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The hi
story of Western psychiatry is replete with mistakes as well as successes. Currently, high-income countries desperately need reforms to enhance the effectiveness, efficiency and availability of behavioral health care (relating to mental functioning and substance use). Meanwhile, developing behavioral health systems in low- and middle-income countries presents major challenges to policy makers. Unmet behavioral health needs and burdens are enormous, but as change occurs, there is the danger that Western mistakes will be repeated.
We need to review bio-psycho-social understandings and see how these may be implemented most effectively in the context of diverse cultures, beliefs and values. Innovations in service delivery, taking advantage of upcoming and adapted technologies, offer opportunities which should be assessed in ways appropriate to those different contexts. We also need to explore how patients’ interests, rights and preferences may be best elicited, protected and acted upon, consistent with institutional and legal norms informed by health care delivery science. Both aspects are key to determining how health systems’ capacity can be built most economically and effectively, and how ‘patients’ can be ‘agents’ in their own behavioral health care.
1) Human rights: Some institutional or traditional practices can be abusive or fail to give voice and agency to people with behavioral health problems. How can competing behavioral health care practices be aligned with basic human rights and patients’ rights?
2) Patient-centeredness: How can countries build behavioral health care systems based on the needs and wishes of service users and families rather than those of professionals and industries?
3) New systems: Existing Western behavioral health systems are in need of reform and fit poorly in other countries for many reasons. But how can low- and middle-income countries develop affordable and culturally relevant systems without suitable precedents?
4) Existing resources and cultures: How can new systems best leverage existing behavioral health resources, models, and cultures?
5) New technologies: Information technologies (which leverage the Internet and mobile devices) may allow countries to skip over many unhelpful steps and develop more effective and efficient models, but how do they proceed?
New Paradigms in Behavioral and Mental Health - Day 1
New Paradigms in Behavioral and Mental Health - Day 2
New Paradigms in Behavioral and Mental Health - Day 3
Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series – Health and Health Care Innovation in the 21st Century – to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.
