promotion is the foundation from which the three forms of primary, secondary, and tertiary prevention develop. Primary prevention focuses on protecting individuals and populations from illness, hurt, injury, and abuse; secondary prevention are means of therapeutic healing; and tertiary prevention signifies rehabilitation.
In this WHO approach, the point of departure is not the state of disability or illness, as is usually the case within the bio-medical model. Rather, it recognizes the whole person as a bio-psycho-social being, capable not only of accepting disabilities and illnesses as an integrated part of life, but also of overcoming them.
This point of departure aligns with another WHO request, according to which all individuals are given a fair chance to fully realize their health potential, which implies removing all obstacles that restrain this potential, as exemplified by the “Recovery” movement initiated by people with schizophrenia that turns their state of crisis into a chance.
On account of these promising developments, today we face new challenges and questions that we jointly need to address:
If a society is to open up possibilities of integration for all its participants, what new problems, new helpful forms of differentiation and cooperation will contribute to and be necessary to move forward?
From here we need to reconsider again where we stand in regards to the promotion of mental health in its subtle and manifest forms. This includes appreciation of every human life, reducing stress in schools and workplaces, cultivating human relations, nutrition, movement, regeneration, relaxation, sleep, reducing smoking and alcohol consumption, etc. We need to consider the strong link between the promotion of health and the capabilities needed to lead a meaningful life. This implies an integrational thinking that conceives a differentiated continuity of health.
From here we also need to reconsider primary prevention again. Does it not imply our right to be protected from excessive (self-)demands and burn out in its many forms, from childhood on?
We need to learn from each others’ best practices of fruitful cooperation and different ground-breaking examples of promotion and prevention that safeguard individuals from hurt while healing and integrating into society those in need.
In this time of rapid change stake-holders in the domain of mental health, along with members of society, need to pause and reconnect in order not to miss out on the chances unfolding today.
In Bratislava, we invite you to pause and consider questions with major practice implications. The cooperation needed to jointly tackle these issues starts right here and right now.
Welcome to the juncture-point Bratislava!
Pětr Nawka, Chair of Integra