Leadership in Mental Health Research, Training and Advocacy
The Department of Global Health and Social Medicine supports a range of programs of mental health research, training and advocacy, and has provided leadership in the fields of social and cultural psychiatry, psychiatric anthropology and global mental health research and practice. Members of the Department have been deeply involved in: placing social and cultural forces at the intellectual and research heart of psychiatry and mental health care (“rethinking psychiatry”); de-centering and ‘decolonizing’ psychiatric research and knowledge; critiquing ethnocentric practices that base psychiatric knowledge nearly exclusively on research with majority populations in North America and Europe; demonstrating the importance of diverse populations, societies and cultures for knowledge of human experience and psychopathology; demonstrating how approaches which leverage resources in communities can be effective for the prevention and care of mental health problems; advocating for global and country action to close the global mental health care gap; advancing the teaching and practice of global mental health as an academic discipline; and responding to new crises for mental health such as COVID-19 and other complex humanitarian disasters.
The Department has had a long, historic commitment to work in the field of social and cultural psychiatry and global mental health. Dr. Julius Richmond and Dr. David Hamburg were pioneers in science and advocacy for mental health and psychosocial programs for children. Dr. Leon Eisenberg, first Chair of the Department of Social Medicine, was a psychiatrist with wide ranging interests in social psychiatry, child mental health, and international mental health, having collaborated for years at the Division of Mental Health at WHO. Dr. Arthur Kleinman is a widely recognized pioneer in cultural psychiatry and psychiatric anthropology. Professor Byron Good and Professor Mary-Jo Good have been leaders in cross-cultural knowledge of mental illnesses and research on the culture of psychiatry within anthropology. Professor Anne Becker has innovated research on the social and cultural mediation of presentation and risk of eating disorders, social barriers to care for mental disorders, and school-based mental health promotion. Dr. Alex Cohen has made significant contributions to medical anthropology as it relates to the social worlds of people living with severe mental illness, case studies of successful programs in global mental health delivery, and has led the development of the innovative MSc in Global Mental Health at the London School of Hygiene and Tropical Medicine. Professor Norma Ware is a medical anthropologist and leading mental health services researcher on social and behavioral dimensions of HIV treatment and prevention. Professor Joseph Gone has worked at the intersection of community-based mental health services and traditional culture and spirituality for advancing indigenous well-being. Dr. Giuseppe Raviola has advanced the field of global mental health delivery through academic efforts linked to Partners In Health sites, building on integrated care delivery platforms developed for HIV and TB care, as well as responding to multiple complex emergencies over the past decade. Professor Vikram Patel has advanced the field of global mental health through work on the burden of mental disorders, their association with poverty and social disadvantage, and the effective use of community resources for the delivery of interventions for their prevention and care.
Training and Education
These faculty members are linked to collaborating scholars from diverse disciplines and with mental health professionals across the Harvard community, and a large network of former fellows and colleagues who are leaders in related fields around the United States and globally. As mental health services have increasingly become critical components of infectious disease and non-communicable disease programs, and programs in these health areas conducted by other members of the Department and its affiliates, various interdisciplinary collaborations have evolved, drawing strands of the Department and the University together. Moreover, several faculty members have forged long-standing, mutually rewarding, partnerships with institutions in low-resourced contexts, both in the United States and globally, creating sustainable platforms for scholarship, education and service.
The Department has additionally had a long commitment to training programs in mental health care, foundational concepts of mental health, and mental health research. The Department ran an NIMH training program in culture and mental health services for a quarter century, and its international training programs in East Africa and Asia have focused on issues of global mental health. The International Mental Health Training Program, funded by the Fogarty International Center, NIH, has brought psychiatrists from Shanghai and Beijing to the Department and has built on years of collaboration between the Department and leading Chinese psychiatrists and psychiatric institutions. In addition, the Freeman Foundation and Carnegie Corporation supported the Department to become a leading site for the training of psychiatrists and social scientists from China and Africa in cultural psychiatry and medical anthropology, organized around studies of mental illness and care in non-Western societies.
