(Inaugural session, Part 1) 24th World Congress of Psychotherapy

Good morning to all. Distinguished senior United Nations officers, Chief of the United Nations Critical Incident Stress Management Section, World Psychiatric Association President, City University of New York Dean of the School of Public Health, President of the Association of Women Psychiatrists, members of the World Federation for Psychotherapy Board of Directors, councilpersons of the World Federation for Psychotherapy, and mental health professionals, Congress registrants representing all clinical disciplines. Welcome to the World Federation for Psychotherapy 24th World Congress of Psychotherapy. WFP is the oldest international psychotherapy organization founded in 1934 with over 50,000 constituents at present. We're pleased to collaborate with the United Nations, the City University of New York, the Association of Women Psychiatrists as co-sponsors of this 24th World Congress of Psychotherapy. We are also a dutiful affiliate organization of the World Psychiatric Association. The theme of this World Congress is Psychotherapy, Mental Health, and Human Rights: Caring for Vulnerable Populations humanitarian relief workers, and healthcare professionals, bringing together international scholars from 56 countries and all continents. We're delighted to hold our opening and plenary sessions at the United Nations Headquarters today, followed by two rich days of educational activities at the City University of New York Graduate Center on Fifth Avenue, an equally magnificent venue across the street from the Empire State Building. Clinical guidelines recommend psychotherapies as effective treatments. While the effect size of all psychotherapies is similar, certain clinical scenarios merit different approaches. Dedicated lectures and interactive educational activities incorporated in the scientific program of this congress will help those in attendance develop their clinical skills. The accumulation of scientific evidence and the proliferation of manualized psychotherapy treatments may be overwhelming, as there are over 1,000 recognized psychotherapies, many of which with proven efficacy and effectiveness. Important recent movements in the clinical provision of psychotherapy include the cultural adaptation of treatments, and identifying the curative factors responsible for therapeutic progress. This Congress will be attentive to these imperatives. Furthermore, our subjects are human beings, and protecting their rights and helping them overcome vulnerabilities must guide our clinical efforts. Taking care of the disenfranchised, of the neglected, of the persecuted, of the marginalized, is our ethical responsibility. Attending to the ego strength of caregivers will help build resilience, prevent burnout, and combat moral injury. As President of the World Federation for Psychotherapy, I declare this 24th World Congress of Psychotherapy officially open.

Thank you.

My colleague, Sohail Ali, now will share his remarks. Rather than wasting time with individual introductions, we're projecting slides introducing each speaker.

Thank you, Professor Alfonso. My name is Dr. Muhammad Suhail Ali. I am the Chief of the Critical Incident Stress Management Section in the United Nations Department of Safety and Security, and we have the honor of welcoming you to our home at the United Nations. And the privilege of co-hosting this Congress with the World Federation of Psychotherapy and the other esteemed organizations that are joining us. I also have the privilege of introducing the next three speakers, and after that I will hand over to, to César after that. So our first speaker for her remarks is the Assistant Secretary General for the United Nations Department of Safety and Security, Unaïssi Wouniwaka, and she has been a leader, an advocate, an ally for mental health and psychosocial support services in the United Nations across the UN system. So I'll hand over the floor to Unaïssi.

Thank you very much, Sohail. The President of the World Federation in Psychology, Professor Alfonso, fellow senior UN officials present here, participants of the World Conference of Psychotherapy, a very warm greetings to each and every one of you and welcome to the United Nations. It's a pleasure indeed this morning for me to welcome you. And I know it's a global network, and you are here at the UN Secretariat this morning. I know it's a congregation of professionals that we have in this room, and I know that you can sense the atmosphere in this room already with your contribution that, you know, you're looking forward to make in the next in the next couple of days. So I've noted that you have an exciting agenda ahead of you, and I'm sure you're all looking forward to contribute meaningfully to the various discussions that will take place. The theme of the Congress could not be more timely. In today's volatile geopolitical landscape, protecting psychosocial resilience is not merely a well-being preference, it is an absolute human rights and operational imperative. I also want to, to recognize our Critical Incident and Stress Management section that is headed by Sohail for leading this important partnership and elevating psychosocial support for our staff on a global scientific platform by helping shape the scientific agenda SISMAS is ensuring that the UN's internal psychosocial efforts remain anchored in peer-reviewed, cutting-edge global clinical data. We must also remember the difficult realities our department, and especially our colleagues in the field, face every day. As USG for the Department of Safety and Security, Mr. Gilles Michaud reminded the Security Council during his periodic briefing in April pertaining to protection of humanitarian personnel under the Security Council Resolution 2730. United Nations and humanitarian personnel continue to risk their lives to relieve suffering and sustain hope for millions. Sadly, we have lost some of our colleagues who have paid the made the ultimate sacrifice, and some have continued to live with scars, both physically and mentally. It is for that reason that we have a duty to support and protect our colleagues as best as we can. The reality is that the global security environment is under extreme strain. The number of high-risk locations that we need to deliver UN programs in have continued to rise steadily in the recent past, and as forecasted, may continue to do so. Armed conflict, political instability, and climate-related crisis, to name a few. Frontline personnel continue to face unprecedented violence, repeated violations of international humanitarian law, arbitrary detention, and disinformation that unfortunately turns those trying to save lives into targets. Security is not only about armored vehicles, physical perimeters, personal protection equipment, and gears. We need to remember that psychosocial resilience is also a core part of operational security. Before I close, I would like to encourage you to use this gathering to turn research into practical, scalable support models that UN Stress Counselors can use in active crisis settings. The United Nations' most important asset is its people. Protecting their psychosocial well-being helps ensure that humanitarian workers can continue to stay and deliver where they are needed most. Thank you, and I wish you a productive for productive and inspiring discussions in the days ahead. Thank you very much.

Thank you so much, Unaesi. Those words of wisdom, they'll go a long way to guiding us over the next 3 days. I now have the pleasure of giving the floor to Dr. Andreas Vlades, He is the Director of the Division of Health Care Management and Occupational Safety and Health in the United Nations and a global leader for health care management and especially occupational safety and health across the UN system. I will hand over now the floor to Dr. Vladis.

Thank you, Sohail, for those kind words. Dear colleagues, I want to welcome the World Federation of Psychotherapy to the United Nations and also say how pleased I am to join this exchange. As Sohail said, I speak on behalf of the department— sorry, the Division of Operational Healthcare Management and Occupational Safety and Health, which is part of the Department of Operational Support. As a surgeon for, for many years, I can attest to the importance of occupational safety and health. My many years in the field have also made me acutely aware of the importance of staff mental health. It can no longer be treated as a secondary component of medical readiness. In my view, it's, it's a core pillar of clinical medicine and of long-term sustainability of our workforce, especially in the field. I want to take this opportunity to commend the Critical Incident Stress Management Section. For his proactive leadership in building this global scientific alliance. I also want to highlight the vital operational synergy between my division and the Critical Incident Stress Management Section. We are the central authority for UN medical standards and occupational safety and SISM— CISMS, sorry, there are many acronyms in this organization. My division and your division, we operate very closely and we managed to focus on field psychosocial interventions in a timely manner. I would like to underscore that this collaboration is essential to ensure the UN's medical and psychological responses, that we function as one coordinated, scientifically validated continuum of care. Today's complex field environment, which, which we, which was just alluded to, with a diminished respect for the Geneva Convention's provisions of protection of medical staff, require us to evolve how we understand occupational health. We are seeing UN medical staff, along with other humanitarian staff, confront compound trauma and severe occupational stress alongside physical injury every day. The breakdown of health infrastructure in crisis zones places an unprecedented burden on frontline healthcare and relief workers. For that reason, the Congress theme of, of caring for healthcare professionals is extremely timely and necessary, and it resonates strongly with me as a critical priority for the United Nations Medical Administration. We know today that psychological injury and chronic burnout, due to structural occupational safety hazards can be mitigated through evidence-based, uh, measures. This is an important shift in the perspective if we respond, uh, timely and effectively. I therefore want to emphasize the importance of the institutionalization of proactive, preventive, mental health, and psychosocial support strategies within the United Nations frameworks. We must move beyond reactive crisis management toward a durable psychological resilience across our global workforce. So, to end my remarks, I want to challenge you all, each and every one of you, as experts, as clinicians, as academic researchers, to ensure that the scientific breakthroughs which are discussed today and in the coming days are translated to actionable, peer-reviewed operational protocols that genuinely support our colleagues working in extremely difficult circumstances. At the end of the day, the only thing that counts is the impact, right? Research in and of itself has its maximum value when it changes things on the ground. That's the way I look at it as a previous professor of disaster medicine and traumatology. I want to conclude by reinforcing that my division, DIMOSH, remains committed to implementing evidence-based medical, psychological, psychological safety standards to protect and support our staff. I firmly believe that we must protect the holistic health of our staff. This is what enables the United Nations to sustain its vital field presence and safely deliver on its global mandates. I want to thank CISMS, the World Federation for Psychotherapy, for the invitation and the opportunity to give these opening remarks and express my appreciation for the opportunity to, to be here. I wish you all meaningful days, interesting interactions, and never forget those of our colleagues who are on the ground in the field now and today.

Thank you.

Thank you so much. Thank you so much, Dr. Vladis, for those wise words. The holistic approach, the biopsychosocial model of health and well-being, is the cornerstone of our work. So we really appreciate the partnership and the collaboration. I would now like— I have the honor of introducing my third colleague, Dr. Nana Ndugue. She is the global lead of the United Nations Mental Health and Well-being Strategy, and she, she is representing the Department of Management Strategy, Policy and Compliance She's an ally and a global leader in workplace mental health and well-being. So I'll have the pleasure of handing over the floor to Dr. Nana Ndokwe.

Thank you very much, Suhal, and also thank you very much to Professor Alfonso for opening up the Congress. As my colleague Suhal said, I'm Nana Ndokwe. I'm HERTS, the global lead for the mental health strategy for for the UN. Today I have the great opportunity to provide opening remarks on behalf of ASG Marta Helena Lopez, who is a strong champion for mental health and well-being across the UN. My position sits within the Division of Management Strategy and Policy within OHR. So first of all, I'd like to share a warm welcome to SISMSS of UNDSS for its leadership in bringing this valuable collaboration together. Partnerships like this matter because they remind us that mental health is not just a clinical concern, but it's also a strategic priority for institutions, organizations, and the people that they serve. From a human resources perspective, we're living in a time when mental health and psychological safety can no longer be treated as secondary issues. They are central to organizational effectiveness workplace sustainability, and our collective duty of care. In every complex environment, and especially in field and crisis settings, the wellbeing of staff is directly linked to our ability to perform, to retain talent, and to remain resilient. We also know that today's workforce faces increasing exposure to stress, to fatigue, and compounding trauma. And for those of us working in humanitarian settings, healthcare, high-pressured context. These are not abstract concerns. They are real operational risks that affect individuals, teams, and institutions alike. And this is why the theme of today's congress is so pertinent. Caring for healthcare professionals and humanitarian workers is not only an ethical imperative, it's also a practical necessity. As you know, too often burnout and workplace stress are seen as personal shortcomings, but in reality, they are symptoms of deeper systemic challenges. This means that our response must be systemic. So we need policies, structures, and leadership approaches that are proactive rather than reactive, preventative rather than solely responsive. We need to embed mental health and psychosocial wellbeing into the core of our management structures and HR frameworks so that we build workplaces that are inclusive, supportive and free from stigma. So this is where scientific expertise and institutional practice must meet. The knowledge and experience represented in the Congress today can really help us to shape practical tools, guidance, and policies that will make a real difference in workplaces around the world. The challenge before us is not simply to understand the issues, but to really translate that understanding into action. So on behalf of the Department of Management, Strategy, Policy and Compliance and Office of Human Resources and the United Nations, we remain strongly committed to advancing staff well-being and strengthening the systems that really support it. We believe that protecting mental health and emotional health of our personnel is really essential in sustaining our human capital and enabling our global workforce to deliver effectively and even under the most demanding conditions. So thank you again for the invitation and take this as a warm welcome to the World Federation, and you can assure that the Department of Management, Strategy, Policy and Compliance is fully supportive in strengthening mental health and well-being moving forward. Thank you very much for this opportunity.

