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Artists, curators, and arts administrators are all implicated in this shift.

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The days when value was mutable, indeterminate and experimental; when ideas around cultural worth could be deployed by artists with reflexive criticality has given way to hourly rates and standard fees. I am not saying that artists should not be compensated, but that compensation, when negotiated through a fixed transactional lens is no longer a fluid site of criticality.

Insidiously, we have come to confuse transformation with transaction. Transactional standards prioritise short term goals and demand predictable and fixed outcomes, seeking measurable results.

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Transformational work on the other hand is messy and drawn-out, but has the potential to challenge conventional standards of evaluation. Our transactional culture has impaired the artist-directed imagination and thwarted the virtue of evolving new artistic forms for the ease of guaranteed short-term results. It is not surprising that Marshall decided he would never create another public work after this experience.

We may know the exact conditions of our work and exactly how much we will be compensated for it, but the price of this exchange comes at an immeasurable cost to the cultural imagination. For more information, contact info theartnewspaper. Our daily newsletter contains a round-up of the stories published on our website, previews of exhibitions that are opening and more. As a subscriber, you will also get live reports from leading art fairs and events, such as the Venice Biennale, plus special offers from The Art Newspaper.

You may need to add the address newsletter theartnewspaper. The focus and funding driven by the MDGs between and had effected a number of positive changes such as in increased school enrollment and decreased mortality among children.

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Things such as access to drinkable water and combating HIV, malaria, and tuberculosis also registered progress. It can therefore be stated, with some satisfaction, that the matter of mental health and its alleviation has received new impetus and that attention to mental health can take its place alongside environmental sustainability and human development more generally and more forcefully.


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However, they are able to take the inclusion of mental health as a starting point for another chapter of advocacy. That chapter is possible because indicators on mental health have not as yet been agreed to or included in the list of indicators. This matter of indicators will be important because when agreed to, data will be collected and published on progress that countries are making on mental health.

Advocates argue that data on mental health must be included in the final indicators that are developed. This is something that we feel sure the Indian Psychiatric Society may well want to monitor and make a contribution to. This occasion in Bhopal is one of the larger gatherings of professionals in the mental health field, anywhere in the world since September when the sustainable development goals were agreed to by world leaders and this conference offers the possibility of considering preliminary action in support of the newly calibrated goal and what remains to be done.

There is then potential for smaller groups of nations within the United Nations to develop a strategy to deal with this and to offer what may be done as a benchmark. One such group could be the Commonwealth with its 53 countries, 31 small states, 2. There is already talk of a Commonwealth Convention on Mental Health. Commonwealth Health Ministers, in their own separate meeting, have agreed that the post development agenda could include universal health coverage, address the unfinished business of the MDGs, cognizant of the need to accelerate progress on reducing maternal, newborn and child mortality, and incorporate a life-course approach to health, with a focus on morbidity, noncommunicable diseases, strengthening health systems, equitable access to medicines, and links health to other development goals.

If you are persuaded that a case has been advanced for mental health to be more prominent as an issue affecting countries throughout the world, one might then ask, how is this to be done? As outsiders to your number, we hope that the following suggestions may find some degree of acceptance. It seems to me that India could play a leading role in this. Second, if it were thought desirable, submissions of this kind could be made to a forthcoming meeting of Health Ministers of the Commonwealth.

That group of Ministers meets regularly, and the same task force might be empowered to work on a specific convention regarding mental health within the Commonwealth. India is an important and respected member of the Commonwealth whose voice carries considerable weight. Third, at an operational level, there is much work to be done in clarification and achieving harmony in mental health terminology and documentation.

This requires attention in many areas and the education of professionals and those who assist them in their work. A Commonwealth Task Force, perhaps suggested from India, might be one way toward achieving this. Addressing chronic and serious mental health issues for patients is a complex and demanding challenge for any health system.

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Alleviation of this, even slightly, would be in the eventual interest of the consumer, the person or persons who at the end of the day need and desire relief in their quest for wellness. There is much work to be done and it is hugely worthwhile because the end result will be to create a level playing field for the 21 st century mental health patient.

