MC and Global Health--8

Home Coming

Back home in our garden in France
--and in member care--
 after travels in the Global Health domain.

Roads go ever ever on

Under cloud and under star,
Yet feet that wandering have gone
Turn at last to home afar.
Eyes that fire and sword have seen
And horror in the halls of stone
Look at last on meadows green
And trees and hills they long have known.
(JRR Tolkien, The Hobbit)
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In these entries we’ve explored some of the concepts, challenges, and practices of global health (GH) and GH's relevance for member care and mission. It is just a start for us and hopeuflly others will take GH further, sharing how GH is and can be actively part of mission and member care.

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Central to GH are the notions of equity and quality care for all. Our exploration has taken us to places all over the world via articles, web sites, short video docs, and analyses about issues and opportunities. We highlighted vulnerable populations, coordinated efforts, and further integrating both physical and mental health into the work of mission/aid. Health statistics, democratizing GH, and preventing sexual exploitation/abuse were also specifically addressed. Global mental health (GMH) was especially emphasized and  a crucial part of what we called mhM--mental health as/is misson.

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We advocate for a broader vision and a new phase for member care, in keeping with the challenges and opportunities facing humanity.

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We encourage maintaining the focus of the MC core while expanding the function of the MC corps (i.e. emphasizing wellbeing/effectiveness for mission/aid workers vs pursuing skills/involvement for  GH/GMH).

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Reflection and Discussion

Can we develop a consensually-derived global framework (agenda) for member care, even as there have been global frameworks within the health and mission domains?  

 

Could a Global Summit be set up to pursue this framework, including a diversity of people interacting before, during, and after such a Summit?

 

Here are some examples of frameworks/agendas to stimulate our thinking and inform our actions.

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Global Health

**A Framework Convention on Global Health: Health for All, Justice for All
Journal of the American Medical Association (16 May 2012)
**One Health Summit 2012: One Health, One Planet, One Future
Global Risk Forum (human, animal, environmental health, agriculture, food safety/security)
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Global Mission

**Missiometrics 2008: Reality Checks for Christian World Communions
International Bulletin of Mission Research (January 2008, see line 79 in summary chart; for 2012 statistics: click here)
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Member  Care

**An Agenda for Member Care in Frontier Missions
International Journal of Frontier Missions (July 1992)
**Global Treasures for a Global Field (resources and directions)
Member Care in India: Ministry Call to Home Call (MUT, 2012)
(initial version in Momentum May/June 2006, pp.49-52)

MC and Global Health—7

Mental Health IS Mission

As early career psychologists, we headed into mission/aid work 25 years ago.

This 1987 photo is from a special farewell party in Los Angeles with friends.

We have grown deeply and broadly and so has the member care field!

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"The Christian mission requires that we meet basic human needs for education, food, water, medicine, justice, and peace. As is evident in the Apostle John’s assertion that Jesus was sent to “destroy the works of the devil” (I John 3: 8), our mission is to continue his earthly mission by undertaking the kind of organized research and enterprises that combat evil in all its forms—violence, injustice, poverty, environmental exploitation, drug trafficking, and disease… All of this is to the ultimate glory of our good and gracious Creator and Redeemer God." David Hesselgrave, describing the essence of Dr. Ralph Winter’s “kingdom mission.” Evangelical Missions Quarterly, (Volume 46, April 2010; p. 196).

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To “meet basic human needs” and to “combat evil in all its forms” also includes combating the causes and results of human suffering, such as mental ill-health and disease. In this regard, connecting and contributing to the global health domain (GH) is an important opportunity for the member care field even as it has been for parts of the mission/aid sector. Global mental health (GMH) is particularly relevant, as we have seen in these entries.
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Mental health (MH) fits solidly into the scope of “mission.”

It is not just a means to a “greater” spiritual end.
It is not just a bi-product of mission.
It is a core part of mission.
MH is mission (mhM).
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“The global burden of disease attributable to mental, neurological, and substance use disorders is expected to rise from 12.3% in 2000 to 14.7% in 2020 (1). This rise will be particularly sharp in developing countries. Research has documented the socioeconomic determinants of many disorders, the profound impact on the lives of those affected and their families, and the lack of appropriate care in developing countries. The enormous gap between mental health needs and the services in developing countries has been documented in international reports, culminating in the World Health Report 2001 (2). This evidence has increased the profile of international mental health, but action still remains limited. With every new public health challenge, mental health is once more relegated to the background. We argue that moral arguments are just as important as evidence to make the case for mental health intervention. At the center of these moral arguments is the need to reclaim the place of mental health at the heart of international public health.” (Beyond Evidence: The Moral Case for International Mental Health; Patel, Saraceno, Kleinman, American Journal of Psychiatry, 138:8, August 2006, pp. 1312-1315)

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Some Basic Applications

1. Further develop MH awareness/skills for:

**mission/aid workers
**member care workers
**health care workers
**the people and communities that are the focus of mission/aid and health care workers
(including vulnerable populations: the poor, those with minimal access to health resources, settings of conflict/calamity)
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Some resources:

**Mental Health First Aid (12 hour course)
(Links for Training in 15 Countries)
**Psychological First Aid: A Guide for Field Workers
(World Health Organisation, World Vision International, War Trauma Foundation)
**Community-Based Psychosocial Support: A Training Kit
(International Federation of Red Cross and Red Crescent Societies)
**Integrating Mental Health into Primary Care: A Global Perspective
(World Health Organisation and World Organisation of Family Doctors)

**Where There Is No Psychiatrist

(Vikram Patel)
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2. Encourage mental health professionals and students to find relevant ways to connect and contribute to global MH.