Thank you so much. Thank you, Dr. Ndukwe, for those words of wisdom as well. The individual doesn't operate in a vacuum, operates in an organization context, and this partnership between human resources, medical, and security are just some elements of the wider organizational approach to ensuring that humanitarian workers are protected and their mental health and well-being is promoted as they carry on their essential work around the world, helping those who need their assistance. So with that, I'll thank our esteemed speakers and I will hand over to my friend and colleague, Professor Alfonso.

Before we continue, let's offer a round of applause to our gracious and impressive hosts at the United Nations. It is an honor now to present, to introduce the President of the World Psychiatric Association, Professor Danuta Wasserman. Professor Wasserman.

Thank you very much, dear colleagues, dear friends, and thank you, Professor Alfonso, for inviting me to speak here. The World Psychiatric Association is an old organization, not almost as old as United Nations. It started in Paris at the Congress in Sorbonne in 1950s. And now we have members from 147 national psychiatric associations on all continents in 123 countries. So we are a very good vehicle for everything you are speaking about here. And we have 250,000 psychiatrists which means it is not enough, but quite substantial number. I must make a personal confession. In my childhood, I start— studied psychotherapy and psychoanalysis. And then I became head at Karolinska Institute's Department of Public Health Sciences and global management, which means that from the individuals I went into the systemic approaches, how to improve mental health. So it is not surprising that my action plan is in fact built on 17 Sustainable Development Goals of United Nations, which should be used in almost all countries. Unfortunately, the developments are as they are, which means that we have a lot of difficulties. But still, my big organization tries to fulfill those goals as well as they can. And those goals mean that good health, both somatic and mental health, depends on so many environmental factors: poverty, hunger, crisis, wars, stress, good working conditions, good schools, good education, equality, clean air and clean water, et cetera, et cetera, and collaborations. And cooperation. And I really hope that in spite of the realities, today's realities, we will work on those goals in all sectors of the societies because that will lead us to better health for all and better living conditions for young and adults and older ages and beyond. In my organization, we put into the fore also so-called edit principles, like editing a book. And what we are trying to edit is equality in our organization concerning different positions we have, how many speakers we have in different congresses, how many fellows we have of female gender or male gender or transgender from all continents. It is not an easy work. When I started this work, my colleagues were really upset because it was difficult to find speakers from different continents in a specific topic or subject, but we are moving slowly forward, and we have also evaluation of the process by our younger colleagues and publishing articles how we achieve those goals or not achieve those goals, because only having open goals we can achieve results and some kind of better outcomes than we had. So now I hope that during your Congress you start to think how your knowledge in work with individual patients, clients, families can be translated, as you say, to the field and for bigger groups. Because I learned a lot from my training in psychotherapy and psychoanalysis, and I know that everything can be translated in all interactions we have on the group level and nations levels, et cetera. So thank you very much once more for inviting me to say a few words, and I wish you all a very successful congress.

Thank you.

Thank you, Professor Wasserman. We're really honored to be affiliated— that for WFP to be affiliated with the World Psychiatric Association, and we'll continue to do our best to represent ourselves and protect psychotherapy within psychiatry at meetings of the World Psychiatric Association. Our next speaker is the illustrious founding Dean and tenured Professor of Epidemiology of the from the City University of New York Graduate School of Public Health and Health Policy, Professor Ayman El-Mohandes.

Good morning, everybody. I think we can do better than that. Good morning, everybody.

Good morning.

There you are. We entrust our mental health to you, so you better be Alert. On your toes. Truly, thank you, Professor Alfonso and Dr. Zuhair Ali, for inviting me to this morning event. CUNY and its Graduate School of Public Health and Health Policy are honored to co-host this very important meeting. But before I go any further, I'd like to introduce our university to you because just as Professor Wasserman just said, the ecological awareness is very important in our daily tasks. And as your co-host, I feel like I should introduce our university. City University of New York is the largest urban university in the United States with 250,000 students. Students in one city. Yes, you're right, 250,000 students in one city. 50% of our students are first-time college-goers, and 60% of our students come from diverse ethnic and cultural backgrounds. We're 26 institutions of higher learning in one city, in the five boroughs of this very great city. It should not surprise you that this population puts us amongst the 30 top cities in the United States. But we primarily serve the city of New York, with its 8.2 million citizens. We, as the CUNY Graduate School of Public Health and Health Policy, are the public school of public health in the city. And I need to emphasize that we are in a city of great privilege in terms of public commitment. Currently, City University of New York 60% of our students pay no tuition, and 75% of our students graduate with no debt. That is because the city and the state of New York stand staunchly behind higher education. We are proud of our institution. We're proud of our standing. We are the workforce engine for New York, but also the generators of new science and discovery. City University of New York in its entirety generates approximately $680 million in research. As for our Graduate School of Public Health and Health Policy, We are very, very proud to co-host this important meeting. Within our mission, human rights and human dignity are core, and it is indeed core to public health. Thank you, Professor Wasserman, for reminding us of the importance of contextualizing mental health within the larger rubric of population health. Unfortunately, I don't have good news to share with you today, but hopefully challenging news. I've just returned from Oxford, England, where a group of WHO experts were looking at the attainment of the non-communicable disease, um, Goals within the Sustainable Development Goals. Of the 17 Sustainable Development Goals, there are about 32 health indicators, many of which are non-communicable diseases. I'm very gratified that mental health is amongst non-communicable diseases by WHO criteria, but need I say It is one of those where their ability to reach any of their indicators is very unlikely by 2030. Being in a public school of public health, I cannot complete my remarks without indicating the importance of commercial determinants of health and how they are impacting on the world health population and the mental health of the world population. It should not surprise you, you may have already heard, that the tobacco industry last year reached $900 billion in its entirety, but it should shock you to know that last year the alcohol industry in the world reached $2.7 trillion, which puts it as number 8 of the GDP of countries around the world. Today, media, social media, Substances and stressors to which we are exposed as professionals, as academics, as citizens, and need I say, as adolescents and children— thank you again, Professor Wasserman— is a big responsibility, and I will not call it a burden. Your shoulders are broad. Otherwise, you wouldn't be psychiatrists. And your spirit is strong. Your work in the next few days is cut out for you, gentlemen, and dear ladies and others. We are looking for solutions to leapfrog barriers. Walking up the stairs has proven to be a very slow and non-sustainable process. Leapfrogging, or frog leaping, whichever the expression is, requires genius, energy, dedication, spirit. And we rely on you to leapfrog. Thank you.

Thank you very much, Dean. And I would like now to thank all the speakers from this panel and please I'm going to announce that we need to make space for the next set of speakers. So thank you very much for your contribution to the opening session. Your names should be appearing on this screen shortly. Okay, so would you like to— We continue with the opening session, and I am pleased to introduce to you now the current president of the Association of women psychiatrists, Nicole Benders-Hadi.

Good morning. Um, thank you so much. Welcome. First, I want to sincerely thank the organizers of the 24th World Congress of Psychotherapy, our hosts, my fellow panelists, uh, for the opportunity to be here today. It's a privilege to help open this congress and join colleagues from around the world who really share a commitment to advancing mental health and human dignity. I think the theme of this Congress, Psychotherapy and Human Rights: Caring for Vulnerable Populations, couldn't be more timely. So I'm honored to be here today, both in my role as president of the Association of Women Psychiatrists, also in my role as chief medical officer at Talkspace, a digital mental Health Company. While these roles really focus on different aspects of our profession, they're really united by a common purpose that's expanding opportunities for healing, connection, and care. At its core, psychotherapy is an affirmation of human dignity because every day psychotherapists and mental health professionals really meet individuals during some of the most vulnerable moments of their lives. So across countries, cultures, communities, people are really facing rising rates of loneliness, trauma, displacement, uncertainty, psychological distress. Yet individuals who most need support are often those who face the greatest barriers to receiving it. And so that's why conversations like the ones we'll have today and during this Congress matter so deeply. Psychotherapy is not simply about reducing symptoms. It's really about creating spaces where people feel seen, heard, respected, and safe enough to tell their stories. It's about recognizing the humanity of every individual, particularly those whose voices often have been marginalized or overlooked. As president of the Association of Women Psychiatrists, I have the privilege privilege of leading an organization dedicated to supporting psychiatrists throughout their careers and advancing leadership within our profession as well. So through mentorship programs, our scholar initiatives for early career psychiatrists, our virtual educational programming, our annual virtual conference, and awards recognizing excellence in scholarship, advocacy, advocacy, mentorship, and clinical care, we work to really strengthen the future of psychiatry and encourage women to pursue leadership, innovation, uh, research, and advocacy. When we invest in people who provide care, we really strengthen our ability to serve patients and communities around the world. In my work at Talkspace, I also see how innovation and technology can help reduce barriers to care and expand access to mental health services for individuals who might otherwise go without support. Access itself is a human rights issue, I believe. And so even as technology continues to evolve, we recognize that psychotherapy remains profoundly human work because trust matters, presence matters, empathy matters. Later today, I look forward to discussing how we can really thoughtfully integrate technological innovation into psychotherapy while preserving ethical principles and the human connection that remains the heart of our work. So despite many challenges facing our world, I do remain hopeful. I'm hopeful because gatherings like this really bring together people across disciplines, across cultures and nations who share a belief in healing, compassion, and the inherent worth of every human being. So I thank all of you for the work you do every day. Thank you for your commitment to vulnerable populations and to human rights. And thank you for the opportunity to help begin this Congress together.

Thank you so much. We look forward to a continued collaboration with the Association of Women Psychiatrists. Our next speaker is a dear friend and future board member who will be elected hopefully tomorrow at our general assembly of WFP. She is moving from the council to the board of directors, Ekaterina Sukhanova, who's an associate dean of the City University University of New York School of Medicine.

