Vikram Patel

Vikram Patel is a professor of global health and social medicine and psychiatrist whose work over the past two decades has focused on reducing the treatment gap for mental disorders in low resource countries. His work has addressed four major themes: (1) generating policy relevant evidence on the burden and impact of mental disorders; (2) developing and evaluating mental health interventions for delivery by non-specialist and lay health workers; (3) developing training programs to build research capacity and leadership in global mental health; and (4) communicating research to diverse audiences to act on this evidence.

Contribution to Science

1. Evidence of the burden of mental health problems in low- and middle-income countries, which has been the foundation for advocacy on why action is needed to address these problems. Key findings included the demonstration of the strong association of mental disorders with social disadvantage, the first nationally representative survey of suicide mortality in India, population-based surveys carried out in 60 countries examining the association of depression with other chronic conditions; and the identification of a strong association of mental health issues with child under-nutrition and delayed cognitive development (as PI).

2. Evidence on the effectiveness of task-sharing of psychosocial interventions, which has been the foundation for demonstrating how action can be taken to address mental disorders even in low-resource settings. Key findings include: the demonstration of cost-effectiveness of contextually adapted brief psychological treatments delivered by lay counsellors for depression in primary care, the demonstration of the cost-effectiveness of collaborative care led by a lay health worker for depression and anxiety disorders in primary care in the largest RCT in psychiatry from the developing world; the first trial of task-sharing for supporting caregivers of persons with dementia from a LMIC, which won the Alzheimer’s Disease Society Prize for psychosocial  interventions in 2010; and the first evaluation of  a community based intervention to enhance demand for care for depression. 

3. Designing the methodology for the development of scalable psychological treatments, i.e. which can be delivered by non-specialist workers in routine health care settings for culturally diverse populations. Key findings include the development of two new treatments, the Healthy Activity Program for severe depression and the Counselling for Alcohol Problems for harmful drinking; the development of novel measures and strategies for evaluating the quality of psychological treatments delivered by non-specialist workers; and the demonstration of the effectiveness of peer supervision for assessment of therapy quality by non-specialist workers.

4. Demonstrating the great paucity and inequitable distribution of global mental health research resources and outputs and setting the research agenda for global mental health which has led to over 100M US$ in funding (for example from the NIMH and Grand Challenges Canada) since 2011. Key findings include: bibliometric research demonstrating that LMIC contributed just 6% of the published output in leading psychiatric journals; setting research priorities for mental health in LMIC and for psychosocial interventions in humanitarian settings; and establishing the research priorities for global mental health through the Grand Challenges in Global Mental Health initiative of the NIMH (of which he was the co-chair of the Scientific Advisory Board). 

5. Synthesis of research in global mental health for effective communication and uptake by a variety of stakeholders. Major examples of this synthesis include his role as lead editor of major series of articles on global mental health published in The Lancet in 2007 (six article series) and 2011 (five article series) and PLoS Medicine in 2009 (six article series) and 2012 onwards (an open series, now with over seven articles published to date). These syntheses have informed: global and national policies for improving access to mental disorders including the WHO’s flagship program on mental health (mhGAP) on which he served on the guidelines development group and India’s first national mental health policy in 2014 drafted by the Mental Health Policy Group on which he served; the funding of the PRIME consortium leading implementation research to integrate mental health into routine health care programs in countries in sub-Saharan Africa and South Asia (he is research director);  the publication of guidelines for decision makers on the packaging and delivery of interventions for mental disorders using a platforms based approach (from the Disease Control Priorities group on mental disorders which he led); and the first Lancet Commission in Mental Health and Sustainable Development, (which he led, forthcoming).