Giuseppe James Raviola, MD, MPH

Mental health has historically remained outside of the field of global health, whether related to humanitarian crisis response, epidemics, or to the development of systems of care inclusive of mental health.  Dr. Raviola’s work sits squarely at the intersection of Psychiatry, Global Health, and Social Medicine, to promote the development of innovative models of delivery of mental healthcare to people living in the economically poorest communities in the world, and to show evidence for these advances. He has led research and academic scholarship to evaluate the impact of the services developed by the service delivery teams he has assembled or supported over the past decade. This includes implementation science research focused on demonstrating the effectiveness of the public sector-embedded, integrated care delivery models that the teams he supports are evolving on a continuous basis. He has led efforts to develop novel clinical evaluation and measurement systems, novel electronic medical record systems, and novel quality improvement systems, with use of targeted qualitative and quantitative methods. This includes processes to develop and document a systematized understanding of the essential steps in developing an evidence-based, locally relevant model of care through a service delivery planning matrix and value chain for global mental health.

Dr. Raviola’s scholarship reflects the application of accumulated research evidence on functional practices within the public sector, effective primary care-based mental health care delivery, the use of participatory and community-based approaches to evaluate services, and the use of data within routine clinical management consistent with highly effective performance improvement. His work has contributed to shifts in government policies in a number of counties, related to mental health as part of integrated, sustained, government-run health care programming, and informing the implementation and scaling up of services.

Dr. Raviola has applied his clinical, consultation, and systems expertise to create substantial, measurable, innovative global mental health delivery models that are unique in the world for their capacity to address complex, co-morbid mental health conditions in low-resource settings, as well as for their global scope. He has responded to humanitarian crises as opportunities to strengthen health systems following catastrophic events by building integrated models of care for complex mental health conditions, demonstrating the feasibility of task-shared, locally adapted services that are collaborative, comprehensive, and community-based, for the long-term, in “real-world” settings. This work has often been produced de novo, requiring the establishment of basic human resource and management capacity. He has also advanced evidence that safe, effective, quality care for debilitating, severe, and common mental disorders can be delivered at the front lines of global health delivery, within already burdened public health systems.

Dr. Raviola has also led the implementation of mental health delivery across twelve countries as Director of Mental Health at Partners In Health (PIH), an international health care delivery organization linked to Harvard Medical School (HMS) through the Department of Global Health and Social Medicine (DGHSM). Since 2016, PIH has delivered more than a quarter million mental health visits across 105 PIH-supported facilities, and has newly enrolled more than 62,000 people living with complex mental health conditions in settings with limited formal available services. Through the HIV/AIDS crisis, in post-genocide Rwanda, in Haiti following the 2010 earthquake, in Liberia and Sierra Leone following the 2014-16 Ebola outbreak and where they reformed the oldest psychiatric asylum in sub-Saharan Africa and co-led the accreditation of a new residency in Psychiatry, as well as across global sites and in the Commonwealth of Massachusetts during the 2020-22 COVID-19 pandemic, he has supported and catalyzed comprehensive health system strengthening that is inclusive of mental health. In the post-COVID era, this experience in community-based, task-shared mental health care delivery in a variety of settings carries the possibility of effective translation to high-income settings such as the US, where mental health services remain fragmented, inequitable, and difficult to access.

Selected Recent Research

• Advancing Community-Driven Mental Health in Massachusetts, Blue-Cross Blue-Shield Foundation, 2023
• Many Voices Collaborative in Community-Based Mental Health Care for Common Mental Disorders at Partners In Health, 2018-24
• Grand Challenges Canada, The Partners In Health Mental Health Learning Collaborative: Capacity-building for mental health care delivery and implementation across global sites, focusing on Peru, Lesotho, Liberia, and Mexico, 2020-22
• Burke Global Health Fellowship, Harvard Global Health Institute, Assessment of the Feasibility of a Novel Care Service Delivery Planning Matrix to Achieve Universal Mental Health Coverage in Low-Resource Settings, 2018-19 
• Grand Challenges Canada, Promoting a Novel Community-Based Mental Health Model in Rural Haiti, and Building a National Scale-up Plan (Zanmi Lasante and Partners In Health), 2015-16 
• Grand Challenges Canada, Integrating mental health into primary care: expanding a community-based mentorship and enhanced supervision (MESH) model to address severe mental disorders in Rwanda (Inshuti Mu Buzima and Partners In Health), 2014-16
• Grand Challenges Canada, Expansion of a new implementation model to address severe mental disorders in rural Haiti, to inform the development of a national decentralized mental health plan following the 2010 Haiti earthquake (Zanmi Lasante and Partners In Health), 2012-15