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Some resources:

**A Resource Map for Connecting and Contributing (short article: July 2011)
**Finding Your Niches and Networks (short article: March 2012)
**A Resource Primer for Exploring the Domain (journal article: July 2012)
**GMH-Map website: A global map for a global movement
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Finally, and for some stats and real-life examples: Watch the short overview video about global mental health from the World Health Organisation’s “Mental Health Gap Action Programme.”
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Reflection and Discussion

**Christian mission keeps the person and message of Christ central. Respond to this assertion in terms of the MH perspectives shared in this entry.
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**How could people in your settings including yourself further develop MH awareness and skills? How feasible is this?

MC and Global Health—6

Mental Health as Mission:

Go Broadly, Grow Deeply

In Tamil Nadu, India. April 2012

Is it time to seriously tweak our member care paradigms and skill sets?

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How does Global Health (GH) relate to member care and vice versa? One key connecting point is through global mental health (GMH). We think that GMH will have an increasing role to play for member care and mission/aid. We like to think of it as “mental health as mission” (mhM).
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mhM embodies our joint efforts to serve humanity via the mental health sciences/disciplines. It is an important extension of our member care work, building upon the core MC focus of wellbeing/effectiveness for mission/aid workers in order to further equip/support workers who themselves are helping people in areas like domestic violence, depression, substance abuse, traumatic stress, etc. It can also involve our own direct services for people needing mental health and psychosocial support—so another important way for skilled MC workers to contribute beyond their usual roles.  

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mhM is quite a frontier too, especially since mental conditions are largely untreated among the poor, and there are lots of poor among Unreached People Groups of course. For example, currently it is estimated by the World Health Organisation that estimate of 450 million people suffer from mental, neurological, or substance abuse conditions (MNS)--with about 75% going untreated in low to middle income countries. Further, one in four humans will likely experience some type of serious MNS condition during their lifetime. The ripple effects of course are considerable especially when MNS conditions are not treated, affecting friends, family members, finances, communities, the economy, etc.

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Interview in India

Here are some more thoughts about mhM, weaving together global health and global mission realities. They are excerpted from our recent interview in the Chennai-based Christian Manager magazine (April-May 2012). Have a look at the entire interview (pages 23-28) as well as other articles in this issue on mission in India. This interview encourages us to consider the many opportunities to relevantly connect and contribute to mhM as we go broadly and grow deeply.

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"One of the global trends challenging missions is the issue of migration--people who are on the move. According to the Geneva-based International Organisation for Migration (IOM), there are around 300 million people who are in some form of significant international migration…The transition experience of migration incurs loss, grief and perhaps alienation [and many positive benefits!]. So the transition experience is not just something to focus on for mission workers and their families, but for other major blocks of humanity as well. I see all this as opportunities for missions.The world’s on the move and we should be too….The mission community can benefit from cutting edge resources such as the materials on the website of Families in Global Transitions (www.figt.org).”

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“…the concept  of missions and who is a missionary needs to be revisited in the light of global realities...we can no longer talk only about traditional missionary work in an explicit evangelism and cross cultural contexts.  The utter need for crossing cultures and focusing on unreached people groups is still at the heart of mission. Yet the mission of God is much more than that. This also means going cross-sectorally in order to connect with human structures such as the global health community (e.g., World Health Organization and many NGOs), the United Nations Millennium Development Goals, [e.g., end hunger and poverty, provide universal education, improve child and maternal health, ensure environmental sustainability] and other organizations with an international, multi-sectoral, and faith-based reach—a good case in point is World Vision International. Clearly it is a call to bring both new and old gems out of our mission treasure chest, an ongoing process,  as envisioned by Christ in the Kingdom parables (Mt. 13:51,52).” “

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Going Further

1. Have a look through our new and main website for Member Care Associates, Inc. (www.membercareassociates.org). This site, like all we do in MCA, is dedicated to encourage us as we intentionally cross sectors, disciplines, and cultures for good practice in light of global realities. You will find a lot of materials to help broaden our boundaries—thinking, relationships, activities—for mutual learning and effectiveness as learners-practitioners.

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2. Review the new article in the 16 May 2012 issue of the Journal of the American Medical Association, A Framework Convention on Global Health: Health for All Justice for All by Lawrence Gostin.  If you get a bit lost (in spite of how well-written it is) don’t fret, since there are probably several new terms, organisations, ideas, and issues that you will come across and which are all part of becoming more conversant with GH. Why read this article? One important reason is because GH realities needs to inform our thinking and work in MC in mission/aid.

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 Reflection and Discussion

**List a few items from the materials above (interview, web site, article) that are most relevant for your life and for your member care work in mission/aid. We really encourage people to review the materials with colleagues.

**Try to make a case (list a few reasons) for mhM being a distraction for MC and then in contrast for it being a duty of MC. Is MHM an obstacle or an opportunity--what do you think?