Good morning, um, esteemed United Nations officials, distinguished guests, dear colleagues and friends. It is an honor and a privilege for all of us at CUNY to co-host the 24th World Congress for Psychotherapy with the WFP and with the Critical Incident Stress Management section of the United Nations Department of Safety and Security. I would like to thank in particular the WFP President Cédric Alphonse, President-Elect Dieribjeste, Secretary-General Alma Giménez, and all Executive Board and the leadership for this exceptional opportunity to partner with WFP and the event. We are excited to join forces with a global organization that has such a remarkable history. As we all know, The first president of WFP was Carl Jung, whose work has influenced not only the modern understanding of the construction of self, but also the contemporary educational theory and practice that still today helps educators embrace the emotional, symbolic, and developmental layers of student experience. The conviction that mental health is foundational and not peripheral animates everything that WFP does. Promoting the highest standards of clinical care and research, building shared frameworks across psychotherapeutic schools and national cultures, and advancing mental health as a human rights issue at the highest levels of international policy. That mission allies naturally with CUNY's, a university built on the idea that access to world-class education and to the health and well-being it supports should not depend on privilege or social circumstance. As Zeno Mohandes already mentioned, we are a city by ourselves. We span 26 institutions and bring together nearly 250,000 students from families rooted in more than 160 countries, a breadth of global representation that is reminiscent of the United Nations. This is why we are particularly grateful to Dr. Mohamed Saïl Ali, Chief of the Critical Incident Stress Management Section, and his esteemed colleagues for generously hosting this special plenary day that is certain to be remembered for a long time. We are eager to be your partners in this project. The theme of this Congress, "Caring for Vulnerable Populations: Humanitarian Relief Workers and Healthcare Professionals," resonates across a wide range of CUNY disciplines. And professional schools. The CUNY Graduate School for Public Health, which is of course our co-host for this congress, is dedicated to improving health and social justice in New York City and across the globe. The university at large, there are also other units that are pursuing similar goals that are well aligned with the congress team. The CUNY School of Medicine has a dual mandate to produce diverse medical professionals and provide quality health services to underserved communities. In addition, across the CUNY campuses, we have a doctoral program in clinical psychology, multiple graduate programs in mental health counseling, social work, psychiatric nurse practitioner program at the master's level, and more than 350 health and human services degree and certificate programs enrolling some 40,000 students. So this Congress is of direct relevance to our communities, our students, and our mission. This is reflected in CUNY's presence and the scientific program, at the center of which is, of course, the CUNY School of Public Health and Health Policy, founded just over a decade ago and already at the top ranks of American public health schools. We are deeply grateful to Dean Ayman El-Mohandes for his vision and commitment in supporting this Congress. In tangible and intangible ways, which was critical for making this project a reality. Special thanks are also owed to Professor Victoria Ngo, Director of the School's Center for Innovation in Mental Health, for playing a leading role in its success, and to Francesca McLaurin, MPH, the Project Manager at CAMH, for facilitating the planning and communication. This page is prominently featured in the Congress program, from this afternoon's high-level plenary on mental health diplomacy, to a plenary on task-sharing intervention, to a roundtable on healthy cities with New York City senior health officials. Tomorrow the Congress will continue at the CUNY Graduate Center, the only public institution in New York City to hold the Carnegie Research I designation and an intellectual hub for doctoral education and system-wide scholarly initiatives. And it just happens to be my alma mater, So it gives me a particular pleasure to invite you to my academic home. And many thanks are due to Graduate Center President Joshua Bloomberg, Dean of Science Brian Gibney, and other GC colleagues for welcoming the Congress. I would also like to thank Dr. Rosemary Wesson, CUNY's Associate Vice Chancellor for Research, Dr. Alan Shee, University Executive Director of Research and Innovation, and Ms. Astrid Sylvester for helping with the— logistics of the QE part of the event. We are proud to stand with you in the work that you do around the world. May this Congress give rise to many dialogues, partnerships, inspirations, and the new resolve. Thank you.

Our next speaker is Professor Professor Silvia Olarte, a council member of the World Federation for Psychotherapy and also a past president of several organizations including the Association of Women Psychiatrists. Professor Olarte.

Thank you. I wish to thank the United— the UN Critical Incidents Stress Management Section, the World Federation for Psychotherapy Board of Directors and Council, the CUNY School of Public Health, and the CUNY Graduate Center for having invited the Association of Women Psychiatrists to participate in this illustrious opening session to the World Federation of Psychotherapy 24th World Conference. The Association of Women Psychiatrists was founded in 1983 by women shaped by the women's movement of the '60s and the '70s. They had participated in development and approval by Congress in 1972 of the Equal Rights Amendment. They fought for the ratification of the needed approval by 38 states of the union and witnessed the defeat by one vote in 1982. I remember that in person. These women respected diversity that they were not given, believed in equal opportunity that they were not granted, fought for gender and sexual equality while not receiving it. They had been active in the American Psychiatric Association political structure, had advanced in the leadership of the association's assembly, but could not advance in the political structure of the board of trustees. They could go into the national committees, but not the board of trustees. Meanwhile, women psychiatrists by the 1980s had become over 25% of the American Psychiatric Association membership. Yet no woman had been elected president to the president of the association, and only one had been elected vice president. The founders of the Association of Women Psychiatrists, realized they needed to form an association for women psychiatrists under the umbrella of the American Psychiatric Association, joining other allied organizations which represented the need of different subspecialty groups in psychiatry, facilitating members within similar interests to participate in the governance of the American Psychiatric Association with one voice. Before the foundation of the association, The women would join other allied organizations which represented their professional interests. Still, they felt disenfranchised, discouraged, and with no place where to discuss and voice their concern as women patients and the concern for women patients. Our founders left us, Women Psychiatrists, an association through which our members can experience the power of a united voice. This association encourages to encourages us to develop our professional skills guided by the belief that human beings can be educated to help them change if they are treated with respect, humbleness, patience, and dedication. We protect our patients' identity, their culture, and their beliefs. We enhance their ability to develop their full potential within their choices. The Association of Women Psychiatrists goals and objectives are very much in sync with the goals of the World Federation for Psychotherapy and the other participants of this wonderful conference. Thank you very much for attending it, and I look forward to all of your presentations.

Our next speaker, coming to us from Germany and before that from Iran, Professor Hamid Peseschkian, Council Member for the World Federation for Psychotherapy and President of the World Association for Positive and Transcultural Psychotherapy, one of the WFP's most active international member societies. Professor Peseschkian.

Dear friends, as you are sitting already a long time, let's start with an exercise. If you just get up for a moment. Yeah, and now we can sit again because everybody is now awake and aware. Thank you. An old wisdom says that if you want something you have never had, you have to do something you have never done before. If this is true, dear colleagues and guests—and I believe it is—then we must ask ourselves: Are we doing enough differently to create the peace we speak about? We gather in places like this to negotiate peace to design frameworks, to build agreements. And yet, before conflicts appear between nations, they begin elsewhere. They begin in the human mind, the human heart, the human soul. In fear, in mistrust, in the inability to understand the other. And today, in an interconnected world, this other is often someone from a different culture. We live closer to another than ever before, and yet in many ways we understand each other less. Difference becomes threat, misunderstanding becomes division, and division, if left unattended, becomes conflict. So if we truly want peace, we must learn something which we have not yet learned well enough: to understand across cultures—not as an ideal, but as a skill; not as a slogan, but as a practice. Decades ago, Nosrat Pizeshkhan recognized this with remarkable clarity: that culture is not a barrier to overcome, but a bridge to be built. At the World Association for Positive and Transcultural Psychotherapy, we continue this work today, in more than 65 countries with more than 3,000 members. We train psychotherapists —to listen beyond words, to recognize values within differences, and to transform tension into dialogue. Because this is the deeper truth: Peace is not only negotiated at tables. It is cultivated in minds. It is practiced in relationships. It is learned in the way we see one another. And this brings me to a final thought. A family is a nation in miniature, and a nation is a family on a large scale. The happenings in the family are the happenings in the life of the nation. If there is no understanding in the family, there will be no understanding in the nation. If there is no dialogue at the small scale, there will be no peace at the large scale. So if you truly want something we have never had, a more peaceful world, then we must be willing to do something we have never done enough: to place understanding within ourselves and across cultures at the very heart of peace. Thank you very much.

And our next and last speaker for this opening session is a person who needs no introduction, our dear president-elect of the World Federation for Psychotherapy, Professor Dilip Jeste.

Thank you. Good morning. Good morning. It's really a pleasure and an honor being here. The World Federation for Psychotherapy is truly an amazing organization. It was established 92 years ago in 1934 by Carl Gustav Jung. One of the pioneers in the psychodynamic psychotherapies. He called it somewhat different. It was called International Medical Society for Psychotherapy. And it has changed the names over a period of decades, but it's called the World Federation for Psychotherapy about 10, 15 years ago. I'm also delighted that we have some past presidents here. Dr. Ulrich Schneider from Switzerland, who was president more than 25 years ago. Dr. Driss Moussavi, who was the first ever— first ever non-European president of the World Federation, and that was 3 years ago. And then, of course, César Alfonso, the first president from the US. And as you all know, César has done an amazing work during these 3 years. Including the fact of having the meeting at the United Nations and having multiple regional meetings, really expanding the focus of World Federation in a major global way. And I should also mention somebody who will be president 3 years from now, Dr. Alma Jiménez from Philippines.

Welcome.

It's really wonderful to have this meeting at the United Nations. As you know, United Nations was established in 1945 after World War II ended. It was not clear where the world was going to go at that time, and yet today we are in such a great situation in many ways across the globe, being together, focusing on peace, humanity, and really that is why it's an honor for us to meet in the United Nations. Also, I want to thank the World Psychiatric Association, of which our Federation is an affiliate. So our focus is on psychotherapy, right? What is psychotherapy? To me, psychotherapy is not just a psychiatric or psychological treatment. It is actually meant for improving well-being and general health of the people. It is not restricted to people with mental illnesses. It affects and should have impact on the well-being of every single person in the world. And we are talking about 8 billion people. And what do we mean by health? The modern definition of health It is called actually whole health. This was something that was published by the National Academies of Sciences, Engineering, and Medicine, formal definition. Whole health is physical, behavioral, spiritual, and socioeconomic health and well-being. This is really the formal definition. So it is not just related to diseases, it's related to well-being, which applies to every one of the 8 billion people in the world. And that is what psychotherapy does. Our job is to improve the well-being, not just to reduce the symptoms of illnesses, but really improve the well-being, and as I said, in a broad way: physical, behavioral, spiritual, and socioeconomic. And not just at the individual level, but at the societal level. I mean, in a way, the world is not undergoing some very good circumstances right now. There's a loneliness epidemic, for example, which has become really a WHO-defined crisis across the world. What can we do? What we can do is to improve not only at the individual level, but at the societal level. Social connections, there should be greater compassion, greater wisdom. And that is why I feel that even the artificial intelligence, AI, should be changed into artificial wisdom. That's what the society needs, and that's what we can promote. One other fact I want to quickly mention is that our journal, Psychotherapy and Psychosomatics is one of the highest impact journals in the entire medicine. We should really be proud of that. And so really we have many important tasks to accomplish during the coming years, and our goal is really to look forward to improving the happiness, well-being, and overall health in the entire population of 8 billion people. Thank you very much.

Thank you to all the speakers, and we will officially begin with our plenary sessions with no break. So if you need to take a break, please feel free to exit the room and come back in at your leisure. Thank you.

Yes, great as usual. He will come.

I feel deeply sorry for you, friend. It's quite unbelievable.

