Mental Health Promotion in India: A Critical Lacuna

By Dr.R.Thara MD Ph.D.

With a population of a billion, India is the second most populous country in the world. A modest estimate indicates that 15 to 20 million Indians suffer from some kind of mental morbidity. Many of them are in rural areas. Although the National Mental Health Program (1982) centered on the admirable philosophy of integrating mental health with primary care, this has not been uniformly implemented in the country. There are very few states which have some programs running to implement integration, thereby ensuring some kind of mental health service to the rural population. Hence, the people in many parts of the country, especially in the north, have no access to any formal mental health services and largely resort to religious and traditional modes of treatment.

Many Indians still seek solutions to mental illness in traditional ways at temples and sacred sites.

Mental Health Services

The number of mental health professionals in India is woefully inadequate to meet the challenge of providing basic mental health care to all in need of it. There are only 3500 trained psychiatrists and maybe an equal or lesser number of clinical psychologists and social workers. The profession of Psychiatric Nursing is at a very rudimentary level and in many centres general nurses work in mental health settings. There are about 40,000 mental hospital beds and some general hospitals are equipped with a mental health team. The fact that most of the mentally ill, even those who are severely disabled, continue to live with their families and are taken care of by them, obviates the need for a large community based care system as in the case of many developed countries. Nevertheless, the breaking up of joint families, the number of non-available siblings or peers, either because they are outside the country or are reluctant to take on the responsibility of caring, and the increasing number of women (traditional carers) engaged in a job, have all eroded the caring patterns. This trend certainly will require supplementary community based services.

Mental Health Promotion

With this kind of scenario, when even basic mental health services are out of reach for many Indians, it is not difficult to understand why mental health promotional activities have taken a back seat. Delivery of mental health care, largely by medication, is the main cornerstone of the mental health system here. Even rehabilitation is sadly neglected with only a few NGOs, largely concentrated in the southern part of the region focussing on this. Any reference in Indian textbooks of psychiatry or publications to mental health promotional activities is meagre.

Health is a state subject in India. The health budget of the country is very low, and mental health is has even lower priority within in that budget, with infectious and transmissible diseases occupying the front benches. Hence, there are practically no health promotion policies or programs, and consequently, no budgetary allocation to mental health promotional activities. The National Mental Health Program does make a brief mention of a Prevention Sub programme, with a focus on prevention of alcohol and drug related problems, prevention of suicides and juvenile delinquency. However, no clear-cut strategy or plan has been elucidated.

Those mental health promotion activities that are being carried out are limited in scope with no capacity to make a national or even a regional impact They are also largely NGO activities, and hence, limited by funding and other resources.

Present Activities

• Production of manuals on early diagnosis of mental disorders for various target groups such as health workers and primary care physicians. Organizations such as NIMHANS (Bangalore) and the Schizophrenia Research Foundation (SCARF, Chennai) have developed such materials.
• Material for schoolteachers to enable them to identify emotional disturbances and intervene early.
• There are a few suicide prevention centres, all of them run by NGOs and making use of volunteers. One such centre in Chennai had put up information on suicide on city buses and trains.
• Some de-addiction centres have publications on preventive strategies.
• Stress management workshops are held in industries and business houses largely by private agencies or individuals.

Unfortunately, even these meager efforts have their limitations. All are conducted at a micro-level, and hence, their regional and national impact is not high. Mental health promotion activities that do exist in India tend to be highly dependent on resources which can hardly be termed consistent, and many have not had professional input. Moreover, there is no coordination of efforts among different NGOs or Government agencies which produce mental health promotion and prevention material. The programs are not evaluated, and wit no evaluation of such programs, and since this mental health promotion is not a priority issue for Government, there is no state support.

What can be done?

Formation of a central, nodal body/network, which will be almost exclusively devoted to Mental Health Promotional (MHP) work is necessary. This could be comprised of people from several walks of life: mental health professionals from both Government and NGOs, educators at school and college levels, primary care personnel, media representatives, policy planners and consumers of the mental health services. An Action Plan and strategy to provide a policy and conceptual framework for promotion, prevention and early intervention for mental health could be drawn up. Clear guidelines could be provided as to the nature of MHP activity, content of these programs and an in-built evaluation component. The finer details should be left to the individual agencies to allow for flexibility and innovation. Replicability and acceptance of such programs in the rural areas should be stressed. If funds are available, training outside India should be provided to some key players of the program.

