Elizabeth K. Carll, Ph.D.

The transformation from an industrial society to information society in the 21st century provides limitless opportunities for the improvement in the lives and well being of all people. The recognition of the importance of this global revolution and the need to reach global agreement on complex problems such as broadening access to information, bridging the digital divide between the rich and poor, right to privacy, and the right of free expression, was the basis for establishing the first United Nations World Summit on the Information Society (WSIS). Certainly, an admirable goal, however, the journey will be long a one with many obstacles to overcome along the rocky road.

The implications of using information and communication technologies (ICTs) for improving the health, including mental health, of the world community is an exciting prospect and prompted me to read the draft proposal of the WSIS Declaration of Principles and Plan of Action. To my surprise, there was no mention of mental health anywhere in either the documents, including the section on health.

The omission of any reference to mental health prevention, treatment, services and promotion of mental health in the WSIS documents was reminiscent of the lack of parity between physical and mental health services in health plans and programs in the United States. The lack of parity in access, services, and costs, reflects the failure of the integration of mental health services into the health care system even in a nation, which is considered the most affluent and technologically advanced nation in the world.

Mental health is fundamental to overall health and is the foundation for learning, thinking, communicating, self-esteem, and resilience, as well as successful functioning in one's work, family, community, and society. Yet the majority of the world's people do not receive treatment for diagnosable mental disorders as mental health is often viewed as disconnected from health services (Carll, Danieli, Braak, 2003).

Globally, more than 400 million people are known to suffer from mental and brain disorders and these numbers are expected to rise sharply over the next few decades, particularly among people in the developing world. Despite the enormous social and economic burden, more than 40 percent of the world's countries have no articulated mental health policy, and over 30 percent have no mental health programs.

Given this unfortunate situation with regard to the lack of integration of mental health services in comprehensive health care, the landscape is ripe for replication of the existing problem on a much larger scale involving ICTs. To prevent the recurrence of this problem, it became evident that integration needs to take place at the time of the inception and development of the recognized basic services that will be included in global declarations as necessary and accessible through ICTs. This prompted my collaborating with mental health organizations and professionals to address this problem.

The International Society of Traumatic Stress Studies (ISTSS) has spearheaded the initiative to address and rectify this problem. The ISTSS Statement on Information and Communication Technologies, Mental Health and Trauma was drafted (Carll, Danieli, Braak, 2003) identifying the issues and the importance of the integration and access of mental health information services via ICT. It was also helpful to have the support of the NGO Committee on Mental Health in New York, a consortium of approximately 60 organizations, for which I serve as chair of the Media/ICT Working Group.

The collaborative support of ISTSS and the NGO Committee on Mental Health in conjunction with the ISTSS Statement on Information and Communication Technologies, Mental Health and Trauma (Carll, Danieli, Braak, 2003) served as a foundation to support my participation and efforts in working with the drafting group of the Civil Society (CS) WSIS Declaration. This collaborative initiative led to the successful outcome of the inclusion of mental health in the CS WSIS Declaration. This was critical as the Governmental WSIS Declaration was essentially finalized prior to the Summit, with the exception of some issues relating to Internet governance and funding. In addition, this was the first time that Civil Society (CS) was invited to be an active participant in a UN World Summit and the CS Declaration officially recognized.

As the only mental health professional involved in the drafting of the CS WSIS Declaration, it demonstrated for me the importance of multidisciplinary expertise in the complex process of developing consensus in a diverse multi-stakeholder community, as well as the importance of a single or small group of voices in a democratic process.

A major difference between the Governmental WSIS Declaration and the CS WSIS Declaration is the emphasis of the CS Declaration on a more comprehensive people centered approach focusing on what should be done to benefit all members of the global community rather than what could be done based on governmental agreement. The CS Declaration also emphasizes the importance of a communication society as opposed to an information society, highlighting the need for the two-way flow of information, particularly from the bottom up vs. the dissemination of information to the public from the top down. The recognition of mental health as a necessary component to the well being of all people and an essential prerequisite for reaching the Millennium Development Goals (MDGs) further highlights the people centered focus of the CS Declaration.

The prevention and treatment of mental illness and the promotion and protection of mental health via ICT provide the necessary foundation for truly resilient communities within a global society. Only through collaboration, cooperation, and effective communication among civil society, government, and the private sector will comprehensive health policies be developed that will truly benefit a global society.

What remains to be seen is whether the outcome of WSIS I and II will serve to advance the utilization of ICTs to benefit all within the world community or merely mirror existing problems on a more technologically advanced scale.

References

Carll, E., Danieli, Y., & Braak, J. (November, 2003). Statement on Information and Communication Technologies, Mental Health and Trauma. The International Society for Traumatic Stress Studies.

Elizabeth K. Carll, Ph.D.
Focal Point to WSIS
International Society for Traumatic Stress Studies;
Chair Media/ICT Working Group,
NGO Committee on Mental Health, New York
PO Box 246
Centerport, LI, NY 11721
Tel: 1-631-754-2424
Fax: 1-631-754-5032
ecarll@optonline.net
Elizabeth Carll, PhD, has organized a WSIS Working Group on Health and ICT to promote access for all people to comprehensive health information and services, including mental health, via ICT. If your organization would be interested in joining the Working Group, please contact Dr. Carll at ecarll@optonline.net