Program in Global Mental Health and Social Change

Giuseppe Raviola, MD, Program Director

Program Background
The Program in Global Mental Health and Social Change, housed in the Department of Global Health and Social Medicine at Harvard Medical School, brings together scholars, researchers, educators, and health care practitioners to address the global burden of mental disorders, with a focus on improving and expanding mental health care to those who live on less than one dollar per day. 

Mental health problems impose a serious and widespread health burden, yet remain a neglected and under-resourced domain of global health. Lack of access to safe and effective services remains a significant barrier to mental health care globally. Neuropsychiatric conditions, including depression, alcohol and drug dependence, bipolar disorder, schizophrenia, dementia, and anxiety disorders comprise approximately one-third of “years lost due to disability” (YLD) among people older than 14. Depression is the leading cause of disease burden in most regions of the world; by 2030 it is predicted to be the leading single cause of disease burden globally, particularly among women. With the onset of approximately half of all adult mental health disorders occurring before the age of 14, it is estimated that 20 percent of children aged 9 to 17 have a diagnosable mental health condition that impairs their ability to function. Mental disorders significantly compound physical illness, reducing life expectancy from communicable diseases such as HIV and tuberculosis, and promote the advance of other noncommunicable health problems such as heart disease and diabetes. Stigma related to mental disorders prevents those afflicted with mental illness from seeking access to mental health care, and ultimately compromises their human rights. Globalization and broader social phenomena such as migration and access to technology serve as key forces affecting biology, psychology, and health in contemporary society. Poverty compounds the factors that perpetuate mental disorders, and leaves those in the “bottom billion” particularly vulnerable to illness, and lack of safe and effective treatments. 

The Program draws together departmental expertise in the clinical, evaluative, and social sciences—including medical and psychological anthropology, social medicine, and history of medicine, as well as methodologies in quantitative and qualitative research—and seeks to build upon a generation of knowledge regarding service delivery and capacity-building in health services. Program research efforts focus on the innovation of models of care that bridge the preventive and the clinical, the community and the hospital, and the indigenous and the biomedical. By harnessing the resources, passion, and best practices of health care systems worldwide, the Program’s faculty and trainees aim to place the care of patients with mental health disorders squarely within the dialogue on health and human rights.

References
Martin Prince, Vikram Patel, Shekhar Saxena, Mario Maj, Joanna Maselko, Michael R Phillips, Atif Rahman. No health without mental health. The Lancet. September 4, 2007.

World Health Organization. Caring for children and adolescents with mental disorders: setting WHO directions. 2003.

World Health Organization. The global burden of disease: 2004 update. 2004.