jueves, 2 de noviembre de 2017

Jaime Fernandez, President FEARP.

Jaime A. Fernandez, President FEARP.

Not long ago, I returned to visit the old Psychiatric Hospital of Gran Canaria with students of Psychiatry and Psychology (MIR and PIR) as part of a seminar on History of mental health care. The story of the director of the facilities (a person who accumulated more than 30 years of work in that place) told tricky stories. He said "in past times we were afraid, of the patients; to enter a cell we needed five guards behind a mattress"; or also that "we caused an infection that gave fever to be able to contain them, there was no other way to lower the agitation". The visit to the Psychiatric Hospital took us to another century.

After the visit, a seminar on the current mental health network was given. We experienced a vertiginous jump from 1985 until today. The enumeration of the services created in the last 30 years dizzied the students: services for health (USM, UIB, HD, ETAC, etc.), services for social health (CRPS), social services (CD, residential, work, etc). But the biggest jump in time is the relationship between professionals and patients, now more horizontal. Today people with mental health problems give us lectures, participate in our seminars as trainers, organize events and activities together with us, participate in the decision making of the devices, etc. In Spain there is a model of community mental health care, assertive, the provides psychotherapy, attention at home, health and social care, etc. There is still much to be done and to improve, but giant steps have been taken toward the dignity and effectiveness of care.

Students visiting the Old Psychiatric Hospital in Gran Canaria.

In this transformation, Psychosocial Rehabilitation programs have played a fundamental role incorporating the functional approach. Today no one disputes that Psychosocial Rehabilitation is a fundamental strategy in the treatment of mental health problems and that it has contributed the main advances of the decade in addressing serious mental disorders (such as some evidence-based interventions: family interventions, vocational, neurocognitive, etc.)

Madrid, headquarters of the XIII WAPR 2018 Congress, has played a prominent role in the national development of Psychosocial Rehabilitation. The Madrid network has been an organizational reference. The different Spanish autonomous administrative territories have adopted different types of rehabilitation networks according to their autonomic context, with greater or lesser fidelity, or as an alternative model to Madrid, but always with it as a reference.

The service network in Madrid has also been an example of collaboration between professionals from different administrations (health and social) as well as public and private management. There are four different approaches (health-social, public-private) that have generated multiple debates about the effectiveness of their management, but that seem destined to live together and to understand each other. The 13th WAPR Congress will be an occasion to reflect on all these achievements and the path taken by Psychosocial Rehabilitation in Spain and around the world.

In addition, the XIII WAPR 2018 Congress, as its president R. Guinea has said, pays tribute to a whole generation of professionals, mental health workers and pioneers of psychosocial rehabilitation.

I am a clinical psychologist, and as such I have been witness for decades of the thrust of a progressive psychiatry (which includes all types of mental health professionals) in defense of the dignity of the patients. A movement that has fought, researched and worked to improve the effectiveness of treatments and has spearheaded the defense of the rights of the people affected. Social psychiatry, which was the germ of the WAPR in 1985 and of the FEARP in 2001, together with other groups (AEN, etc.), led in its day the process of the Psychiatric Reform in Spain.

As president of FEARP www.fearp.org) I encourage professionals from all over the world to participate in the XIII WAP 2108 Congress in Madrid, because it will be the privileged place to debate and get infected with the experiences in Psychosocial Rehabilitation that have arisen throughout the world .

martes, 24 de octubre de 2017


Ricardo Guinea, Chair Organising Committee WAPR Madrid-2018.

WAPR is an international organization that groups more than 30 national branches. It was created in 1986 by a group of veterans psychiatrists of social psychiatry with the mission of expanding the practice of Psychosocial Rehabilitation to improve care for people with mental illness; an approach that initially sought to eliminate obsolete and depressing mental health practices, and today traces, studies and raises global initiatives and technical models aimed at the participation and social inclusion of people.

A World Congress like the one that we plan to celebrate in Madrid is the maximum scientific and social global event of our discipline, the Psychosocial Rehabilitation of people with mental illness. It is the largest space for discussion and technical and scientific elaboration, the place of exchange that allows us to put our conceptions in perspective and discuss them collectively with the world's leading experts on the subject and, not least, a place for the proclamation of human and civic values ​​that for some decades, and in progressive evolution, guide the transformations that we propose and that we consider necessary.

To receive the commission of the organization is undoubtedly an honor, which recognizes the great trajectory of our country (Spain) in the last 20 years; and it is a great organizational, technical and economic challenge, a challenge of great magnitude, which I am sure, with the contribution of our professionals, our social leaders and the entities involved in this field, we can certainly face successfully.

And it will also be the culmination of the contribution of a generation of Spanish professionals, who in the last 20 years have given unselfishly their best effort and many hours of effort apart from their work dedication to this noble cause.

At the global level, we are at a very special moment in our discipline.

In recent years:
- awareness of the importance of mental health has grown,
- an enormous amount of research has emerged in the biological, psychological and social fields,
- great innovations have been made in many countries - for example, in Spain; and in others the ground is being prepared for them to occur.
- there is proven experience of effective technical alternatives to help affected people to live their lives in the community, under conditions of standardization and with opportunities for social participation.

However, there is still much to do and much to discuss. At the global level:

- Access to services is still a challenge in many countries; is something you need to remember.
- The transition from the old models to the new ones is an ongoing process, which is being implemented at a global level in an unequal way, and which still requires a lot of energy and leadership.
- At the purely scientific level, it is still necessary to advance and improve our understanding of the complex interrelation of the biological, psychological and social planes in that human condition that we call mental illness.
- And, as you can see in the specialized media and also in more and more in the media, there are a number of hot topics.
o Further research is needed on the role of drugs and the development of the best pharmacological strategies based on the experience and value they bring to the lives of the people who use them.
o We need to better understand the emergence of diseases and the best strategies for early intervention.
o There is a large ongoing debate on legal issues related to protecting the legal capacity of individuals, and affecting the rights of those affected.
o The latest perspectives from the point of view of Human Rights require a responsible review of historically accepted practices (such as coercive treatments, physical restraints and other practices that have been used for decades and considered appropriate as security measures).
o The so-called Recovery Model puts on the table issues related to the design of institutions and interventions, to study how they support and not hamper the process of recovery of the person.

In order to address these and many other issues, we will convene this Congress, where we will have first-class speakers, which will be a forum for meeting all stakeholders in this discipline: professionals, families, caregivers and users.

We will announce new developments as they are produced. We are sure it will be an excellent call.