Psychiatry and conflict management

Interview with Eliot Sorel


Main theme: Psychiatry at war

 

The World Psychiatric Association founded a scientific section “Conflict Management and Conflict Resolution” in 1990 on the initiative of Professor Eliot Sorel.



You are the founder of the “Conflict Management and Conflict Resolution” Section. What were the reasons for starting this Section?


The idea for the Section dates back to 1981 at the International Association of Social Psychiatry Congress in Zagreb where I proposed a symposium on the role of psychiatrists in international conflicts. The organizers thought that this topic should be dealt with sotto voce but I insisted, and the symposium was a success. In 1989 I was invited to participate in the congress on “Physicians against Nuclear War” in Moscow to contribute on the role of social psychiatry and the social science regarding conflicts, their management and resolution. I was privileged to have led a World Association of Social Psychiatry Good Will mission to USSR, Poland, and West German in 1986. During that visit the vice-president of the USSR national psychiatric association acknowledged a “process of conscience” that was emerging at that time related to the use of psychiatry for political purposes in the Soviet Union.


The above stated antecedents are among the tributaries that led to the proposed the WPA Section on Conflict Management & Resolution. The Section’s mission included the applications of psychiatric theory and practice to managing and resolving conflicts among ethnic groups, politically, economically, and culturally diverse systems. We also wanted to develop and test conflict management theory, compare practices, initiate, and develop transdisciplinary projects.


Could you briefly describe some of the major tasks and achievements the Section has accomplished during its existence?


The Section was launched at the XII World Congress of Social Psychiatry in Washington, DC in 1990, which focused on “East – West, North – South: The psychobiological, political, economic and cultural contexts of Social Psychiatry”. It was the first western congress attended by Soviet psychiatrists for the first time in many years.


The Section held its first WPA symposium in Budapest in 1991, with the theme, “Conflict, aggression, and violence: The healing roles of religion, psychiatry & diplomacy.” Since then, the Section has carried out a vast number of activities, including more than 70 WPA symposia at World and Regional Congresses and published three books, three book chapters, created two DVDs, and executed a Consensus Statement.


Our most recent symposium took place at the last WPA World Congress in Colombia, in 2021. Thanks to our fine collaboration with the World Federation of Psychiatric Trainees, we are now actively recruiting early career psychiatrists to join the Section; their role today is more relevant than ever before.


Another important Section milestone was advocating for our patients at WHO and UN. In 2011 the UN had non-communicable diseases on the General Assembly agenda for the first time, but unfortunately excluded mental health. Together with Dr.David Satcher, the 16th US Surgeon General, we published an opinion editorial on this issue in October 2011; in 2012 we successfully advocated this subject’s inclusion on the WHO agenda; at the UN 65th World Health Assembly our recommendations were recognized along with the integration of psychiatry into primary care.


How do you see the role of psychiatrists in managing conflicts and in war situations – at an individual level as well as on an organizational level?


At an individual level, psychiatrists have an important therapeutic role to play both in identifying the immediate needs and providing care to traumatized populations, whether refugees or internally displaced. Today we recognize that interventions are needed to overcome the impact of war, active and frozen conflicts.


From an organizational systems perspective, it is important to recognize the synergy of working closely with other disciplines. Here, I particularly think of integrating primary care, public health, mental health into a TOTAL Health model and delivered via integrated care. In the current Central Europe conflict situation, professor Michael Marmot and I are exploring with the WPA a pilot-phase project focused on Republic of Moldova with a TOTAL Health model to meet the needs of Moldovan people, refugees and displaced populations.


Finally, do you find that current psychiatric training provides the qualifications required?


There is an increasing need for training regarding trauma consequences among refugees and displaced populations, and their TOTAL Health needs. This should start in medical schools and include training on how to work in well integrated multidisciplinary teams with a total health mission. □