We are going to begin with the first panel. Please take your seats. We're having a 2-hour lunch break, and you may use that time for networking and conversation, so I am asking for your cooperation.

Um, dissipation. Yeah, young people.

Good to see you.

Okay, okay, just get started.

Dear colleague, please, we will start the session. Please take your seat. Thank you for taking your seat. Okay.

Good morning.

Dear colleagues, I have the great honor and pleasure to co-chair this session with César Alfonso. Thank you. Good morning again. I am François Ferreiro, a professor of psychiatry at Geneva University in Switzerland, and I devoted almost a half century to psychiatry and psychotherapy. I'm currently the Treasurer of the World Federation of Psychotherapy and the President of the Geneva Prize for Human Rights in Psychiatry. It's now my great pleasure to introduce César Alfonso. You all knew him very well. César is a psychiatrist and a psychoanalyst, a man with great creativity and tireless energy. He is clinical professor of psychiatry at Columbia University Medical Center. He serves as a visiting professor or adjunct professor at 4 Asian universities. He serves as editor-in-chief of the journal Psychodynamic Psychiatry, president of the American Academy of Psychodynamic Psychiatry and Psychoanalysis, and chair of the Psychotherapy Section of the World Psychiatric Association. César's recent work includes the study of the psychodynamic determinants of treatment adherence, biopsychological and transcultural aspects of suicide, the clinical care of people with low vision, and of course, the design and implementation of psychotherapy programs. Among other books, he published Advances in Psychodynamic Psychiatry with Richard Friedman and Jennifer Dooney. During his 3-year term as president of WFP, he demonstrated exceptional commitment. This New York Congress that he organized with his colleagues is the perfect illustration of both his remarkable impact and his generosity.

You have the word.

Thank you, François. I will carry you in maybe 4 or 5 minutes through a brief history of our Federation, 90, 92 years since the Federation began. I have no conflicts of interest to declare relevant to this presentation. I would like to thank the board of directors of WFP. All of the directors are here and two of our consultants are here as well, so please, they are our living history, so use any opportunity you have to chat with them. Also, I would like to thank The members of our council, our advisory board, and those highlighted on this list are also present at this congress, and we are quite pleased to have a hefty representation of our two boards. And here I'm listing for you the presidents of our organization going back to the very beginning. We're very proud of our European heritage, but we're also happy that we are moving around the world, first with President number 10, Professor Driss Moussaoui, and now following into the Americas, and soon after that, hopefully she'll get elected tomorrow with Professor Alma Jiménez moving into the Asian arena. We have 21 member societies from all continents representing over 50,000 constituents, and our member societies are national, but we have also 2 international member societies which are quite active and large. And in countries where there are no member societies represented, we accept individual members, and some of our individual members are here as as well. This is just photographs of our presidents to honor them. You may be familiar with the work of some of them or many of them. I love this picture of Dr. Moussaoui. And of course, you know, my favorite picture of Dr. Jeste. I think this was from a TED Talk that he gave. I stole it from the internet. So we have changed our— we've modified our identity over the years. We started at the— as the International General Medical Society for Psychotherapy, and as we became more sophisticated, we decided to to be more inclusive and welcome all professionals from all the mental health disciplines years after we shifted from medicine and psychiatry into general mental health. As mentioned before by Professor Jeste, our journal is very well placed, and we're happy that one of our panelists today is the editor-in-chief of the journal. And we have met all over the world in very vibrant cities. We met once in the Americas before, in Rio in 1982, and a couple of times in Asia. I am looking forward to finding out by the end of this congress where Professor Jesty is holding the next world congress in years. And I invite you to my plenary address tomorrow morning at the CUNY Graduate Center where I'll be talking about psychotherapy advances, challenges, and opportunities. Thank you so much. And now I will pass on the clicker to Professor Jeste, who's going to be talking about the importance of social determinants of health.

Good morning. So I'll be talking about social determinants of health. And I have no conflicts of interest. Medicine over centuries has focused mainly on the biological aspects and physical aspects of health. Yet the social factors are very important for our health. And we really haven't paid much attention to that until very recently. In 1998, the World Health Organization published a report for the first time on social determinants of health, and it talked about the importance of factors that are non-medical, but they have a major influence on health outcomes. These include conditions in which people are born, grow, work, live, and age, as well as a wider set of forces and systems that shape the conditions of our life. And the WHO has published several reports since then, and in recent— last 20 years or so, this has become really one of the major issues, areas for research in health in general, mental health in particular. There are two subtypes of the social determinants. One is at the individual level. For example, if somebody doesn't have transportation to go to the clinic, they will miss the clinic visits and it increases the risk of relapse, right? Food security. If people can't get good enough, healthy enough food, their health will go down. Trauma. Trauma is a major, major factor, and trauma in early childhood affects all the rest of the life, including old age. So these are factors at the individual level. There are also factors at the family level, community level, or societal level. For example, the neighborhood in which we live. Is it a violent neighborhood with a lot of problems, or is it a more compassionate, a kind neighborhood, right? That will affect our health. Discrimination. Discrimination against women or against ethnic minorities or even LGBTQ status. That kind of discrimination is very unhelpful in general. Climate change. Again, this is something that is becoming of greater interest. So these are the social factors that have impact on health. And believe it or not, the single factor that has the greatest impact on health is social connections. I'll come back to that. But I want to talk about major social determinants of mental health, both adverse and positive. A number of illnesses like schizophrenia, major depressive disorder, PTSD, so on, they are not only affected by direct biology, they are affected to a serious level by factors like childhood abuse and neglect, food insecurity, homelessness, even access to internet. If you don't have access, you are going to suffer in many ways in daily life. Immigration, incarceration, Social isolation, social fragmentation, racial discrimination, climate change. Again, these are all evidence-based social determinants. They are not just somebody's thinking or philosophy. Studies have shown that people with these social determinants actually do much worse than people who don't have them. But there are also some positive factors, positive factors that improve health. Social network, for example. If you have a large social network, that is positive, that is very helpful. School connectedness, especially for the kids, how connected they feel with other kids as well as with the teachers. Workplace for adults, that's really an important aspect, right? Parental care for children. Being married, and of course being married and having a positive relationship with your spouse or partner. Religiosity has also been shown to be an important social determinant. So, numerous studies have shown that these factors have great impact on health, even more so than things like diabetes, hypertension, obesity, etc. For the last 25 years or so, the world is going through a difficult period, what is called The Silent Epidemic of Loneliness. 162,000 Americans die per year because of illnesses related to loneliness. That is more than the number of people who die from lung cancer or stroke. So what are these illnesses? These illnesses include heart disease, stroke, dementia, depression. These are all illnesses that are associated with increased loneliness. And it is not just a health issue. New Ministries of Loneliness have been established in the UK and Japan. So it's a broader issue for the whole society. And the World Health Organization in 2023 said that loneliness is not just a US or European or Asian problem. It is a worldwide problem. It's a global health priority. So what do we do? So there is an antidote or vaccine for loneliness, and that is wisdom. What is wisdom? Wisdom has been known since ancient times. You know, almost every religion, if you look at the original scripture, they talk about wisdom. But scientific research on wisdom only started in the 1970s. But it has been growing rapidly since then. So what is wisdom? Wisdom is a unique personality trait which enhances personal well-being as well as community well-being. It is different from intelligence. Wisdom is not just intelligence, it is more than that. And what is it? Empathy and compassion. How we connect with others, how we help others and others help us. Emotional regulation. Self-reflection, acceptance of diverse perspectives, wise advising, spirituality. Once again, these components are based on empirical published research. This is not just a philosophy, but research has shown that presence of these factors improves health and well-being. And we and others have done a number of studies that have shown that really wisdom, especially the compassion component of wisdom, markedly reduces loneliness. And this has been shown not just using clinical studies, but also biological studies, like EEG and gut microbiome. And even longitudinally, we have found that people who score higher on wisdom, especially compassion,, they're much less likely to be lonely 5 to 7 years later. So clearly, we have this global pandemic of loneliness for the last 25 years. We need to do something about that, just as we did with COVID and other pandemics. But what we need is really improving the social connectedness, compassion, and wisdom. So there are Interventions that have been used that showed that if you transmit wisdom, especially compassion, it will bring down loneliness. This is a very important study that was published recently from Hong Kong, and they found that conveying wisdom actually improved loneliness significantly. And I'm coming to the end of my talk. So how can we do that? The number of human therapies is very small. We have 8 billion people who need that. You know how many human therapies we have? The number is— and this is according to WHO— 50 per 100,000 people in high-income countries, 10 per 100,000 people in middle-income countries and 1 or less per 100,000 people in low-income countries. We don't have enough human therapists, so we need to use something else, and that is AI, artificial intelligence, because artificial intelligence is very commonly available. For example, 6 billion people in the world have mobile phones, 2.5 billion people in the world use ChatGPT. And I'm not advocating for ChatGPT, anything like that. All I'm saying is these are cheap, widely available technologies that are there. Should we not use them to help our patients? Because there are not enough of the humans. But of course, the current AI won't work because it really has many problems. But future AI, If we convert it into artificial wisdom, it will work and it will help us. So, this is my last slide. So, we actually have the ability to change today's lonely, distressed, polarized, socially isolated world into happier, healthier, and wiser society. And I really think the World Federation for Psychotherapy can play an important role Because we are global, we assess various different kinds of populations. We have therapies from various different parts, including in future, the AI therapies. Thank you very much for your attention.

Can you advance the next slide? Next slide. Okay, so it's my pleasure now to introduce Professor Alma Lucindo Jiménez. Professor Jiménez is our Secretary General for the World Federation for Psychotherapy for the last— and during this last triennium, and she is running for election and unopposed tomorrow, hopefully will be elected as the first woman president of this organization. It's about time.