One of the biggest stumbling blocks to such a coordinated effort is funding. It is well nigh impossible to expect much from the Government of India, with its shoestring budget for health, let alone mental health. All attempts should be made to muster support from within, and outside of, the country for financial support, which alone in the long run, can lessen the morbidity caused by mental disorders and lessen the burden of the families who have displayed great tenacity and commitment in caring.

Dr.R.Thara is Director of the Schizophrenia Research Foundation (India). He may be contacted by mail at R/7A, North Main Road, West Anna Nagar Extension, Chennaai- 600 101, India. Tel: 6263971, 6207073. Email: scarf@vsnl.com. URL: www.scarfindia.org

Truth and Consequences in North America: Active Living and Promoting Mental Health

By Vivian Blaxell

In recent years, the North American media has regularly aired reports about a beneficial relationship between physical exercise and mental wellness. One report went so far as to claim that the physical activity is as effective as the current generation of antidepressant medications in promoting mental wellness. Anecdotal evidence does suggest that simply walking for thirty minutes several times a week both alleviates depression and enables lifestyle improvements in depression sufferers, but any general assumptions about the positive affects of exercise on mental wellness still needs to be questioned.

Reviewing the Research

Daniel Landers and Shawn M. Arent, both of Arizona State University in suburban Phoenix, have looked exhaustively and closely at numerous scientific studies of the effects of exercise upon mental well-being, some of which claim a causative relationship between exercise and mental health, others which do not. Interestingly enough, Landers and Arent come to the conclusion that although active living does indeed bear a relationship to desirable changes in a range of mental health variables, such as anxiety, depression, stress reactivity, positive mood, self-esteem and cognitive functioning, active living does not cause these beneficial changes to occur. This picture is further complicated by more recent research published by P. Salmon in the February 2001 issue of the Clinical Psychology Review. Salmon suggests that physical exercise seems to possess both negative and positive effects on mental health, depending onthe relevant variable.

Still, the evidence for the mental health promoting qualities of exercise is building up and current research evidence now supports stronger conclusions about exercise and mental wellness than those presented in the 1996 U.S. Surgeon General’s Report. But, the relationship between exercise and the mental health variables used by Landers and Arent are still not understood. How does active living influence variables such as depression and cognitive function which arrive on both biochemical and psychological/lifestyle vectors? How can we scientifically show that exercise interacts positively with such intangible and unscientific variables such as self-esteem?

Methods for arriving at answers to these conundra about the relationship between exercise and mental wellbeing are essential if we are to convince medical health practitioners to view exercise as an alternative or adjunct to traditional therapies currently used to treat people with problems in these mental health areas. They are essential too, if active living, one of the centerpieces of health promotion science and practice, is to be accepted as a way toward mental wellness, just as it is accepted as a route toward physical health.

Wellness in Illness

But, while the debate about the power of physical exercise to prevent and promote mental health goes on, there is another intersection of mental health and active living where the beneficial effects of health promotion are less controversial. I refer here to the role of physical exercise in cases of chronic and major mental disorders where drug therapy involves significant physical side effects, and the socioeconomic conditions surrounding onset and persistence of the disease also entail negative effects on wellness.

For example, a recent report in the United States describes the effects of regular exercise on a 48 year-old woman with chronic schizophrenia. After staying with an exercise program for 5 months – a daily routine that included a 1-hour ride indoors on a stationary bicycle and a half-hour walk outdoors with her husband – the woman shed 47 pounds and reported feeling stronger and healthier. At the time of her diagnosis of schizophrenia, the woman weighed 116 pounds, but because of the side effects of medication and changes in her diet associated with her disorder, her weight had increased to 286 pounds, with all the associated deteriorations in cardiac and respiratory wellness and self-esteem. After 5 months of regular exercise, the woman’s weight dropped, and her pulse rate slowed and steadied. The woman’s husband reported that her attention span had improved and that she was more affectionate toward him.

