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Fighting stigma with openness Kjell Magne Bondevik was diagnosed with depression during his first term as prime minister. His honesty and willingness to speak openly about his illness led to an outpouring of support from across . He talks to Ben Jones.

Q: When did you realize you were de- pressed? Kjell Magne Bondevik is the founder and president A: One Sunday morning in August of the Oslo Center for Peace and Human Rights. 1998, I couldn’t get out of bed. The He was prime minister of Norway 1997–2000 and minister of foreign affairs, a close friend 2001–2005, minister of foreign affairs 1989–1990 of mine, came. I told him I wanted to and minister of church and education 1983–1986. resign. I felt totally empty, without any Bondevik was a member of parliament from value. Everything was black. He said I 1973–2005 and leader of the Christian Democratic should not make such an important de- Party 1983–1995. In 1979, he was ordained as a Courtesy of the Oslo Center for Peace Peace for Courtesy of the Oslo Center and Human Rights cision when I was in bad shape. Another priest in the Lutheran . He served friend came with a psychiatrist. Together Kjell Magne Bondevik as the United Nations Secretary General’s Special they got me out of bed and, after talking to me, the doctor diagnosed me with Humanitarian Envoy for the Horn of Africa during “depression”. 2006–2007.

Q: Why did you decide to go public? A: The next day we had to do a press release to announce my absence as prime minister, but were unsure how to of them said that, for the first time, they friends, and taking time to experience explain this. After a few minutes, I said: could talk to somebody else about their nature, music and art. I also think that ‘Why don’t we tell it as it is?’ and that’s illness. They were thinking: ‘If the prime a good physical condition through ex- what we did, for two reasons. First, to minister can talk about his mental health ercise improves mental health. But most avoid speculation and, second, and even problems, why can’t we do it too?’ of all I learned about the importance of more importantly, I could contribute openness about mental illness. to more openness about mental health problems and help to combat the stigma Q: Your openness led to a change in at- attached to them. Today I’m even more ‘If the prime minister titudes to mental health care in Norway, convinced than I was then that it was the can talk about did it lead to a change in mental health right thing to do. his mental health care provision too? problems, why can’t we A: The health services in Norway Q: Do you know the cause of your depres- do it too?’ are financed by government funds and, sion. How long did it take to recover? in general, have a great capacity to meet A: During over 30 years in politics, the needs of the people. Hospitalization, stress was common in my life, but this for both physical and psychological dis- time it was different. When I became eases, is also free of charge. Still, when prime minister I took on too much and the Norwegian parliament discussed a hardly had a break. At the same time I Q: What did you learn from your illness? white paper on mental health and the was going through a time of loss and A: The need to dare to feel your health system in 1997, there was broad grief as three of my best friends had all weakness and to accept all the painful political agreement that mental health died of brain cancer in the space of three feelings. I believe that it is possible to had been neglected and that this had years. I didn’t realize that grief, when it show weakness when you are a leader. to change. is not managed properly, depletes your That way we become even stronger. As strength. I was away from the office for prime minister, it taught me how to set Q: What changed? three and half weeks, after what I call limits on what I should be involved in A: The government presented an ‘walking and talking therapy’ in a cot- and what people could ask of me. I be- eight-year plan for mental health ser- tage in the mountains. came a better leader and a better prime vices to spend 24 billion Norwegian minister. As a human being, I learned a krone (US$ 4.3 billion) more on mental Q: What was the public response? solid lesson in how delicately tuned hu- health care services, including on re- A: I received about 1000 letters from man nature is. It is all about balance be- search into mental health. We wanted people across Norway, saying they had tween our physical and mental situation. a warmer and more humane society, similar problems and that when I was And I learned about the importance where people care for their fellow hu- open about my diagnosis, it became of taking care of the good moments in man beings, care for the less fortunate easier for them to be open as well. Some life, of the relationship with family and among us and take responsibility for

862 Bull World Health Organ 2011;89:862–863 | doi:10.2471/BLT.11.041211 News

each other and for future generations. people from all walks of life, celebrities The idea was to support people with More and more and ordinary people alike. Also, people mental health conditions so that they people have come working in the mental health system could become independent and organize “ have taken an even more active position forward to tell their their own lives. We established several stories about their in the media. Since my announcement, principles for expanding mental health we have also seen an increase in the services including prevention, where mental health problems, number of people with mental health possible, and that users should have a people from all walks problems, but this is because they are say in the services that are on offer. Also, of life, celebrities being diagnosed and counted better treatment should be voluntary as far as and ordinary people than they were in the past. possible, while service users should have alike. plenty of contact and companionship Q: Are there arguments for locking away with other service users. The idea is to ” psychiatric patients, for example, those give the recipient of the services a new who have committed criminal acts, such quality of life. as violent attacks? system. Since then, we have built 75 A: These acts are a sign that mental Q: Now more than a decade later what new mental health centres across Nor- health services are not fully equipped is the result? way’s 18 districts. Some big psychiatric to deal with the challenges and that A: The mental health care system hospitals have been closed down. In there is still a lack of capacity. Locking was not good enough, so there was general, there has been a greater focus up patients is not the way to go, but in strong pressure from nongovernmental on public health. More and more people some extreme cases it may be necessary organizations and health workers to have come forward to tell their stories for the shortest time possible and with improve and expand the mental health about their mental health problems, adequate legal safeguards. ■

Corrigendum In Volume 89, Number 11, November 2011, p. 808, the 3rd and 5th equations should read: 95% CI of N 1882 + 556 1882 +179 2670× ()1− ×−(1 ) = 2670 ± 19. 6× 2670 22670 + + 1882 556 × 1882 179 ()2670 ()2670 = 2653– 2687 95% CI of Du 1882 1882 1− × ( + )( + ) = 8.69 ± 19. 6× 1882 179 1882 179 1882 27660×−1 ( 1882 +179) = –

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