Good morning, everyone. Distinguished colleagues, honored leaders of the World Federation for Psychotherapy, Estemed guests and friends from across the world. It is a privilege to speak at this World Congress of Psychotherapy here at the United Nations, a place founded on the belief that human dignity is universal, even as human experience is profoundly shaped by context. In many ways, psychotherapy stands at the same intersection. As psychotherapy expands across cultures, languages, belief systems, and social realities, we face an important question: Can we preserve what is universally healing in psychotherapy while honoring the diverse human contexts in which healing occurs? My proposition today is simple: we can and we must. In fact, I believe the history of the World Federation for Psychotherapy tells precisely that story. Story. For more than a century, psychotherapy has evolved through many traditions. Some emphasized insight, others behavior, others relationships, meaning, emotions, or social systems. Their theories differed, sometimes dramatically, but they are all trying to answer the same questions: How do human beings heal? The early history of WFP emerged from that search. It provided a place where different schools of thought more from the Western part of the world where they could meet, debate, and deepen our understanding of therapeutic change. But as psychotherapy became increasingly global, particularly in the last 10 years, the conversation expanded expanded. A new question emerged: How do culture, community, spirituality, and social realities shape healing? This did not replace the original question. It enlarged it. The conversation shifted beyond understanding how people heal to understanding how healing is experienced and sustained across different human contexts. One of the most important lessons of global psychotherapy is that suffering speaks different cultural languages. A patient may not say, "I feel internally fragmented." Instead, they may say, "Our harmony has been broken. I can no longer fulfill my role in the family. My spirit feels lost." These are not merely different words. They reflect different ways of understanding distress, identity, relationships, and recovery. And pathways to healing may differ as well. Healing may occur through individual reflection, but it can also be through family relationships, through community support, through spirituality, or through restoring social harmony. The question then is whether these different pathways reflect different processes of healing or different expressions of the same underlying processes. Increasingly, the evidence suggests the latter. Across cultures, Certain elements of healing appear again and again: the therapeutic relationship, empathy, hope, meaning-making, and emotional processing. Why do they recur so consistently? Because beneath cultural differences, human beings share fundamental needs. We all seek connection. We all seek belonging. We all seek understanding, meaning, and hope. Shared humanity is the foundation. These healing processes are the pathways through which human capacities are activated. Importantly, this is not merely a philosophical claim. It is increasingly supported by psychotherapy research, attachment science, neuroscience, positive psychology, and work on the social determinants of mental health. The evidence increasingly suggests that psychotherapy can be culturally grounded without losing its identity. But how do we understand understand that relationship? The answer may lie in recognizing that psychotherapy has always lived within productive tensions. It is both science and human encounter, evidence-based and relational, universal and contextual, individual and collective. These are not contradictions. They are dialectics to be navigated. Universal principles help us understand what facilitates healing. Culture helps us understand how healing becomes meaningful. One explains the process. The other shapes its expression. The growing validation of psychotherapy across cultures suggests that these are not competing realities. Universal healing mechanisms can be preserved while being expressed through diverse cultural pathways, and that realization makes something important possible. That is meaningful equity. Both because equity requires more than access. It requires care that is both effective and meaningful within the patient's own context. And it requires representation. Different regions of the world must participate not only as recipients of knowledge, but as contributors to it. That I sit here today speaking to you as an Asian woman serving within the leadership of WFP reflects more than symbolic diversity. It reflects a recognition that the future of global psychotherapy depends upon inclusiveness, plurality, and shared ownership. As a global federation, our responsibility is to create spaces where scientific knowledge and cultural knowledge enrich one another. Spaces where diverse understandings of the human condition help advance the field for everyone. This brings us naturally to the future. The future of WFP lies in bringing universality and context together. It lies in expanding access while preserving quality, in leveraging digital innovation while protecting human connection, in strengthening regional leadership, and in preparing the future generations of psychotherapists to understand both the common processes of healing and the cultural realities in which those processes unfold. The search that began with understanding how human beings heal now continues through understanding how human beings heal across cultures. Today, we understand that universality and context are not competing truths. They are complementary realities. Shared humanity gives rise to the processes through which healing occurs. Culture shapes how those processes become meaningful. The history of WFP mirrors that evolution. It began for a search for universal principles of healing It expanded into a recognition of cultural context, and its future lies in bringing both together. The promise of global psychotherapy and the promise of WFP is to unite science and culture, evidence and context in service of human healing. Not a federation united by a single theory, not defined by a single culture, but a federation united by a shared commitment to the preservation of our shared humanity. Thank you very much for your kind attention.

Now it is a great pleasure to introduce Ulrich Schneider, who is Professor Emeritus of Psychiatry at the University of Zurich in Switzerland, the famous university where Eugen Bleuler and Carl Gustav Jung worked. Ullrich is well known for his expertise and his scientific contributions to various aspects of traumatic stress. More recently, he has developed research on refugee mental health and on the psychosocial and physical consequences of child abuse. Ullrich served as president of the WFP— you know that now— of the European Society for Traumatic Stress Studies, as well as of the international society. His impact on the field is hard to fully capture in such a brief introduction. Ulrich.

Good morning, everybody. I will say a few words about advances in the treatment of of post-traumatic stress disorder and other trauma-related disorders. I have no conflicts of interest to declare. We are in a quite rather comfortable situation in psychotraumatology in that overall the psychotherapeutic approaches to treat post-traumatic stress disorder are quite efficient. If you compare them to other psychiatric disorders, the effect sizes are quite large, over 1.0. So that's the good side of the information. There is always room for improvement, of course, and I will talk mostly about, you know, a selection of ideas for the future. Uh, I will not talk about what most of you will be familiar with, namely the currently available evidence with regard to the psychotherapeutic treatment of post-traumatic stress disorder. I will not talk about specifically about prolonged exposure therapy or cognitive processing therapy, narrative exposure therapy, et cetera. I will just give you a summary of the differences of these currently available treatment approaches. Of course, they differ with regard to duration and number of sessions. The diversity of interventions differs. Also, those exposure-focused treatments, some of them focus more on in vivo exposure, others focus on cognitive work, cognitive reappraisal of the traumatic exposure. Then the way those trauma-focused psychotherapies are being conducted differ with regard to the processing of the traumatic experience. Some focus on a verbal report, some ask patients patients to provide a written account. Some do imaginal experiencing of the event without any verbalization, EMDR for instance. Then of course coping skills are introduced and trained and taught mostly in the introduction to treatment. Others have no explicit attention to skills strengthening. Also, those approaches differ with regard to whether or not they integrate the traumatic memories with other positive— other more positive life events, and in this way creating an autobiography of the lifespan versus just an exclusive focus on the pathology, on the single traumatic event. So there are lots of differences. However, there are many more commonalities, and I will also list them just very briefly. Psychoeducation is being provided in the beginning of treatment and also throughout the treatment in all these approaches. The training of emotion regulation and coping skills you can find in various variations across these approaches. Some form of exposure you can find, some form of cognitive work, cognitive processing, cognitive restructuring you can find in all these approaches. And of course, like all psychotherapy, we focus on emotions, mostly in psychotraumatology, mostly on fear, but also on more complex more socially determined emotions such as shame or guilt, anger, grief, sadness, et cetera. And finally, as a goal of treatment for trauma-related disorders, we could define that memory processes should be reorganized in such a way that people, patients, learn to create a consistent trauma narrative. Now, if we look into the efficacy and effectiveness of trauma-related— trauma-focused treatments, we are in a quite comfortable situation. We find in a majority of patients a loss of diagnosis across all these three treatments. On the right-hand side of this graph, you can see that the efficacy is a little less strong in military and veteran populations as, as compared to non-veteran populations. So, as I said, there is room for improvement, and many people wait for even better treatments or other treatments, alternative treatments, and one of them that has attained quite a lot of attention is psychedelic treatment, especially MDMA-assisted psychotherapy. Here is the first publication in a treatment sample of severely traumatized PTSD patients, and— there's another one also in Nature Medicine that appeared in 2023 on MDMA-assisted therapy for moderate to severe PTSD. So that was quite encouraging. And we could see that on the, on the right-hand side, you can see the MDMA group, that there are more responders, more loss of diagnosis, more remission as compared to the comparison group. Another quite interesting approach in my view is 3MDR, multimodal motion-assisted memory desensitization and reconsolidation therapy. There are quite a number of methodologically well-designed studies out there also in Psychotherapy and Psychosomatics, by the way, in 2020. And that is basically the idea of conducting trauma-focused treatment, exposure treatment, while the patient is walking sort of towards his traumatic, his traumatic scene. So they walk on a treadmill, they walk into an immersive virtual reality environment that has components of the individual traumatic experience. There are individualized images related to their experiences and also music that remind them of the past trauma and also help them to reconnect with the present. This is quite, you know, sophisticated technological equipment is necessary, of course, and not in every psychotherapeutic practice it will be possible to to implement such a setup, but I think it is interesting to see how physical movement can be sort of combined and integrated in psychotherapeutic approaches. My time is up? Okay, okay. So very short. Acupuncture is interesting because it not only reduces trauma-related symptoms but also fear potential, potentiated startle. Let's carry on. This is my last slide. There's also a new compound, neuroplastogen TSND-201, that seems to be quite effective in the treatment of PTSD. That's a very recent publication. I don't know much about this, but just to show you that also in medication there is some movement at long last, because for a long time medication for PTSD was not very satisfactory. So thank you for your attention, and sorry for going over time.

Thank you, Uli, to be on time. Our last speaker, Stefan Zippel, is professor at the Department of Psychosomatic Medicine at the University of Tübingen, Germany. And Vice Dean of the Medical Faculty. He is recognized as the leading clinician and scientist in eating disorders, psychosomatic medicine, and personalized psychotherapy. Among many other publications, he has developed with some of his colleagues a psychodynamic psychotherapy for patients suffering from anorexia nervosa, which has greatly impacted the field and its patients. Stefan serves as president of the International College of Psychosomatic Medicine, and since last year he's editor-in-chief of our official journal Psychotherapy and Psychosomatics. The last paper I read by him was his recent editorial called The Future of Psychotherapy and Psychosomatics. That paper is a great example of his thoughtfulness and expertise and leaves us with no doubt that the journal is in very good hands. Thank you, Thomas.