Dr. Joseph Loizzo, clinical professor of psychiatry at New York City's Columbia Presbyterian Medical Center, argues that for people with schizophrenia, active living of any sort promotes physical wellness and thus promotes physical and relative mental wellness within a mental illness matrix. Very often, people with a chronic mental disease avoid physical activity because their psychoactive medications cause fatigue and weight gain. In addition, people with schizophrenia tend to avoid social interactions at gyms or in exercise classes. Yet, Loizzo maintains that if people push themselves to exercise, regular physical activity can ultimately decrease the sedation effects and weight gain caused by some medication, while offering people with schizophrenia an opport-unity to be with other people without having to depend on verbal communication.

But there are a few prerequisites to be considered before health promoters should take clients, with serious mental illnesses such as schizophrenia, into an active living or exercise protocol:

The most recent research moves us closer to the final evidence that active living possesses the potential to promote mental wellness. When that evidence is finally arrayed mental health promotion will receive its due. Until then, we must continue to work towards strategies that promote mental wellness and physical well-being in all.

Vivian Blaxell is the Managing Director of the International Institute for Health Promotion at American University, and Managing Editor of Health Promotion: Global Perspectives. She may be contacted at +1-202-885-6218 or blaxell@american.edu.

Strategies for Mental Health Promotion

Promotion of mental health is a relatively new field in the discipline and practice of health promotion, and health promoters often ask, "How do we promote mental health?" Vivian Blaxell’s article discusses the uses of exercise in mental health promotion, but to learn about more varied strategies and methods, visit http://www.york.ac.uk/inst/crd/ehc33.pdf where you will find a downloadable and printable PDF document, "Mental Health Promotion in High Risk Groups." You will need to have Adobe Acrobat Reader installed on your computer to read and print this document. To download Acrobat Reader, go to http://www.adobe.com/products/acrobat/readstep.html

The Problems For Mental Health Promotion in Lebanon

By Dima A. Tabbara

Mental health is still something of a taboo subject in many countries of the Middle East, especially in Lebanon. Seeking therapy for mental illness is seen as a last resort, and evidence of mental illness, including visits to therapists are hidden from family and friends for fear of the stigma of "craziness" and resultant social isolation and marginalization. Additionally, years of civil war have left Lebanon’s health infrastructure in tatters, but rehabilitation/reconstruction plans for Lebanon’s health services have no place for mental health and mental health promotion. Instead, priorities have been established as follows: essential drugs; expanded program on immunization; diarrhoeal diseases control; support to public hospitals; primary health care; control of drug abuse; strengthening of epidemiological services; tuberculosis control; and control of water quality. In such a context, mental health promotion is a difficult endeavor indeed.

Mental Health Care in Lebanon

There are only two psychiatric hospitals: the 1500-bed Psychiatric Hospital of the Cross, run by a Maronite order of nuns, with psychiatrists mostly of French background and specialization, and the Mental Hospital of the Muslim Old People’s Asylum located in Western Beirut. Both institutions are constantly at full capacity.

It is estimated that there are 45 psychiatrists in Lebanon, some of them are attached to the mental hospital where they work part-time while having private practice. The others are working in private clinics and refer their patients to one or other general hospital. This gives a ratio of psychiatrists to population of 1.2 to approximately 100,000. There are very few clinical psychologists and they work mainly in schools.

Unfortunately, not only is care for mental illness limited by the Lebanese mental health services infrastructure, traditional attitudes toward mental illness persist. Mental illness may be hidden, regarded as a flaw and seen as a sign of sin in some Lebanese communities. The very intangibility of mental health and mental disease makes it hard fro some Lebanese to accept that mental illnesses are the same as physical illnesses.

Toward Mental Health Promotion

A poster by a Lebanese artist with  mental illness

Lebanese society is in a transition period – just beginning to understand and accept the value of mental health. Attempts are being made to raise awareness of mental health issues: medical students are now sensitized to mental health by a two-month training course in their fourth year of education, family physicians, internists and general nurses receive two to three months’ mental health training, while community involvement includes the activities of the Christian church in response to the major national problem of drug dependency.