Thus far we have discussed what we see at the major contemporary macro level challenge for the delivery of mental health services in the Commonwealth. We turn now to a second macro level challenge that stands in the way of progress and that is, unhappily, the specter of corruption.

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Reduced to its essence, corruption is the misuse of power for gain. Across the world, corruption occurs at many levels, in every day-to-day transaction between common people, all the way up to the topmost levels of business and government, more so in some places than others and the delivery of health care and pharmaceuticals are not immune from this. If the figure means anything, the World Bank estimates that more than 1 trillion dollars are paid in bribes each year. Like many things, corruption has a supply side and a demand side — the supply coming from unethical business people, greedy corporate enterprises, and the hapless common man who is either prepared to pay or who has no choice about doing so.

The demand side comes from wrongheaded politicians, equally wrongheaded bureaucrats, and those in business who are prepared to exercise discretion in an improper manner. We are pleased to note that one of the other major outcomes of the same UN Sustainable Development Goals meeting at the end of September was Goal 16, dedicated to the promotion of peaceful and inclusive societies for sustainable development, the provision of access to justice for all, and building effective, accountable institutions at all levels.

The Conference recognized that much had been achieved during the 15 years since the MDGs were put in place, in the alleviation of poverty and mismanagement. At the same time, the finger was pointed at corruption being a scourge and sadly present in many countries inclusive of being present in the police and the judiciary.

In the detail of the expression of Goal 16, some crucial items are covered. For example If it all works, there will be a hugely powerful way for justice and equity to prevail. The provision of effective accountable institutions and thereby justice for all is something which calls for the actions of governments and also civil society.


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Ladies and gentlemen, in your role, leading your profession in this country and its efforts in the 21 st century, you are in a unique position to offer support for the recognition of corruption and its eradication, alongside the advancement of mental health. Addressing macro level issues requires a reconfiguration of the most powerful influences on mental health. At the first tier, elevating consideration of mental health in its own right as a sustainable development goal will require the creation of specific indicators, and the collection of data to enable periodic reviews of progress made over time.

Ensuring mental health services are not affected by corruption will also increase the effectiveness of efforts and extend the reach of services. Adopting mental health as a sustainable development goal and resolving to eliminate corruption will not in themselves lead to addressing the challenges currently inherent in the delivery of mental health services.

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However, they will reorientate the focus specifically on the plight of the mentally disabled. The mechanism for translation of any broad direction is the development of specific policies on the delivery of evidence-based services. This requires specific policies that constitute the second level of challenges we want to discuss briefly. Mental health policies need to be tailor made to the demands of a particular society, but they need to be based on the best evidence available.

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For example, contemporary policies in many countries now set aside funds for public education and the use of modern medicines for the treatment of mental disorders. There is every opportunity for a working group in the Psychiatric Society to review current legislation impacting on the delivery of mental health services and recommend changes that would better address the concerns.

A third tier of work is around actions at the community level where civil society can be encouraged to discuss, debate, and reach a new level of understanding about mental health that is modern, knowledge-based, and proactive. In some countries, New Zealand being one of them, a successful media campaign has been implemented to raise awareness of mental health, to encourage people to seek help and shape public opinion that is more positive, and less judgmental about mental health.


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  4. Finally, the fourth tier of action that can be undertaken is to do work with families coping themselves with mental health issues. Thus, external intervention is extended beyond medical treatment to shape and harness the resources of the entire family that may be affected by it. There is plenty for community leaders to do and there is plenty for practitioners to do.

    Effective change occurs when actions are comprehensively designed, competently implemented, carefully reviewed, and actions reformulated in keeping with local experiences and opportunities. There is plenty to do, and we wish you well in your search for answers. As we reach the end of our paper, we hope that we have adequately addressed the brief to examine some of the contemporary issues in the delivery of mental health services and some practical action that an illustrious group like you can take.