Active involvement in international professional associations is stimulating and rewarding, but it requires time and commitment. In this article, I would like to describe the World Psychiatric Association (WPA) and my experience and involvement in its professional activities and organizational components. In my opinion, the WPA is the most important association of psychiatrists in the world.
The WPA had its origins in Paris at a 1950 congress of psychiatrists who, under the leadership of Jean Delay and Henry Ey as president and vice-president, respectively, agreed to form a group dedicated to promoting the holding of regular congresses in psychiatry. At that time, just following the devastation of World War II, our field was ripe for development with new ideas about the range of action and possible contributions that psychiatry could make to the health of nations. Similarly, new opportunities developed as, for the first time, the World Health Organization (WHO) included in the International Classification of Diseases a section on “mental, psychoneurotic and personality disorders” (1). It was also realized that, independent of old or novel theories, psychiatry had to be based on empirical knowledge, which had to be fostered, and that there was a need to transmit this knowledge to psychiatrists worldwide. A more formal and organized forum for this exchange of knowledge among world psychiatrists was required, and the original idea of a group organized to hold congresses developed into the WPA in 1961. The aims of the new association were, and still are, to advance psychiatric and mental health education, research, clinical care, and public policy, as well as to foster professional identity among psychiatrists and to move the field of psychiatry along the path of empirically demonstrable scientific knowledge (2).
The WPA is a nonprofit organization functioning in compliance with the Swiss Civil Law with a registered office in Geneva, Switzerland, where its General Secretariat is also located. It is formed as an association of associations, where national and subspecialty associations of psychiatrists are encouraged to join for as long as their goals and ethical standards are consonant with those of the WPA. Although, by nature of society membership, every psychiatrist in the world who is a bona fide member of a psychiatric society affiliated with the WPA is a de facto member of the WPA, individual psychiatrists could also become special individual affiliated members. Members can become fellows after 5 years, and there are also categories for honorary members and honorary fellows. At present, the WPA comprises 112 member societies and seven internationally affiliated associations from 96 countries in the world. The WPA is governed by the General Assembly, which meets every 3 years, with its functions and mandates being carried out by an eight-member executive committee, elected by statutes and bylaws for a period of 6 years. The executive committee works in close cooperation with a council and with the zonal representatives from the different world areas in which the WPA is divided.
The WPA discharges its professional and academic duties through a number of standing committees, such as ethics, review, and nominations; international and regional congresses and the world congress, which takes place every 3 years; publications of books, such as the regular Advances in Psychiatry and World Psychiatry, the official journal of the WPA; and special programs, such as the Global Programme to Fight the Stigma and Discrimination Because of Schizophrenia, Core Curriculum for Medical Students, Core Curriculum for Psychiatrists, International Programme for Eastern Europe and the Balkans, and Globalization and Mental Health.
In close cooperation with WHO and within the postulates of the United Nations, the WPA considers its duty, and that of every affiliated society, to uphold the highest ethical standards and the protection of the human rights of persons affected with mental disorders. Throughout the years, the WPA has enshrined such obligations in a series of ethics codes, from the Declaration of Hawaii in 1957, modified in Athens in 1983, to the most recent Declaration of Madrid, 1996, which is updated and enlarged by regular reviews conducted by the standing committee on ethics and approved by the General Assembly every 3 years.