In December 1987, a national mental health program was prepared with the following objectives: to make mental health care available for everybody, anywhere in Lebanon, without resorting to specialized institutions and centers in the main cities (that means well-planned decentralization of mental health services); to adapt care models to the social and cultural patterns of the rural communities which, up to now, have not, or have received little attention to mental health matters; to expand mental health knowledge and enhance it in the community in order to remove prejudices still existing about mental disorders; to developed suitable programs to assist the large numbers of displaced persons, the disabled, the bereaved, and so on, affected by the war; to provide every mental health clinic created and integrated with primary healthcare with all the drugs necessary for treatment of mental troubles. However, progress toward the plans objectives have proven very slow.

The Future

Funds and materials for mental health promotion in Lebanon need to be secured and developed. Public education is especially important, and the media especially, should be more involved in showing the importance of mental health, solutions to mental illness and ways to promote mental wellness.

One might say that mental health is just starting to be valued in Lebanon as one of many areas of total wellness. Perhaps when this value is fully realized, Lebanon will turn some resources and energies over to mental health promotion.

Dima Tabbara is a psychology student at the American University of Beirut. She has plans to open her own clinic in Lebanon.

Country Profile: Hong Kong

By Roy Ngai

Cleaning Hong Kong Harbor

Hong Kong is located at the southeastern tip of mainland China, and has a total area of 1098 square kilometers, comprising Hong Kong Island, Kowloon, and the New Territories & Islands. Formerly a Crown Colony of Great Britain, Hong Kong has been a special administrative region of the People’s Republic of China since 1997. Almost 6.9 million inhabitants make Hong Kong one of the most densely populated places in the world. Coupled with the growth of financial and business related services, Hong Kong is developing into the financial hub of Asia.

In spite of these problems, Hong Kong still takes pride in having one of the best health indices in the world. For more than 3 decades, the life expectancy at birth has been reached – 77.2 for men and 82.4 for women. Mortality rates for infants and children under 5 are consistently low, as is the maternal mortality and the percentage of low birth weight infants. The overall mortality rates for all ages have also fallen significantly in the last 2 decades. The leading causes of death (death rate per 100,000 population) are malignant neoplasms (164.80), heart disease including hypertensive heart disease (78.4), cerebrovascular disease (52.4), all forms of pneumonia (44.7) and injury and poisoning (30.8). Public health expenditure amounts to HK $31.9 billion (US $4.9 billion) annually.

Government Health Promotion Efforts

In response to perceived public health problems, the central government launched a 3-year health campaign in June 1998, titled "Healthy Living into the 21st Century". This campaign aims to make Hong Kong a cleaner, healthier and more comfortable place to live. Each year the campaign adopts a theme, such as "Clean City", "Clean and Safe Food" and "Sustain a Healthy Lifestyle." The campaign is implemented by 7 sub-committees.

In line with the theme of "Sustain a Healthy Lifestyle" for 2000-01, the Department of Health and the Leisure and Cultural Services Department put together a program called "Healthy Exercise for All" to stimulate more community participation in physical exercise and to promote public awareness of the health benefits of physical activity and leisure activities.

Sports and Recreation Participation

According to 1998 figures, Hong Kong men (57.3%) were more active participants in sports and recreation than women (51.3%). The favorite activities of men were basketball and soccer, whereas women preferred calisthenics, badminton and walking. The top ten physical activities were: basketball, swimming, badminton, walking, calisthenics exercise, jogging, soccer, squash, weight training and hiking. Young people, and those with a higher educational level, exhibited higher participation in physical activities. Overall, about 75% of Hong Kong residents believed that physical activities would be good for health, but 48% of them had no participation in active living at all. The top 3 reasons for not taking part were lack of time (65.3%), work (19.9%) and no interest (13.1%).