For several decades the Department sponsored a leading journal in the field: Culture, Medicine and Psychiatry. Faculty carried out NIH and National Science Foundation-funded research and published articles and books on Culture and Depression, Global Pharmaceuticals, Reducing Suicide, Normal and Abnormal Behavior in Chinese Society, and other mental health-relevant themes from stigma and indigenous healing to family care for the mentally ill, as well as the culture of psychiatry in Taiwan, China, Indonesia, and African societies. Since it’s inauguration the Department has organized relevant courses at HMS and the Harvard University Faculty of Arts and Sciences on culture and mental health, drawing from this foundation of leadership in research. This long academic tradition of mental health research and teaching in the context of Social Medicine attracted many, and made Harvard University a leading center for such work for decades. One such student, a young medical student named Paul Farmer, who started by studying cultural psychiatry in Paris, and then in Haiti, went on to revolutionize global and public health, and by extension, global mental health delivery.
Today, the Master of Medical Sciences in Global Health Delivery has supported the development of a number of careers in mental health research at front-line sites in global mental health delivery, with a number of current departmental faculty supporting teaching and projects in mental health. This year, the Department will launch a new post-doctoral program in global mental health implementation science, in collaboration with the Aga Khan University campuses in East Africa and South Asia.
Members of the Department lead popular courses with significant mental health components, including Who Lives, Who Dies, Who Cares: Reimagining Global Health (Harvard College, Gen Ed 1093). Departmental members have recently developed new courses on various aspects of global mental health within the department and across Harvard, including:
- Foundations of Global Mental Health, HMS/T.H. Chan School of Public Health/HMS (GHP 204)
- Global Mental Health Delivery: From Research to Practice, HMS/T.H. Chan School of Public Health/HMS (GHP 208/SM 518.0)
- Mental Health Champions: An Executive Leadership Program for Mental Health, T.H. Chan School of Public Health, Program Co-Director:
- Foundations of Mental Health Care (ECPE-MHF 0522)
- Scaling Up Mental Health Services (ECPE-MHS 1022)
- Mental Health Care Peer Learning Collaborative (ECPE-MHP 123)
- Counseling as Colonization? Native American Encounters with the Clinical Psy-Ences (Harvard FAS, Anthropology 1900)
- Legacies of Violence and Healing: Mental Health and Illness in Colonial and Independent Africa (Harvard FAS, History 1924)
Advocacy for global commitments to global mental health has been a key engagement for the Department. In 1995 the Department launched the first World Mental Health Report at the United Nations ( Oxford University Press) and at regional meetings in Asia, Europe, Latin America and Africa. Funded by several of America’s major foundations the report was the first to provide a global picture of the situation of mental illness and mental health care globally. In 2016 the Department led the Out of the Shadows report, the first report by the World Bank on mental health globally and its global costs and financial needs. The next year the Department welcomed Dr. Vikram Patel, who has significantly impacted global mental health advocacy through leadership of various publications including The Lancet in 2007 and 2011, and a 2018 Lancet Commission on Global Mental Health and Sustainable Development.
The Department’s current priorities have remained committed to basic research in social and cultural psychiatry; to advancing mental health care on the global health agenda through research, education, critical thinking, and advocacy; to addressing issues of social justice and human rights associated with disparities in access to good quality mental health care; to placing mental health firmly on the agenda for global health; and to advancing implementation science on the effective utilization of community resources and non-specialist providers with the goal of the reduction of the global burden of suffering of mental health problems across contexts settings (as all countries today experience large mental health disparities). Some of these priorities are coordinated through three more recent departmental initiatives in global mental health:
GlobalMentalHealth@Harvard, a virtual, cross-university, collaborative of scholars and students interested in global mental health at Harvard University. One of its signature programs is EMPOWER, which is using a suite of digital tools and methods to build the capacity of front-line providers in the US and globally to deliver evidence-based psychosocial interventions.
The Mental Health For All Lab, led by Professor Vikram Patel, MBBS, PhD, and John Naslund, PhD, which promotes the generation of knowledge and its effective utilization with the goal of contributing to the reduction of the global burden of suffering of mental health problems. The specific emphasis of the Lab’s efforts is to leverage digital technology and task-sharing to scale up interventions for the prevention and care of mental health problems across the life course. Much of this research is funded by NIH grants in diverse global contexts.
The Program in Global Mental Health and Social Change, led by Dr. Giuseppe Raviola, which serves as a conduit for implementation-based training and research in global mental health delivery at Partners In Health global sites. Since 2016 Partners In Health has delivered more than a quarter million mental health visits across 105 PIH-supported facilities. The work at these sites, often borne from disasters and crises, has strengthened health systems through the development of integrated models of community-based care, advancing evidence that safe, effective, quality care for debilitating, severe and common mental disorders can be delivered at the front lines of global health delivery.