Not again! It's the same setup as Cochrane! Imagine the kick back if psychiatry had been filed under neurology rather than the other way around!
The structure and functioning of the WHO's
Department of Mental Health and Substance Abuse as the WHO Division which also has responsibility for disorders of the nervous system is a bone of contention with some neurological federation reps.
The working groups advising on the revision of the various chapters in ICD-10 for ICD-11, were known as "Topic Advisory Groups" or "TAGS".
The ICD Revision Topic Advisory Group for Neurology was chaired by Prof Raad Shakir, a former President of the World Federation of Neurology (from 2014-2017). TAG Neurology ceased operating in October 2016 when a number of TAGs were stood down and replaced with the ICD-11 Revision Task Force.
*The ICD-11 Revision Task Force was later stood down and the committees which advise on ICD-11 are now the
Classifications and Statistics Advisory Committee (CSAC) and the
Medical Scientific Advisory Committee (MSAC).
The
Department of Mental Health and Substance Abuse Director (Dr Shekhar Saxena) is a psychiatrist by training but Dr Dua's specialities are neurological disorders like epilepsy and Parkinson's disease.
*See edit
Earlier this year, I came across a meeting summary which discussed the positioning of neurological diseases and disorders within the
Department of Mental Health and Substance Abuse and the name of this Division.
The response from WHO leads was that this was not an issue currently up for discussion:
(My highlighting)
https://www.eanpages.org/2020/01/09/news-from-the-who/
January 9, 2020
Meeting of WHO with EFNA, EAN and EBC to discuss brain health Report
Participants:
European Academy of Neurology (EAN): Raad Shakir
European Brain Council (EBC): Frederic Destrebecq, Vinciane Quoidbach
European Federation of Neurological Associations (EFNA): Donna Walsh, Tadeusz Hawrot
WHO: Dévora Kestel,
Tarun Dua, Neerja Chowdhary, Katrin Seeher, Alarcos Cieza
Overview of WHO vision for brain health and priority areas/conditions
Under the new leadership of Dr. Tedros Adhanom [Ghebreyesus], WHO has been undergoing a major overhaul resulting in the most wide-ranging reforms in the Organization’s history to modernise and strengthen the institution to play its role more effectively and efficiently as the world’s leading authority on public health.
The Department of Mental Health and Substance Use (MSD), which also covers neurology, took advantage of these changes by introducing the idea of setting up three teams within its structure: i) Mental Health, ii) Brain Health and iii) Alcohol Dependence and other addictions.
The concept of brain health had to be suitably explained to the leadership before it was accepted. Introducing this term and forming the team has been described as a paradigm shift. The brain health team is currently being assembled and will consist of up to seven employees.
(Ed: the members of this "brain health" team have not yet been established by me.)
It was said that this team will focus on three topics: global leadership and advocacy, awareness raising and stigma & guidance and technical assistance to low and middle income countries – all underpinned by a focus on developing an ethical framework for action...
DISCUSSION
Prof. Raad Shakir, delegate for EAN, introduced EAN, its structure and aims. He mentioned EAN’s wish to work closer together with WHO and the ICD11-PC would be an ideal project for doing so.
He expressed regret for the lack of “neurology” in WHO’s policy.
WHO made it clear that there are currently no prospects for changing the department’s name and it does not wish to discuss this any further. It was emphasised that we should look to the future and how we can take advantage of new opportunities.
EFNA expressed its appreciation for the new direction that WHO is taking, however it was reiterated that the terminology used by WHO is problematic when we are trying to engage the neurology community in current and upcoming activities. EFNA made it clear that we would encourage WHO, and we will in fact demand, that there is more visibility for neurology in initiatives such as the Mental Health Forum, the Special Initiative for Mental Health etc. where neurology is covered implicitly, but has a very little practical presence both in initiative names as well as in listed disease areas.
However, it is clear that WHO has been working on specific neurological diseases for some time. This has included, to various extents, efforts in the areas of dementia, epilepsy, Parkinson’s Disease and autism.
In future, though, the work will not be based on a disease specific approach – although case studies will continue to feature when necessary. Their upcoming plans are to work more on cross-cutting issues from a rights based and public health perspective. It was made clear that the upcoming work will look at ‘brain health’ rather than ‘brain disorders’ – with an emphasis on promotion and prevention.
As a starting point, MSD is going to develop a concept paper to better conceptualize what “brain health” means. This could, potentially, be underlined by convening a global meeting as a means of consensus building. This, in turn, could result in releasing an informal roadmap or position paper. It is an area where EFNA, EBC and EAN could be involved. It was requested that we are kept involved etc.
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Edited to add further information.
Edited to add:
Dévora Kestel has replaced Dr Shekhar Saxena as Director of the WHO Department of Mental Health and Substance Abuse - the WHO Division that is also responsible for neurological disorders.