The Physical Fitness Association of Hong Kong, China, is a voluntary and non-profit making organization established in 1986, and committed to the promotion and advancement of health and fitness through safe and effective exercise, both locally and internationally. The Association is the only fitness promoting body recognized by the Sports Federation and Olympic Committee of Hong Kong. The Association works in the following areas:

• Conferences, seminars and practical workshops.
• Publication of a newsletter "Fitness Network".
• Community Services.
• Advisory and consultancy services.
• Consumer education through the media.
• Instructor education and certification.
• Research.

General Health Promotion Strategies in Hong Kong

Emphasis is now being placed on development of healthy lifestyles in Hong Kong. Individuals, groups and organizations are to be encouraged to develop self-help physical activity programs, and to organize popular sporting programs for family or group participation. Personal responsibility in fighting diseases is encouraged.

Hong Kong’s governing bodies play significant roles in the promotion of health. The Department of Health (DH) acts as a source of information about healthy lifestyles, including physical activities and appropriate choices. The DH promotes the concept of a balanced diet and emphasizes the negative impacts of obesity, malnutrition and poor nutrition. It promotes early intervention and the proper use of medication in health education, while working with health care professionals to promote the concept of comprehensive health assessment, including health behavior screening in addition to normal laboratory tests. The HD also works closely with professional bodies and academics in setting up an information network on healthy lifestyle promotion.

The Hong Kong Leisure and Cultural Services Department (LCSD) develops school sports programs tailored to meet the needs of individual schools, (i.e., sports education programs, easy sport programs, sport leader program, outreach coaching program, etc.) LCSD organizes corporate games and masters’ games for companies and communities, and it also encourages the formation of interest groups, particularly peer groups which share a common interest in physical activities or sports.

The Food and Environmental Hygiene Department works with the food and catering industry to display health advice about balanced diet on food containers. It also communicates with the food and catering industry and the general public regarding the development of healthy menus.

Non-governmental organizations in Hong Kong are working to develop remedial programs to strengthen coping skills for quitting unhealthy lifestyles, especially smoking. At the same time, the business sector, including the food and catering industry, sponsors healthy lifestyle initiatives or provides funding for research into healthy lifestyle activities. 

Health professionals and academics undertake research and act as sources of information. They function as experts, advocates for healthy lifestyles, and help to spread the important messages of healthy lifestyle, comprising personal responsibility, physical fitness and healthy diets. Even Hong Kong TV and radio helps to promote healthy lifestyle in their programming, while the print media devotes regular columns on topics relating to a healthy lifestyle.

The World Islamic Association for Mental Health

Since its foundation, the WIAMH has conducted numerous national and international conferences around the world (Lahore, Pakistan – 1985 and 1991; Cairo, Egypt – 1987 and 1994; Tripoli, Lebanon – 1996; Leicester, United Kingdom – 1997).

WIAMH pioneered in the area of Trauma Psychology. In collaboration with University of Missouri, Columbia, International Center for Psychosocial Trauma, they sponsored international conferences on post war mental health issues in Bosnia and Herzegovina. The First International Conference on Post War Mental Health Issues in Bosnia and Herzegovina was held on March 11, and 12, 1996 in Sarajevo. The second was held in Columbia, Missouri, U.S.A. on July 11 and 12, 1998. The third congress was held in Tuzla, Bosnia and Herzogovina, and was organized by the World Islamic Association for Mental Health and the International Center for Psychosocial Trauma (University of Missouri, Columbia, U.S.A.). The central theme which cross-cut these international congresses was: Traumatiztion: An Islamic Perspective. All aspects of Traumatization, including diagnosis, psognosis, treatment, prevention of post traumatic stress were adjusted to the Islamic cultural context.

There is a consensus amongst the anthropologists that religion holds a supreme sway over behavior, thinking and feelings. This is particularly true for Islam which defines self (and hence mental health) in a religious rather than a secular term. In Islamic view, religious and mental health forces are intimately intertwined. These observations have led a number of Muslim psychiatrists around the world to develop innovative methods for the promotion of mental health and the prevention of mental illness. In these conferences, a number of world renowned psychiatrists from Islamic countries participated and presented the programs they have developed utilizing the Islamic principles: Dr. M.F. El-Sendiony from Australia, discussed Islamic views of mental illness; Dr. Osama M. Al-Radi from Saudi Arabia, presented various Islamic preventive and therapeutic modalities; Dr. Gramal Abu El-Azayam from Egypt presented his program on drug addiction; and Dr. Arshad Husain discussed the child rearing practices in Islamic culture and its impact on future mental health of individuals.