Thank you, François. Dear colleagues, it's really a pleasure and honor not only speaking here at the WF but having the option to speak at this venue and standing or sitting here at the United Nations headquarters in New York is not only a privilege, it's a reminder for us, for me, that we are not just caring for our patients and for our healthcare systems, but for humanity as whole. The title of my talk today is Enhanced Psychotherapy: When Technology Meets Patient Participation. During my preparation for this conference, I came across a very recent publication in The Lancet. It was just published 2 weeks ago, and the figures it contains are quite frankly staggering. Santo Moro and colleagues published the new Global Burden of Disease 2023, um, um, um, yeah, data and estimated that there are currently 1.17 billion prevalent cases of mental disorders worldwide. To put that number into perspective, that is roughly 1 in 7 cases on this planet. Between 1990 and 2023, the number of cases nearly doubled. Without exception, every single mental disorder category showed a steep increase. There are not just statistics, there are potential fathers, mothers, children, friends, and colleagues. And the question that what brings us all here today is what are we actually doing about it? What does effective treatment look like in the 21st century? To answer that question, I want to turn to the current state of the art in psychotherapy. And here again, I came across the landmark publication —this time from Pim Korpers and his co-workers, published recently in World Psychiatry. The picture they paint is somehow sobering, but also a bit exciting. The sobering part: despite having effective treatments, fewer than 40% of patients actually respond to psychotherapy. Therapy, and 80% of those who need care globally have little or no access to it at all. Outcomes have not really improved since the 1990s, but the more exciting part is what is on the horizon, and we heard it also from my speakers And I want to briefly walk you through the ideas of Pim Kolpas and his coworkers. First, digital and mostly technology-supported or augmented interventions. Second, personalized treatment. We are beginning to understand that the question is not, does therapy work? But which therapy works for whom? Third, new and improved therapies from psychopharmacology to the enhancement of, for instance, therapeutic alliance. And fourth, and perhaps most relevant for the global health dissemination and also simplification. The bottom line from COPASS is There is no silver bullet, but there is real hope if we are willing to apply multiple incremental improvements simultaneously. Before I discuss aspects of psychotherapy practice further, I want to share another piece of very recent evidence. This time it comes from a large and important study by Krautzinger and colleagues that was published just late last year in Nature. We were also involved in this consortium where the genetic information of over 1 million patients with 14 different mental health issues was involved and compared with data from healthy control subjects. One striking aspect in my view is that GWAS data, and in particular the grouping, provides a new understanding of the genetic underpinnings of mental health clusters. Therefore, we should reconsider how we define some of these entities. As an example, you heard it, in my field the data demonstrates that there are close genetic links between patients with anorexia nervosa and OCD. And so let me move to something very close to my heart and my research program. About 20 years ago, we thought a trial showing the focal psychodynamic psychotherapy might be as effective as cognitive behavioral therapy, the so-called gold standard, was needed. So we designed and manualized the ANTOP study. Back then, it took some courage to apply for such a study. The ANTOP study is still the world's largest randomized controlled trial for treating patients with anorexia nervosa. It contains roughly 242 Patients. patients. Each treatment arm consisted of 40 sessions, and we compared two manualized treatments, focal psychodynamic psychotherapy and enhanced psychotherapy, cognitive behavioral psychotherapy, and we compared it with the best available treatment as usual option in the German health care system. Why does this matter for today's discussion? Because manualization is not the enemy of individualization. It is its precondition. A well-designed manual gives you a scaffold within which genuine individualization becomes possible. Reputable and also, and that's important in my view, teachable. The ANTHUP manual has now been translated from Germany to English and Chinese. But does it work? The outcome speaks for themselves. We published the initial ANTHUP results in The Lancet, as well the 5-year long-term follow-up later in Lancet psychiatry. The key message is sustainability. Weight gain made during treatment are maintained and in most cases continue to improve even after therapy ends. This is not guaranteed in a severe condition like anorexia nervosa, which speaks to the power of well-designed patient patient-centered psychotherapy. About 10 years ago, we considered how to improve psychotherapy in the future. We asked ourselves, what would an enhanced psychotherapy program look like? And this psychotherapy program was built on 3 levels. The first level is often technology-augmented interventions. We heard it already. The second level is on therapies, how we include training and supervision. And the third level is the social system. And we also heard it, the cultural level. And my message also to take home is that we have to include patients more in designing and also in the feedback of doing our research. And therefore, I just brought with me the CONSORT 2023 statement and also from Till Wicks from London, a clear, yeah, vote that— and I just want to quote her— that my hope is that all medical journal editors will follow in the future to involve patients with lived experience because we need it to improve our treatments. And I just learned that I only have 1 minute left, so I will skip 2 more slides. But my idea is, and that's an idea which is at the moment very vital in the so-called German Center for Mental Health that we came up with a participatory concept where patients with lived experience are very early on involved in our research. And that helped a lot. Also that we came up with a so-called academy where education, information, and sharing is our major goal together with experts, together with patients with lived experience, and also with early career scientists. And my very final slide, so, is that I want to invite you to our next ICPM 2026 World Conference in Furka, and that's in Japan, and I would be very happy to discuss further things we started today with you in Japan. Thank you for your attention.

Thank you, Stefan, on time. Thank you to all of you for this wonderful session. I guess I am from Switzerland. I don't have a clock. We have one here. We are on time. Thank you very much. And probably the next session will start immediately.

That's true? Thank you, everyone, for your cooperation. We apologize that we do not have time for Q&A, but we do have a 2-hour break in between plenary sessions, so we encourage people to interact at that time. Now we will vacate the stage and give space for the next panelists. Hello everyone.

Since time is precious, we will continue with the next session, and I would kindly ask you to take your seats. Thank you so much, and please make sure that your phones are put on silent. Thank you. My name is Goran Mihajlić. I'm a psychiatrist from— working in the UK, and I'm also council member for the World Federation of Psychotherapy. And before we start, I would like to say that it's very nice to be here today. Thanks to our wonderful UN colleagues. Myself, I've served the UN as a medical officer in the peacekeeping mission in Congo a while ago, so this feels like a homecoming. I'm very happy to be here on a more personal level. I have with me Dr. Moussa Ba as well, who is a previous UNDSS Critical Incident Stress Management section head, now retired, and our speaker today, Dr. Mohammed Swahil Ali. I will briefly present Dr. Swahil, as we call you. He's the Chief of the Critical Incident Stress Management Section at the United Nations Department of Safety and Security, UNDSS, in New York. With degrees spanning medicine, psychiatry, community mental health, and public health disaster management, Dr. Ali brings more than two decades of experience to his work, including 16 years with the United Nations. Throughout his career, he has served as a stress counselor, trainer, and mental health program manager, responding to natural disasters, conflict, and major organizational crises. Dr. Ali has served in many countries in Africa, Asia, and Europe before his current role in New York. The title for his— today's presentation is "From the Front Lines to The Mind: The Hidden Scars of First Responders, Humanitarian Workers, and Their Families. Dr.

Sohail, please give us your—

Thank you so much. I hope this is working. Yes, it is. Thank you so much, Goran, for the opportunity. And there's an old saying in my culture that if you want to know where you are going, You need to remember where you've been. So with that gesture, I would like to pay tribute to the previous chief of the Critical Incident Stress Management section, Dr. Musaba, who has— who was the one who set up the current structure that you will be hearing about today. So as we think about where we want to go, —there's a vital part of where we have been. So thank you, Dr. Ba. My presentation over the next few minutes, about 20 minutes, is going to focus on 3 areas. We're going to look at what is the current global situation for humanitarian organizations around the world. We will look at a quick overview of what is being done in the United Nations for the protection of humanitarian workers and their mental health, and we will explore a model that we are currently using that can serve as a good framework for humanitarian organizations as they circumvent the challenges of 2026. I hope it will be a useful exercise. To put things in context, when we say the United Nations, it's not a monolith. The United Nations is actually made up of over 59 different organizations. On this slide on the left, you will see the details about 30 of them, and these different organizations specialize in different areas of the human experience and in our efforts to support people of concern and people in need around the world. Some of them focus on health, others focus on food security, others focus on shelter, others focus on the human experience of learning. So together they form the— the garden that is the United Nations. On the right of this slide, you have an overview of the footprint, the global footprint of humanitarian workers working with the United Nations. There are about 130,000 humanitarian workers affiliated with the United Nations, and if you combine the lived experience of their families, That's another 350,000 people. So together it's about half a million people that we look at who dedicate their lives and their loved ones to serving humanity. The largest population of these are in Africa, about 30,000 to 40,000, and then of course you have Europe where many of the headquarters are, and in Asia with many emergencies, and Oceania and the Americas, but we wanted to give you a snapshot of when we say humanitarian organizations around the world in the UN system, what we are talking about. There was a time when the blue flag, the blue banner, the blue helmets or a UN car marked with UN on its side, on its roof, was a source of protection. I remember many years ago in South Sudan, refugees streamed into the UN office because they knew that if it's a UN office, it is safe. That reality is— has been shaken now. Very often, the helpers have become the targets. The picture you see on this slide is from Lebanon, where at the moment we have colleagues from the peacekeeping mission UNIFIL trying to maintain some semblance of human rights, and very often they get caught in the crossfire. What does that practically mean? And I'll focus on some statistics, and these are open source, they're available for anybody to look at, it's on the Aid Workers Security Database. And we will just look at the last 5 years. Over the last 5 years, the number of humanitarian workers killed per year has tripled, 300%, from 118, now at the highest at 385 per year that were killed. If you look at the chart on the right, it shows the trends in terms of humanitarian workers who have been injured as part of their efforts to support people in need. And you will see that it has doubled from 146 in 2022 to 2024, doubled to over 300 that were injured in this line. Both these trends are worrying and they reveal a stark reality, but when you put them together, it reveals another pattern. When you look at these two graphs together, a pattern emerges. In 2021 and 2022, the number of humanitarian workers injured was higher than the workers who were killed. But that trend reversed from 2022 to 2025, where the number of humanitarian workers killed rose much higher and much steeper than those who were injured. The implication? The lethality of attacks on humanitarian workers increased. The purpose— the targeting of those attacks resulted in more humanitarian workers being killed rather than being injured. That is the reality of where we are at the moment globally. Another pattern which runs across injuries, kidnappings, killings of humanitarian workers is the disproportionate effect on local humanitarian workers, national personnel. In this slide on the left, the chart you see looks at the humanitarian workers who have been kidnapped or taken hostage over the last 5 years, the national personnel are disproportionately higher. And in the last 3 years, even though the change in the international personnel being taken hostage has not remarkably changed, there is a stepwise increase in the number of national colleagues who are taken hostage or kidnapped over the last 3 years. And on the right, you will see another stark pattern that data— data often tells a story. In the first 2 years of this 5-year period that we studied, the injuries and fatalities of humanitarian workers were driven by non-state actors, militias, In the next 3 years, the role of state actors, organized military actors, killing and injuring humanitarian workers overtook non-state actors, to where member states of the United Nations were responsible for the majority of the attacks on humanitarian workers. Our section, the Critical Incident Stress Management section, has studied over 9,000 humanitarian workers over the last 5 years. And we've specifically studied the mental health and psychological impact. And my— our lead researcher, Dr. Alvin Tay, will be briefing in more detail about this later on today., but I'll give you a nutshell, a snapshot. The disproportionate impact on national personnel is a pattern, but the data is even much more stark. The risk to them is 22 times higher than international personnel. But look at the reverse. The media attention when an international personnel is injured or killed or kidnapped is 500 times higher than when a national colleague is affected. So that data now tells another story. When we studied these humanitarian workers in active emergencies, almost 40 to 50% of them during the crisis demonstrated signs of post-traumatic stress and other mental health disorders we'll talk about later. And at least 25 to 35% demonstrated signs of burnout. And 22% of them went on to develop long-term mental health consequences. So 1 in 5 of those exposed to those disasters later on developed long-term mental health consequences as per data from the World Health Organization. And there were some other serious trends as well. There was a rise in complex trauma, where trauma is mixed with anger, and that toxic mix of trauma and anger then gives rise to polarization and radicalization. We saw a marked increase in moral injury, where the moral compass of the humanitarian personnel and their families was shattered by what they saw, with the implications that it had. We saw complicated grief, where the grief itself is compounded by the lack of meaning of what has happened, and a sense of disillusionment in international humanitarian law, and in the rules-based order, and in the sanctity of those who are trying to help.. We also saw stark trends in the impact of social media, which I know we have other plenary sessions today that we'll be looking at, where on one hand the live streaming of conflicts and violence gave rise to social awareness and mobilization and pressure from public to change— for governments to change their policies, but also on the other hand gave rise to re-traumatization and vicarious trauma that arise— that arose from the live streaming of violence and conflict across social medias, war crimes live streamed around the world. So this is where we are. What can humanitarian organizations do to make their organizations fit for purpose for 2026. I'll share you what has been done in the United Nations, and then we'll talk about a potential model that can be replicated across organizations. This is what the Secretary-General of the United Nations says should be done. In a briefing for the Security Council in December 2024, he highlighted, among other recommendations, The importance of recognizing the mental health impact of the attacks on humanitarian workers, helping them prepare and the organization prepare, supporting them when it happens, and looking after the long-term care of them and their families. So this is a call for action by the Secretary-General, the highest diplomat in the world. The critical incident stress management section was set up in 2001 by the General Assembly through a resolution that gave it the mandate of coordinating psychosocial support services across the United Nations system, focusing on preparing for emergencies, responding to emergencies, and facilitating the recovery from those emergencies for all humanitarian workers and their families. The team, the core team is here in New York, but the extended team is spread over 50 countries around the world, and we partner with all those organizations that you saw in the first slide to maintain a global network of mental health professionals and stress counselors responsible for supporting the humanitarian workforce. This is a map that depicts where these team members are around the world. Most of them are concentrated in Africa, but in the Middle East, Europe and Americas, Asia Pacific, we have a global coverage which allows us to have a global pulse. The first task that this organization set up to was to set the foundations, have the policies in place, that holds the organization accountable for taking care of the mental health and psychosocial well-being of their personnel. So in 2015, the UN policy on the management of stress and critical incidents, stress under the stewardship of Musa Bah, was approved at that time by the High Level Committee on Management. Then in 2019, the United Nations Workplace Well-being Mental Health and Well-being strategy was designed and adopted to hold the organization accountable. In 2022, the UN Field Manual on Crisis Psychosocial Support Management brought together all the standard operating procedures around the UN system in one place for approval to maintain accountability and commitment from the organization. CISMS set up a global information and data management system, and you will hear more about that from our lead researcher, where we were able to track psychosocial data from humanitarian operations around the world. And that tracking gives us a unique insight into what is happening and what our colleagues will need in the future and to provide foresight. A major effort was targeted towards building the resilience and building the capacity of the United Nations system, and all several different programs were set up ranging from specialized trainings on crisis psychosocial support management for mental health professionals in low and middle income countries, the CISMS certification program, a special training for managers that was developed in partnership with the UN Mental Health and Wellbeing Strategy called the Lead and Learn, special trainings for first responders, peer helpers, to support their colleagues, and trainings for all humanitarian workers as part of their pre-deployment to the field. And we partnered up with partners such as LinkedIn Learning, and Disaster Ready to incorporate online trainings. And because of this spectrum of learning activities, about 20,000 to 23,000 humanitarian workers every year across the world have been benefiting from these capacity-building efforts. We have been trying to pre— prepare and support humanitarian workers in several emergencies around the world. Every year. And there are 6 global epicenters of psychological instability that we have seen and where it is spreading beyond. So in Asia, for example, we have Afghanistan, Pakistan, Bangladesh, Myanmar. In Europe, you have Ukraine and the, you know, the disaster happening over there. In West Africa, the Sahel region, Niger, Mali, Burkina Faso, DRC, the Central African Republic. In East Africa, you have Somalia, Sudan, South Sudan, and, you know, Nigeria and Mozambique in West Africa, Ethiopia in East Africa. In the Middle East, of course, you know the countries that are being affected at the moment, Gaza, Lebanon, Egypt, Libya, Iraq. And all these, and of course in the Caribbean, Haiti, which is one of the epicenters of psychological instability that is spreading across the humanitarian sector. One of the biggest efforts that has been made by this network is that every year we try to develop guidelines for specific Guidelines and best practices for specific areas of mental health and psychosocial support, ranging from mass casualties towards evacuations, hostage taking, epidemics and pandemics, and death in service. Bringing this all together, what's the model? The model is a 7-dimensional psychosocial safety net framework. That CISMS has been pioneering. And the 7 dimensions include having a robust data management and information collection system, using that for evidence-based interventions and programs, making sure that organizational policies and commitments are in place so that the organization is accountable, integrating psychosocial well-being into organizational decision-making through objective psychosocial risk management, including psychosocial well-being into emergency preparedness response and recovery protocols around the UN system, ensuring that capacity building programs are specifically targeted towards psychosocial capacity building so that resilience can be maintained. Having timely support structures for humanitarian workers and their families when they need help, ensuring that a multidisciplinary approach and a coordinated approach with long-term care and specialized care is put in place so that people need help as long as they can, as long as they need it, they will get that help and the duty of care from the organization,, and making sure that all of these feedback into the data management system so that we are able to have foresight and foreplanning about what will be needed in the future. How does this model compare with other models of psychosocial well-being and mental health well-being that are currently around the globe? In science, Models evolve from each other. So this model doesn't replace existing models. It has evolved and incorporated elements of different models over the years. And I'll compare with just a few. The World Health Organization has a model of mental health and psychosocial support in disasters and emergencies. Many of the elements are the same, but that model focuses at the community level This model focuses at the organizational level, but it follows many of the same elements. The Antares Foundation had a very good model of psychosocial well-being during the life cycle of the employee, and those elements are very valid, but it takes a, a life cycle approach for individual staff members. We wanted to look at it at the organization perspective. Their interagency standing committee on mental health and psychosocial support in the UN has some very good frameworks of minimum common standards, that minimum service package for MHPSS in emergencies. WHO has very good papers on disaster risk reduction and incorporating mental health and psychosocial support into that. All those different frameworks have fed into the development of this model. This model is tailored more for organizations that are working in the field, that have personnel who are exposed to trauma on a daily basis. So it brings together lessons learned from all those different models and is a potential blueprint for what humanitarian organizations in 2026 need to look at when they are developing their systems and fostering resilience for their personnel working in the field. And with that, I'll complete my talk, and I hope it is useful in the discussions over the next 3 days. Thank you so much.

