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Joint Statement

International Council of Nurses (ICN)
International Pharmaceutical Federation (FIP)
World Medical Association (WMA)

GENEVA, 15 May 2001  -  The World Health Professions Alliance, speaking for more than 14 million health care professionals world-wide, finds discrimination associated with the mentally ill to be unethical and is calling for its eradication.  Patients with mental illness should be viewed, treated and have the same access to care as any other patient.

Mental disorders represent more than 12% of the total burden of disease.  However, the true extent of the problem is difficult to measure.  Mental health problems tend to remain undiagnosed and unreported because of stigma and exclusion.  This stigma often discourages people in need from seeking help, therefore aggravating their situation.

About 24% of patients who seek primary health care suffer from some form of mental disorder.  A majority of these patients (69%) usually present to health personnel with physical symptoms; consequently, many of them are not correctly diagnosed for mental illness and thus not treated.   In addition, in many countries health care providers are not prepared to address the mental health needs of their patients.  With proper training and supervision, health professionals could become more competent in identifying and treating mental disorders.

Mental health is recognised as a speciality within the health professions, but research shows that mental health problems are common in general health care settings and have severe consequences for individuals and societies.  Since physical illness is often accompanied by a mental health problem, health professionals must have the knowledge and skills to be able to respond to people's mental health needs.

The condition of a patient with mental illness incapable of exercising autonomy does not differ from that of any other legally incompetent patient.  They should be treated like any other patient who is temporarily or permanently incompetent.  A patient with mental illness, including psychosis, should not automatically be considered to be legally incompetent.  His/her judgement should be respected in areas where he/she is capable of making decisions.  If the patient lacks the capacity to make a decision as to his/her medical care, surrogate consent should be sought from an authorized representative in accordance with applicable law.

Involuntary treatments should be used in the treatment of a patient with mental illness only when he/she is in an acute state and may pose a threat to himself/herself or others.  Compulsory hospitalisation should be considered to be exceptional and, therefore, utilized only when and as long it is medically necessary.

Health professionals have a key role in promoting mental health, preventing mental illness and improving access to mental health services.  They also have a role in educating the public and reducing stigma.  Health professionals need to focus on reducing the treatment gap of mental health disorders.  Advances have been made regarding new treatment and care, and on the causation, associations, characteristics and prevention of mental health problems.  The benefits of this knowledge should reach all people with mental health problems, particularly the vulnerable populations.

The World Health Professions Alliance brings together medicine, nursing and pharmacy through their representative international organisations, International Council of Nurses (ICN), International Pharmaceutical Federation (FIP) and the World Medical Association (WMA) and represents more than 20 million health professionals worldwide.

• The International Council of Nurses (ICN) is a federation of 125 national nurses' associations representing the millions of nurses worldwide.  Operated by nurses for nurses since 1899, ICN is the international voice of nursing and works to ensure quality care for all and sound health policies globally.
  
  
• The International Pharmaceutical Federation (FIP) is the worldwide federation of national associations of pharmacists and pharmaceutical scientists. Pharmacists are health care professionals dedicated to improving access to and value of appropriate medicine use worldwide.   
  
  
• The World Medical Association (WMA) is a global federation of national medical associations, representing the millions of physicians worldwide.  Acting on behalf of physicians and patients, the WMA endeavours to achieve the highest possible standards of medical science, education, ethics and health care for all people.

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