As well as working in the UK I spend a proportion of my time working with organisations and partners overseas. I am a firm believer in the usefulness of sharing learning and experience across countries and regions. I feel that the UK has a lot to learn from the innovations and passion of people working for community change in poorer countries.

I have direct experience of working in the following countries - India, Tanzania, Ukraine, Romania, Bulgaria, Albania, Bosnia, Poland, Hungary, Estonia, Slovenia, Vietnam, Lithuania, Armenia, Kyrgyzstan, Georgia, Kazakhstan, Syria, Turkey, Tanzania and Zanzibar

I have managed a number of complex international programmes operating in a range of sites and regions.

The following are some international case studies of work I have been involved in over the last seven years. They focus on the success of developing user led participatory policy forums of local stakeholders. The work has involved network development, local leadership and forms of public action such as lobbying, campaigning and media work :

Kyrgyzstan Case Study

Kyrgyzstan remains a very hierarchical country with a strong legacy from the Soviet past. A group of large, dilapidated psychiatric institutions continue to be used as the main form of treatment in the country. These hospitals are many miles from peoples homes and research indicates the great hardship, poverty and abuse suffered by people sent there. The Bishkek local policy forum has therefore prioritised work to highlight this issue at a policy level and has organised campaigns, lobbying and direct action to challenge the system and promote change. For example, local policy forum members include several people working closely with the parliament and the legal ombudsman and they have targeted activities to inform and influence the opinion of these key power brokers.

In 2002 an open meetings of the Bishkek local policy forum mobilised unprecedented participation of service users and stakeholders in the country’s mental health. Over 300 people attended one day of forum meetings in a central hotel in the capital. The event was organised and run by a team of 15 service users which emphasised the power and importance of grassroots leadership.

Estonia Case Study

The local policy forum in Tallinn decided that they wanted to increase awareness of mental health issues in the city and promote positive images of service users working with other stakeholders as leaders and policy activists. They decided to do this through a cinema project. Several members of the local policy forum had connections with the owner of a central cinema and negotiated with him to use his cinema for free. They also negotiated rights to screen the mental health related film A Beautiful Mind. During the famous summer nights in Tallinn when the sun never sets (due to the northern latitude) they made free screenings of the film for interested citizens of the city. After the film the users led presentations and group discussions about the mental health issues that had been raised. They also handed out a questionnaire seeking people’s opinions and interest in mental health policy and inviting citizens to get involved.

The cinema project was highly successful and resulted in lots of positive media coverage and awareness raising. The questionnaire provided useful data for the work of the LPF including the identification of new priorities for local action.

India Case Study

The local policy forum in India is located in the small rural area of Vellimon West in Kerala at the very south of the country. Despite being culturally and historically very different to eastern Europe, the local people have been able to adapt the local policy forum model and materials to their own needs. They now run a successful local policy forum which meets every three weeks and which involves over 35 representatives of stakeholder groups. The local policy forum has prioritised employment as a high priority for local policy. They have researched and promoted a number of innovative employment schemes including a micro-credit loan system which gives interest free loans to services users to set up their own small business. To date all loans have been paid back on time and the money has been recycled to provide additional loans. Successful projects have included a small incense making business, a candle workshop and a vegetable market stall. In October 2005 for World Mental Health Day the local policy forum organised the first ever march for mental health in the state capital of Trivandrum. Over 150 service users travelled by bus to the city where they marched to the state government offices with banners and placades to demand stronger user involvement. They also delivered a list of demands including a leaflet challenging the local practice of over prescribing multiple anti-psychotic drugs and listing ten questions to ask your doctor.

Romania Case Study

Early in the formation of the Campulung-Moldovenesc local policy forum in northern Romania two priorities became apparent to local stakeholders. The region is rural and much of the population live in isolated farms, villages and hamlets. The lack of transport, communication and services mean that people with mental health needs and their families remain unrecognised. At the same time there is little education or awareness about mental health and as a consequence the area experiences high levels of stigma, prejudice and misinformation founded on local myths about madness. The local policy forum decided to address these issues by working with local schools in the rural areas as a way to reach young people and their families through an already established network. Several members of the local policy forum were involved in the education system either as teachers, administrators or local policy makers. They facilitated direct access to the schools. The local policy forum mobilised a team of local activists (including service users and other stakeholders) to visit the schools, make presentations, provide leaflets and written material and to undertake some action research using semi-structured interviews and questionnaires. As a result many more families have been able to access services and advocacy. At the same time the local policy forum has used the learning and outcomes to influence policy at the local level by raising the issue of rural transport. At a national level a series of National Policy Forum meetings have been organised involving over 80 different mental health stakeholders from across Romania. This has led to the Iasi Declaration (2005) which called on the Romanian government to work proactively with communities. This declaration was delivered in person to the Minister of Health at a public press conference.