Tomorrows’ historians may well look upon the current period as one in which serious attempts were made to better understand the differences, as well as the similarities, between men throughout the world.

In this respect, the reader of this Website will be richly rewarded, as it affords an overall picture of mental illness and its treatment in the Muslim world. But, more than this, the authors of this website will weave this data firmly into the socio-cultural fabric of the Muslim world.

The reader may find it instructive to note similaties to all other cultures, similarties to some, and perhaps some features unique to the Muslim world.

Global Initiatives

A new campaign developed by Quit Victoria, a smoking cessation group, has been launched to encourage parents in the Australian states of Victoria and South Australia to quit smoking. The campaign was launched at the Peter MacCallum Cancer Institute in Melbourne in early August, 2001, where its centerpiece – two emotive new television advertisements – were unveiled. Quit Victoria’s Executive Director, Todd Harper, says the campaign adopts a new approach in the fight to reduce smoking rates.

"This new campaign depicts very powerfully the personal and emotional impact that smoking-caused illnesses have on the lives of smokers." 

Mr. Harper says the campaign is aimed at parents based on data that shows that about one third of Victorian smokers – or about 276,000 smokers – are parents.

"Children’s smoking is strongly modeled on the smoking behavior of their parents. If we can help more adult smokers quit, this will not only improve the smoker’s health in the long term, but hopefully reduce the likelihood their children will start smoking."

The new campaign has been developed jointly by Quit Victoria and Quit South Australia with funding support from the Victorian and South Australian Governments.

For further information, contact Zoe Furman at Quit Victoria: zoe.furman@accv.org.au

The Sheffield Centre for HIV and Sexual Health (http://www.sheffhiv.demon. co.uk) has prepared, and now has available, a sexual health promotion tool kit.

"DOING IT! A Tool-Kit of Practical Strategies for Sexual Health Promotion was prepared and written by Jo Adams of the Sheffield Centre for HIV and Sexual Health in response to anticipation of a new Sexual Health Strategy in the United Kingdom. The tookit is a new resource, full of hints, tips, ideas and practical methods for promoting positive sexual health in a variety of settings and through using a range of methodologies.

The first section of the toolkit sets the scene for Sexual Health Promotion.

Topics covered include:

• The aims and objectives of sexual health promotion.
• Setting quality standards.
• A holistic model of sexual health.
• Implementing a local sexual health strategy.
• Making multi-agency approaches work.
• Media and press management.
• Developing information resources and materials.
• Project management – designing and delivering sexual health projects.

The second part explores Sexual Health Promotion through work on particular topics, or with specific target groups and includes :

• 10 Practical things you can do to promote sexual health.
• Self-esteem building and sexual health promotion.
• Practical tips on sexual health promotion with young people, gay/bisexual men, black/minority ethnic communities, older adults, people with learning disabilities, parents, women and girls and in primary care and clinical settings.

Available only in English at this time, "Doing It!" is priced at £15 plus shipping.

If you would like to purchase a copy of this new resource contact Kirsty Rogers at kirstyr@chsheff-tr.trent.nhs.uk.

School Nutrition Project in China

Staff from the Massachusetts based Education Development Center's (EDC) Health and Human Development Programs (HHD), recently returned from a mid-term evaluation of a school nutrition project in Zhejiang Province, China, along with the World Health Organization (WHO) and the Food and Agriculture Organization of the United Nations (FAO), where they are working to improve the nutritional intake of schoolchildren and develop a WHO model health-promoting school. About 7,500 students and their families, and 800 teachers and school staff, are participating in the project.

