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Exploring the Grand Challenges in Global Mental Health

March / April 2012 | Volume 11, Issue 2

Q and A with Dr. Pamela Collins
Director, NIMH Office for Research on Disparities and Global Mental Health

Headshot of Dr Pamela Collins
Photo by Leo Sorel

Dr. Pamela Collins

Mental disorders are the leading cause of disability around the world. That's why the National Institute of Mental Health, part of the NIH, is joining with researchers from 60 countries across the globe to prioritize research initiatives in the Grand Challenges in Global Mental Health program.

NIMH Director Dr. Tom Insel recently asked Dr. Pamela Collins, Director of NIMH's Office for Research on Disparities and Global Mental Health, about the effort. Here are some highlights of that conversation.

There is growing interest in global mental health. Why is that?

Well, I think we could actually ask why hasn't this happened before? We know that mental disorders are the leading causes of disability around the world. I think there's been a perception that these are problems of wealthy countries and that with so many other competing health priorities in low- and middle-income countries, how could you possibly think about mental disorders? But we have known for some time that these create an incredible burden of illness, they create an incredible burden of disability and they have to be addressed.

PHOTO: A man up close seated on the floor stares off camera; one in the background, out of focus, also seated on the floor
Photo by WHO/P. Virot

Mental disorders are the leading cause of disability
around the world.

What is the Grand Challenges initiative and what do you hope it will accomplish?

What's important to remember about the Grand Challenges in Global Mental Health is that "global" truly means global. And we in the U.S. are part of the globe. So these are priorities that people working in more than 60 different countries came to some consensus on and there are priorities that reflect needs in every country. Certainly, if you look at the top 25 Challenges identified, you'll see issues that the U.S. mental health system needs to address, but you'll also see issues that are relevant to countries around the world, countries that don't have the level of health infrastructure that we do. I think the advantage of this is that it's an opportunity for us to learn from each other. So, it's an opportunity to address some of the daunting issues around access to care, around getting people the services they need that will be just as relevant to people in the U.S. who don't have mental health services as they are to people in other parts of the world.

Access the article Grand challenges
in global mental health
 by Dr. Pamela Collins
et al, from the July 7, 2011 issue of Nature.

Page of Comment article in July 7, 2011 issue of Nature magazine

There are so many pressing issues in global mental health - how do you propose to tackle them?

I think we need to, as a community, choose some very specific goals and perhaps direct efforts toward those. One of the things that we have been thinking about is that there are such clear inequities in terms of access to care. The treatment gap is tremendous in many low- and middle-income countries where you simply don't have the mental health specialists and how can we actually extend services in those settings? Are there other people that can provide care in those settings that are not necessarily psychiatrists? Can specialists train others to provide these kinds of services in order to get people the care they need? I think this is probably one area that's worth investing in: actually extending services.

How do you plan to work with other international funders in this area?

That's actually at the heart of this Grand Challenges initiative - really, how can we build a community of people that are working on these same issues? We're already collaborating with the World Health Organization and supporting some of those efforts in the Mental Health Gap Action Program. By continuing to build partnerships, perhaps with other funding agencies, I think this is a chance for people to pick their own piece of this pie. This is not something that we want to do alone but this is an invitation really - for researchers, for universities, for governments - to get involved in mental health and we'd like to see that kind of collaboration happen.

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