The Scientific Sections are the scientific arm of the WPA and its mechanism for the dissemination of advances in psychiatry; they form the scientific backbone of the WPA and cover practically every technical, scientific, ethical, sociopolitical, and service aspect of the specialty. Sections enjoy a degree of independence within the framework of the WPA statutes and bylaws under the supervision and guidance of the secretary for sections. The purposes of a section include the collection, analysis, presentation, and dissemination of information concerning services, research, and training in the various fields of psychiatry and mental health and the advancement of scientific knowledge in these fields. Sections are expected to achieve these purposes by:
Establishing working relations with national and international organizations sharing the goals of the WPA in the field of the section, with a view to achieving better coordination of activities of interest to the section and the WPA
Organizing scientific meetings on topics of interest to the section
Organizing panels and symposia during world and regional congresses and at regional meetings organized under the auspices of the WPA
Developing educational programs, guidelines, and publications
Developing proposals for adoption as WPA consensus and position statements
Promoting and conducting international collaborative research
Through the work in the sections, networking and meeting psychiatry colleagues interested in the same field take place. The sections are also where theories, ideas, hypotheses, and ethical implications of psychiatric interventions are aired openly and in an atmosphere of academic debate; where professional development and career advancement are obtained; and where professional satisfaction and the quenching of the thirst for knowledge on the latest in the field are realized (3).
Early life decisions on a professional career are always difficult. There are too many fields and opportunities from which to choose, too many imponderables. As young scholars move on in their education, it is hoped that they will develop an interest in or liking to areas of science best suited to their natural abilities and talents. At this stage, advice from parents and teachers is essential so that they can put together natural abilities and intellectual interests with opportunities in order to proceed to a university education and to become the professionals they dream about.
Unfortunately, university programs, geared to acquiring knowledge and skills under supervision and within strict time constraints and, sometimes, rigid intellectual frames, seldom prepare the students for life as it is in the world outside school. Often, on finishing their training, young professionals, although knowledgeable, are still unformed and professionally naïve. It is at this stage that peers, professional bodies, and associations could provide a sense of belonging and professional identification as well as professional connections. It is also at this stage that the young professional makes a decision about which associations to join. Many choose the association of the profession, and many others, focusing only on the aspects of a subspecialty, choose the association of peers in these more narrow fields. This is regrettable; it cuts off the young professional from obtaining a wider view of the profession, and in regard to international trends, it creates a lack of connectivity with the world that could lead to provincialism or, worse, doctrinaire and jingoistic views of the universe of a particular science.
Work in international associations, however, requires a particular mental set and certain qualities. Though it is difficult to amalgamate these qualities in a short list, the following should be considered essential:
An open mind—cosmopolitan and internationalist, sensitive to cultural differences
Willingness to do time as soldier or participate as sergeant or general
Pleasure in collaborating and in sharing time and knowledge
A communicator, including becoming proficient in other languages
Achievement of professional advancement and development of these qualities are all possible at the WPA. Despite the demands for hard work and dedication, the WPA provides personal and professional rewards, not to mention the development of lifelong friendships from all over the world.
In my own case, I have been fortunate to have had the opportunity to be active and to have the occasion to work with the world’s brightest in my combined field of epidemiology and forensic psychiatry through my involvement in the WPA. As an honorary member of the WPA, a member for many years of the standing committee on ethics, a member of the nomination committee, a member of the steering committee of the Global Programme to Fight the Stigma and Discrimination Because of Schizophrenia (4), and, especially, as chairman of the forensic section, I have found my involvement with the WPA one of the most rewarding experiences in my life as a psychiatrist. My work in the stigma program, for example, has given me new insights into sociolegal and political relationships in the management of the mentally ill in different cultures and countries. Work in this program has expanded my intellectual horizons and international networking and made me push the lines of my own science of epidemiology. These new insights have required changes in my methodological paradigms from the narrow confines of quantitative measurements of risk and estimates of frequency to a qualitative understanding of what it is like to be mentally ill in different cultures. They have also had an impact on my specialty of forensic psychiatry from the strictures of law and courtroom evidentiary preoccupations onto fields of political activism on behalf of the human rights of our patients. My work on the ethics committee in the drafting of the Madrid Declaration equally helped me expand my horizons from an ethics of clinical encounters to the macroethics challenges facing our profession.
The WPA is a truly remarkable association and the perfect vehicle for professional development, if the young psychiatrist is interested in following an international path for professional growth, networking, sharing, and collaboration with colleagues from all over the world.