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Written by Dr. Brad Gaynes, Director of the Division of Global Mental Health


What if someone asked you whether it was important to address the 2nd highest cause of disability worldwide? And you knew that there were easy to administer tools to accurately identify the disorder, and there were effective treatments available, and that despite such availability most patients never had this illness identified. And, for those that did have the illness identified, most did not get an adequate trial of treatment and did not recover, so that in the end, only 5% of those that had this illness recovered. And that the main reason was that clinicians did not have the training to identify and effectively manage this illness despite a strong evidence base. And this was even more of a problem in low and middle income countries, where on average there is 1 psychiatrist for every 100,000 patients with mental illness.


And that most people don’t know about the above imbalances for depression.


What would you do?


This yawning gap between what is needed and what is being done for all mental illnesses drives clinical, research and policy activities in Global Mental Health in general, and in our Division of Global Mental Health in particular. More than 85% of the world’s population live in the 153 low- and middle-income countries (LMICs). More than 80% of people who have mental disorders live in LMICs, with mental illness and substance abuse disorders presenting as an important cause of disease burden, accounting for 8.8% and 16.6% of the total burden of disease in low-income and lower-middle-income countries, respectively.


Many are employing creative attempts to address this need. Some address this gap in the child and adolescent populations. Christina Cruz, a child psychiatry physician scientist, for example, is doing ground breaking work in India training primary school teachers as an early warning and intervention system to identify children at high risk of mental illness. Kristen Winsor, a third year psychiatry resident, is leading a project to enhance medical student training in psychiatry at the College of Medicine in Malawi so more might consider psychiatry as a profession. And colleagues from the Gillings Global School of Public Health and I are leading projects to train non-psychiatric clinicians to better identify and manage common mental disorder in medical settings.

October 10th, 2021, is World Mental Health Day. The overall objective of this annual event is to raise awareness of mental health issues around the world and to mobilize efforts in support of mental health. This year’s theme is “Mental health care for all: let’s make it a reality”.

So—is it important? And, if it is, what will you do?

Take some time on October 10th to consider.