Thank you so much, Dr. Sohail, for this wonderful and inspiring presentation. Dr. Ba, would you like to make a comment after Dr. Sohail's presentation?

I think that it's a really big pleasure to have— to be sitting here and co-chairing this panel with Goran. I see that I left 5 years ago, and I see that this process is continuing, and I think that he is holding it a lot. And the world is not becoming safer than I left it. It is becoming worse and worse. It means that I believe we need to find a lot of strategies and see how— what do we do to improve the psychosocial well-being of UN staff.

Thank you very much. Thank you so much. Dr. Ba and Dr. Swahil for this excellent presentation and for pointing out very important aspects of your work and your efforts to kind of integrate all of these aspects, including psychosocial safety net model, which I thought was a very, very interesting aspect. And as well, it's very concerning what you mentioned, that humanitarian worker worker fatalities and injuries are rising, especially killings of humanitarian workers, so I think we should all probably reflect upon that and see how we can contribute to providing us for a safer future for people who are already risking their lives and health by working in the field and helping the ones in need. So with that, I would like to thank you all for your attention. We have time for one question. So we have time for one question or comment, very briefly, I believe.

Don't be shy. Could be a comment, doesn't need to be a question. Jorge? I have to come to you.

Hello, Sohail and Moussaba. It's more of a comment than a question because, I mean, you mentioned the number of people physically injured, but those psychologically injured is very difficult to assess. And of course, we know the high number of colleagues who are experiencing PTSD and a number of other mental health issues. So I wanted just I mean, this is a very short number comparing to those psychologically injured, and in many cultures also people hold this in silence. Thank you.

Thank you for this very important comment. Thank you, Dr. Swahil, Dr. Boh. Thank you all for your attention, and I wish you a successful Philadelphia Conference.

He's there, he's coming.

So, hi everyone.

Uh, It is my pleasure to reintroduce again our next speaker, Professor Moussa Ba. Professor Moussa Ba is a psychiatrist from Senegal whose career has spanned academic psychiatry, humanitarian work, and international mental health. He served as the founding chief of the Critical Incident Stress Management section at United Nations Headquarters headquarters in New York and has extensive experience working in emergency and humanitarian settings. He's also an associate professor of psychiatry at Cheikh Anta Diop University and Fong Teaching Hospital in Dakar and has held leadership roles in medical research and mental health policy. Today, he will present After Action Review When the Mental Health Professional is Caught Between Human Rights, Humanitarian Work, and Ethics. I'm also pleased to welcome our co-chair, Dr. Asher Alagin from NYU Langone Medical Center, whose work focuses, focuses on human rights in healthcare and on supporting traumatized refugees and their families. Please, welcome. Let's welcome our speakers.