Talks with parents during the evaluation revealed that it was not a lack of availability of foods that was a problem, but a lack of knowledge about proper nutrition. For example, some parents said that before the nutrition project, they thought that eating foods high in protein and calories, particularly meat and fish, was preferable to consuming vegetables, even though some grew their own. And, many didn't give their children breakfast in the morning in part because schools start very early. Research has shown that children may have trouble concentrating in the morning due to hunger. The six schools involved in the new project showed great creativity and initiative in promoting health nutrition. Jiubao Middle School in Hangzhou invited parents to attend classes and have a nutritious lunch with students. At Sijiqing Primary School, students made up nutritious recipes and illustrated them. Jiubao Primary School and Chao Yang Middle School in Hangzhou, did outreach to the community and literally hit the streets to share messages with people, one-on-one, about healthy nutrition.

Students themselves reported changes in both their attitudes and habits. One student said that while sweet and sour pork remained his favorite food, he was eating a more varied diet after learning about nutrition in school.

A final evaluation is planned for April 2002. A follow-up survey to the baseline survey, conducted in May 2000, will be administered in November 2001 among a sample of students, teachers and parents of the participating pilot and control schools. If the project is found to be effective in changing both attitudes and behavior about nutrition, the experiences and materials will be shared with other schools in China and around the world.

VicHealth Australian Summer School in Health Promotion

VicHealth invites registrations to the 2002 Australian Summer School in Health Promotion.

The Summer School is a structured two-week program for overseas health workers which provides an overview of the health promotion theories, programs and methods supported by VicHealth and associated agencies. The School aims to create opportunities that may enable adoption and adaption of these approaches in other countries. The Summer School is a collaboration between VicHealth and other leading academics and practitioners in universities and health, and other agencies such as schools.

VicHealth is a statutory body, established in 1987, to replace tobacco sponsorship of Victorian sport and arts events and to develop and support health promotion. VicHealth's Vision is of "a community where health is valued as a primary resource for living; responsibility for creating conditions which support good health is shared across different sectors, and improved health outcomes are shared equally across the community."

VicHealth has been involved in a number of international consultancies and training in China, Fiji, the Philippines, Vietnam, Mongolia, South Africa, Malaysia, New Zealand, Thailand and Sweden. These projects entail building capacity in health promotion at the institutional, community and individual level. This is achieved through the development of health promotion policy and advocacy, and designing and implementing model health promotion programs in various settings and population groups.

International Institute for Health Promotion Newsflashes

by Vivian Blaxell

Tenure-Track Assistant
Professor Position
Department of Health and Fitness

American University is an Affirmative Action/Equal Employment Opportunity, committed to a diverse faculty, staff and student body. Women and minority candidates are strongly encouraged to apply. Visit our website: www.american.edu/healthpromotion

Many IIHP members have met Linda Swanson, who manned the front desk here in Nebraska Hall at American University and who has been of incalculable assistance to IIHP, to Bob Karch and to IIHP members visiting IIHP headquarters in Washington DC, whether for the 2000 IIHP Annual Meeting, or upon other occasions. Linda was offered a promotion and now coordinates faculty matters in the office of the Dean of the AU College of Arts and Sciences. We miss her and thank her for her good work.

IIHP Gets New Worldwide Web Address

As American University expanded and integrated its electronic network, IIHP’s website migrated to the new AU server. On the way it received an updated design and a new web address, http://www.american.edu/academic.depts/cas/health/iihp/index.html. Please change your bookmarks and check our website regularly as we work on adding new interactive features throughout the next year.

Conference Announcements

Health Policy, Practice and Research in the 21st Century: Making a Difference, May 7 to 9, 2002, Sky City Conference Centre, Auckland, New Zealand.

The International Institute for Health Promotion (IIHP) is a global center for the development and advancement of health promotion policies, programs, services, and research that maximizes multiple efforts across the globe.  It was established in 1994 as an addition to the National Center for Health Fitness at American University in Washington, DC, to assist in leading, facilitating, and coordinating the efforts of many international individuals and organizations.  More than 50 cooperating members from 25 nations form an extensive interdisciplinary health promotion network that includes ongoing dialogue, information exchange and project participation.  Email the IIHP at iihpaa@american.edu.  The IIHP website is http://www.healthy.american.edu/iihp.html.