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and institutions are also producing training materials, but these are distributed only  sporadically  and are only rarely updated regularly.

The Task Force recommendation that psychiatric societies should support patient and care-giver organizations and seek opportunities to collaborate with them was generally endorsed. It was pointed out, however, that in many countries such organizations do not exist and that there are numerous obstacles to their establishment – ranging from prohibitive governmental policies to ignorance of the steps that are useful in creating and managing them. The suggestion that the leadership of an international professional organization might bring self-help or user groups together was seen as unlikely to succeed since most such groups deal with local problems and have only limited interest in international collaboration on problems that are not directly related to their sphere of work. International organizations that bring together user and care-giver associations operating in different countries [such as the European Federation of Associations of Families of Mentally Ill People (EUFAMI) and the World Schizophrenia Fellowship can provide useful hints and help national associations much more.  It was felt, therefore, that the WPA should establish links with these organizations at the international level and promote the idea that national psychiatric societies should work with national patient or family organizations whenever possible and useful.

In these discussions, there was almost universal recognition of the difficulties that arise, for any work in mental health, from the continuing stigmatization of mental illnesses, of the patients who suffer from these illnesses, of their families, and of any service or treatment method used to provide care. The WPA Global Programme against Stigma and Discrimination because of Schizophrenia was mentioned in a number of discussions, and its continuation and expansion to countries not yet involved were recommended.

Numerous specific technical points were made in the course of national meetings. They have been very useful in the development of this Update, and are reflected in the texts of chapters 3, 4 and 5.

Options for further work, and lessons learned

The recommendations from national review meetings and the advice of experts and organizations seem to converge on the following activities that the WPA could undertake in the future.

(1)The Executive Committee of the WPA could begin exploring the possibilities for collaboration with the World Health Organization (and possibly other agencies) in an effort to increase access to new medications by using one or more of the strategies mentioned above.

(2)Several versions of the Technical Review and its Update could be developed for use by different categories of health personnel, care-givers and patients.

(3)The documents could be translated into languages other than English. The drafts of the Technical Review were translated into a number of local languages to facilitate discussion in national review meetings, and translation of the final version of the Technical Review and its Update could

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