Thank you very much, Mr. Chairman. Thank you very much, Asher, for coming— being here. It's a really big privilege for me. I would like also to thank the President of the WFP, the past presidents, and to thank everybody that allowed me to come back in this present, in this building to talk. I left this building 5 years ago and did not set foot here at all, and this is the first time I'm coming back here. And I spent 20 years of my life coming on a daily basis in this building to defend and to work to defend policies and to defend psychosocial wellbeing, looking for money, because I think that if we build on what Suhal said, a lot have been done, but it has not been done just easily, because leaders, when there are problems, are emotional. They build the systems, they said, 'We are doing this,' but they want to put the money there. And it's the people who are trapped and who took the position who realize that they have to fight. So what I will be doing, I think that that's what just old people do, we just tell stories. So I will go back and based on what Suhail had said— Let's not talk about age. Yeah. Based on what Suhail has said, I will just try to go back and see how we, using human rights, using our— during that time we were very young, and I should not talk about age— how we managed to build this system, because it did not come. And maybe learning from there, we may see the different setbacks we had and see how with this current setback, what can we do to rebound again. I was telling that it's really— people create systems whenever they are scared. I think that mankind was scared, was horrified of what happened in the beginning of the century, in the beginning of the last century, and they decided to create the United Nations. Based on human rights and multilateralism. What does that mean? What did that imply? It meant that they were horrified and just recognized that something happened, that human beings, they needed to respect the differences. It was extremely important to respect the differences, and somebody said this morning that the differences should not be just noted there should be a way of bridging, and I think that this organization was to build the bridge between the differences. And Alma said something which is really important, which is the core of the human rights. It is our shared humanity, and I think that building this organization was to celebrate our shared humanity. And what is our shared humanity? It is our dignity, what we have, our dignity as human beings, our dignity as just being human. I think that it was extremely important. And this is why we created this organization, and the organization have tried to carry that mandate for a while. They tried, whatever happens. They were capable of indignation and capable of moral outrage, so it has always been there. And the system was built, the mental health system was built based on that, using those levers. But what we see now is that human rights, multilateralism are just mere words. I think that the people who spoke here, everybody knows it when you see the— when you see what's happening. So the protective umbrella of the UN does not work anymore. I remember in the '90s when we were doing UN convoys, people— belligerents would stop and escort us out of the conflict area until we are safe. This was back in the '90s, early 1994. But now it does not exist anymore. Sohel just said that the UN staff are aggressed. They are killed by the government. So I think that this is really important. Based on what I have lived is that whenever we had those problems in the past, the organization, the capacity of indignation, when you use it, would allow to gather money, to have money, to raise funds, to create systems. It's not working anymore. The UN system, mental health system, has increased, was built based on that, and now crises are multiplied exponentially and we are not having money, and they are being closed. When I discuss, I listen to people, leaders, managers, a number of people are telling, 'I have to make cuts, but it is a system, mental health system, we cannot go in the basic social services, a number of things we cannot put money there.' So this is what's happening. Why is it working anymore? I think that this is something that we need to see and discuss and see as mental health professionals how do we use this, the history, to try to navigate through that. So I just explained here that what I will try to do is just to see how we built the UN mental health system by leveraging the human rights, using that lever, describe the global security that what we have now as the global security, and based on that, the impact— Suhail has already described it— and the humanitarian workers, and see and share some thoughts on what can we do to survive. I believe that it's really vital for us because whenever there are problems, the first cuts are on the basic social services, There are two ways of doing psychotherapy: having one-on-one, having technicians that are doing it. One of my mentors told me that, or sit where people are taking decisions and talking to people and doing— making sure that you find the funds, that you find people who would listen, and you build policies that will allow to make the services accessible to everyone. So I am part of that second level. That's what I did. So the stories that I'm telling is the following: how we leverage human beings to build the UN mental health system. In the '80s, UN used to be extremely risk-averse. Whenever there were problems, we were peacekeepers. We keep the peace. Whenever there is a problem, UN would leave. But in the '80s, people UN felt the need to remain, that it was extremely important so that humanitarian workers remain in the area that they were supposed— when they were supposed to keep the peace. And there was a study that was done, and the report said that the United Nations needs to focus on the safety, security, and psychosocial well-being of its— of the humanitarian workers. Fast forward in 1988, the UN created the United Nations Security Coordination. It was an office there. During that time, the psychosocial well-being of staff was taken care of by human resource officers and social workers. Fast forward in the 1980s, after the wars in the Balkans— it's something really important— after the after the war in the Middle East during that time. And yet, we had also the— in Nairobi, the crisis in Nairobi, in Somalia, Burundi, where UN staff were really injured, and the Rwanda crisis, we had a lot of problems. UN decided to activate, to enhance the Chapter VII whereby they should go to maintain the peace. Not only maintaining the peace, but building the peace. It was something that happened. From peacekeeping, they went to peacebuilding. And when this was done, a task force was created rapidly in 1994. I was part of these people when they created this task force that they created. And task force was created to see whether what can be done to bring psychosocial services and security to the humanitarian workers. And they— the task force came back and gave its report in 1995 saying that the security office, the security department should be strengthened and should be supervising, coordinate— the coordinating role of the management of the psychosocial well-being. This is why in the United Nations system, the mental health professionals are under the umbrella of security. That's what many people ask. This is how it came. And fast forward, 1996, '97, '98, we had a lot of crisis. Guinea-Bissau, the crash in the Ivory Coast of the UN envoy. We had in 1998, two plane crash and the— of the UN shuttle going to Geneva. And the trust fund, they created a trust fund in 1998, the trust fund was funded based on that, using human rights, that humanitarian workers needed to get the psychosocial well-being and security, and that trust fund allowed the creation of the first mental health hiring, the first mental health professionals for the United Association for Humanitarian Workers. That was back in 1994, it was created. And fast forward in the, in the year 2000, 198 staff lost their lives, and then they enhanced the system and had hired a second mental health professional. And in 9/11 happened, with 9/11 decisions needed to be made, and they decided to create not only to strengthen the United Nations Security Coordination Office and to make it big and to hire professionals. In the past, the United Nations Security Coordination Officers were not— they were part-time, but they created the United Nations Security Office with a number of things, and that's when I left the field where I was working in UNICEF and came and joined the this team. There were 36 of us here at headquarters during that time. So that's when the CIMS was created, the stress management unit was created, but when they created the stress management as a stress management unit, rapidly we realized that it was not capturing fun. Stress management, everybody's doing it. That's how we change it in critical incident stress, meaning that there are problems that we are solving,— and that was more, I would say, into brackets, more sexy for people who give the money. And I think that it was— everything I'm talking about is what can we do as mental health professionals to capture funds in order for us to build systems. Right after we settled, we had the Iraq bombing. We had the Iraq bombing. And when the Iraq bombing came, what did we do? We realized— it was the first time that we intervened really in the field, and we realized that we had a lot of problems— coordination problems, the standards were not there, everybody would come. And also with the response to the tsunami in 2004, we realized that we needed to create a system, and we built on that, made a report, and decided to request money to have a certification program. Suhail has talked about the certification program. And we pooled resources with many other organizations so that we could find funding. And this is how the certification program began to be implemented in 2004, 2005. With the Pakistan earthquake in 2005, we had also evacuation, Timor-Leste, in Israeli-Lebanon war, we learned a lot on culture sensitivity. What we did there is that, okay, we're having problems, let's have local people who are embedded within the coordination because we have cultural problems and hire them. This is how we began building the critical incident stress intervention cells located by one mental health professional supported by peer helpers, would create the CICIC and would be there, our relay there, and this is how Sohel was hired after Pakistan bombing. This is how Kalhari was— we met Kalhari, the one who is in charge for the Asia-Pacific, in Delhi in 2006, and this is— she was a psychologist working on human rights, but she was certified. I said, why don't we try to manage to bring her in, and this is how we managed to get the funding. I believe that the Algiers bombing also happened, and we had the Haiti crisis. When the Haiti crisis hit, UN decided that they will not leave anymore, and the bombing in 2011 in Abuja, we are not running away now, we are staying and delivering. Since we stay and deliver, we have to expand the UN system, the global mental health system, and this is how we managed to build the system the way it is now. And decided curriculum for tabletop exercises, regional cell in it. In 2017, I think it's something that we learned a lot from. In 2017, with the arrival of— we had major budget cuts. It was the first Trump administration. We had major budget cuts, and this unit nearly disappeared, and they said— I remember walking and they tell me, 'You have to cut your staff. You have to go leave this office, and some of the people will have to go in the field, go to the field.' The only thing we could do was to be very opportunistic and try to see what can we do to prove the added value of mental health, of our work. And we had the chance. There was one abduction, high-profile abduction that happened, and nobody wanted to take it. We decided to take it. We volunteered to take it and worked. And what we did is that we worked really hard to document everything we have done and to be extremely aggressive going and discussing and provided support advice. We support advice to the leaders of the United Nations. We were sitting in the cabinet of the Under-Secretary-General. We were sitting every day in the cabinet of the of the Secretary Generals, discussing with them, advising them at what to do, what not to do with the families, with the member states, and liaising with all the member states that were involved, Minister of Foreign Affairs of the member states, talking with their intelligence services, with the police, with everybody who was embedded. We coordinated that work, and after that, we documented and showcased everything. It was from March July, and after we submitted in July everything that was documented and showcased how we demonstrated that expert advice from mental health professionals and guidance of mental health professionals could protect, enhance, and enhance the image of the organization and especially also of the leaders, because human beings, they are worried, they are good when they see that they can take advantage of a number of things. I think that that was really in the report and very clear. And this is— and when we arrived to that, they gave money. They allowed— what we proposed was a proposal of psychosocial well-being for frontliners. It is the system that Suhail talked about. And they did not have the money, but they said, 'We approve it. We will find the funding.' And they found the funding.— one year after, in 2018, and we began rolling it out, and I think that now it has a profile and Sohel has built it into something extremely interesting. And we got that year, we won the two awards, the Meritorious Award, which is to actions that have brought people, enhanced the picture of the organization, and have saved lives, and we won also Secretary-General's Award, which was the award which is the highest in the United United Nations. The team won it. And the COVID hit, and from the COVID we learned something really important. We needed— we learned to work from home, to use— to work from home, to telecommute, and to do online counseling. In the past, we did not— we could not do it. And we learned a number of things, and working in multidisciplinary teams. We learned that, and I believe that this changed a lot the perspective. We cannot tell anymore to the leaders of the organization that we will continue to do the training, to do counseling the way we used to do it before COVID So we need to, and I think that Dilip was talking about using AI. I think that it goes beyond, and when I talked to him and I read his article, his recent articles, and Artificial wisdom, I believe that it is a way, and I really think it is as we have decided, discussed before, because I drafted this, and after our discussions, I read the article. So based on what we had done also, we had the Meritorious Award, and people— and we were surfing on that., and I retired, but I continued to receive a number of messages now from the UN, from the leaders, from all them, and what they're saying is that, okay, we don't have money, but what happened? The world has changed. We have a lot of leaders, a lot of nationalism, right-wing leaders, you know, bipolarization versus left-wing. We have populism, decline of multilateralism. We don't have people just now discussing and negotiating with the type of negotiation that we have, a major-minor type of discussions. I have the power and I'm giving it. So the resource of competition for control of resources must— and in the other hand also, I believe there is a lot of research on AI because that are triggered by the COVID and new technologies. So member states Focus on protectionism, religious ethnocentric, we have much more crisis, much more issues, Suhal talked about it, I think that some of the predecessors also talked about it. We have proxy wars, and the situation is not conducive to funding basic social services, meaning that the traditional mental health system as it works, we cannot continue doing it. So what do we do? This is the impact of the environment on the workers. Sohel has described it extremely well. I don't need to dwell about that. I'm just finishing, go to my last slide. What is the way forward? I believe that as mental health professional community, we need to adjust to the new environment. We cannot continue doing it. Fine-tune, we need to fine-tune our paradigm of doing business. Do we leverage— how do we leverage the lessons learned from the scarcity when we don't have money, from the fund, from the COVID and take advantage of the new technology while clearly delineating its limits? I believe that it's really important. And research proposals, drafting research proposals that meet the interest of leaders, okay. I think that it's extremely important to have to draft proposals that meet the interests of the leaders, and how do we scale up the mental health services? That's, I believe, that it's extremely important to have to conduct, to have evidence-based research program with multicultural people, multidisciplinary teams, strategically positioning mental health on the agenda of decision makers. I believe that it's really important by going toward them and providing guidance advice. Revisit the mental health services delivery model. I believe that we need to go through that. And research and AI and artificial wisdom and redefining the world of the mental health professionals. I think that with that, I'm almost done. The focus is really important to build and staff resilience. And how do we go to the scale to do that? We need to be extremely flexible and creative to address the huge demand, the resistances, stigma and conflict of interest, because we are used to dealing one-on-one, and this is what we know. I know that psychiatrists, mental health professionals, don't like it, don't like AI, don't like artificial intelligence, but I think that it's a way. It is something that we may do, that we may have to, if we want to survive. I think— and everything, not forgetting that everything we do is rooted in ethics and deontology. Thank you very much.

Dr. Asher, would you like to comment?

So thank you for, Musa, for this wonderful review. Of systems, and I've been a great believer in delivering care in the New York City public system for the last almost half a century, 47 years to be exact. But about 2 weeks ago, all of a sudden the hospital administration had called us in and said, "We're closing your program after 35 years in existence," in the form of some kind of anticipated compliance with the federal reporting of undocumented individuals and the fear that ICE would show up at the doors of the hospital at all and decided they didn't want to take the risk. So they gave us 60 days to clear the offices and to just get the hell out. And the plan is the Human Rights Clinic of what they call it, the new Human Rights Clinic. And by the way, for the people that are not old enough, human rights were conceptualized in these walls here back in 1952. It's only 1952 that there was crystallization of what human rights are. And for some of us, it's within our lifetime. And to think that how this kind of filtered down in terms of how do people around the in the world know what human rights are. And for some of our clients, the worst offenders are their families. For example, for the LGBTQ clients, you know, the worst offenders are the families, the schools, the religious organizations. So in terms of psychotherapy, what is the context of psychotherapy? What are the boundaries of psychotherapy? How do you undo some of that? So that's kind of a lifelong learning. So I just wanted to make the point in terms of system of how vulnerable systems are and how politically motivated they may be. And in terms of resilience, you know, in terms of Yeah, we're going to continue to do the work in one way or another, but the system has become very hostile to all this delivery.

Thank you very much.

Do we have time for a question? No. So, uh, I wish to thank you both for this marvelous presentation. I really liked your final comments, Dr. Asher. And we— so we close the session now and see you later. Thank you.