ABSTRACTS - World Psychiatric Association

one has to act. Governments have to allocate adequate resources, and
support programmes and services. Empowered service users must
assume an active role in advocacy, service planning and care delivery.
Mental health professionals have to continue seeking the improvement
of care by anchoring it on solid scientific, human rights driven evidence.
Managers of services have to eliminate human rights’ abuses.
Families, heads of communities, schools, labour, religious institutions
must assume an active role in advocacy, care and rehabilitation. Parliamentarians
have to promote the adoption and implementation of progressive
legislation. Health insurers have to establish parity in care provision.
The media have to help in the creation of a mental healthfriendly
culture. The Global Forum for Community Mental Health
brings together diverse constituencies with a real interest in better promoting
mental health, preventing and treating mental disorders. Based
on their different perspectives and bringing specific points of view from
their own environments, these constituencies stimulate and lend support
to action aimed at raising awareness in countries around the
world on the burden of the mental and substance abuse problems, the
community based interventions available to reduce them, and the pervasive
effects of stigma and discrimination that affect persons with
mental disorders and their families.
US13.2.
POWER IN NUMBERS: DEVELOPING
PARTNERSHIPS FOR MENTAL HEALTH
C. Underhill
BasicNeeds, Warwickshire, UK
For nearly a decade, BasicNeeds has been building partnerships at
grassroots level with the goal of enabling poor people with mental
disorders to live and work in their community. Across Africa, Asia
and Latin America, we have trained 55 partner organisations to
implement the Model for Mental Health and Development, enabling
54,076 people with mental disorders to access services. We also enter
into partnerships with our service users, whom we have supported to
form over 200 self-help groups that, in some cases, are being structured
into national movements. Based on this rich experience of local
partnerships, we are building a knowledge base in support of international
partnerships and networks, such as the Global Forum for Community
Mental Health and the Movement for Global Mental Health.
This paper gives examples of the process of partnership development
and highlights benefits to working in partnership, namely: achieving
service coverage in a context of resource gaps; making expedient
progress in human rights at local and district levels; and mainstreaming
people with mental disorders outside the field of health.
US13.3.
PARTNERSHIP OR PRETENSE:
CAN PARTNERSHIPS BETWEEN USERS
AND SERVICE PROVIDERS WORK
M. Salie
Cape Town, South Africa
Janet Meagher, a long-time consumer organiser from Australia, wrote
a book entitled “Partnership or Pretense”. This paper addresses the
issue of partnerships between service providers and service user/survivor
(hereafter referred to as user) groups in the light of this title. Is
it possible to engage in partnerships if there remains inherent power
inequalities between these two groups and what are the requirements
for meaningful partnerships An attempt will be made to find
answers to these questions. Also what needs to be discussed are an
analysis of existing models of user/provider engagement and whether
they are reflective of good or bad partnerships. There has also been
confusion regarding family groups and user groups. Are these groups
concerned with the same interests or do they in fact represent different
concerns and where do they fit-in in the larger picture of
user/provider interaction We argue for a strong and independent
user movement and for engagement with providers and user groups
on the basis of equality and respect for our human rights. Human
rights abuse have been the idiosyncratic methodology of psychiatric
institutions in the past and still continues in many places. However,
harmful practices implicit in treatment modalities still continues even
in this enlightened period. Therefore, partnerships in mental health
can only truly be addressed if users, providers and family groups are
on the same page regarding what constitutes respect for human rights.
This is especially true in this present age in which the Convention on
the Rights of Persons with Disabilities (CRPD) has become international
law. The users, as persons with psychosocial disabilities, now
have the protection of the CRPD and psychiatry has to start paying
attention.
US14.
GENOMICS AND PROTEOMICS IN PSYCHIATRY:
AN UPDATE
US14.1.
RETHINKING PSYCHOSIS
N. Craddock
Department of Psychological Medicine, School of Medicine,
University of Cardiff, UK
It has been conventional for psychiatric research, including the search
for predisposing genes, to proceed under the assumption that schizophrenia
and bipolar disorder are separate disease entities with different
underlying etiologies. This represents the traditional dichotomous
classification of the so-called ‘’functional’’ psychoses and forms the
basis of modern psychiatric diagnostic practice. Recently, positive
findings have been emerging in molecular genetic studies of psychoses.
However, the pattern of findings shows increasing evidence
for an overlap in genetic susceptibility across the traditional classification
categories, including association findings at DISC1 and NRG1.
Genome-wide association studies (GWAS) now provide greater
power to explore the relationship between mood and psychotic illness.
Within the context of the Wellcome Trust Case Control Consortium
(WTCCC), we have studied 2700 mood-psychosis cases and
3000 controls, and several other large-scale studies have been undertaken,
including studies of structural genomic variation. The emerging
evidence suggests the existence of relatively specific relationships
between genotype and psychopathology. For example, in our dataset,
variation at GABA A
receptor genes is associated with susceptibility to
a form of illness with mixed features of schizophrenia and bipolar disorder.
Genome-wide significant associations at CACNA1C in bipolar
disorder and ZNF804A in schizophrenia show evidence for a contribution
to susceptibility across the traditional diagnostic boundaries.
The elucidation of genotype-phenotype relationships is at an early
stage, but current findings highlight the need to consider alternative
approaches to classification and conceptualization for psychiatric
research rather than continuing to rely heavily on the traditional
dichotomy. As psychosis susceptibility genes are identified and characterized
over the next few years, this will have a major impact on our
understanding of disease pathophysiology and will lead to changes in
classification and the clinical practice of psychiatry.
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