by Aislinn McNiece and Matt Ellison
To culminate the World Bank’s “Out of the Shadows: Making Mental Health a Global Priority” conference, Georgetown hosted its own Global Mental Health Symposium: Transdisciplinary Perspectives on Sunday, April 17. Nationally and internationally renowned experts in the field gathered at the symposium to discuss the role of mental health care in development and policy situations.
Dr. Emily Mendenhall, professor of global health in the STIA program and co-organizer of the symposium, explained that the objective of the event was to serve as a space to talk about how people in the field understand both the complexities of the problems in global mental health as well as the place of mental health on the development agenda. The symposium, co-hosted by the Science, Technology, and International Affairs (STIA) Program in the SFS and the Georgetown Department of Psychology, covered these issues in four panels and two keynote addresses over the course of the day.
Dr. Vikram Patel, a psychiatrist and researcher best known for his work on development and mental disability in low-resource environments, delivered the Maloy Distinguished Keynote Lecture to open the day’s discussion. His lecture focused on “Bridging the Gap” between global mental health and transcultural psychiatry with the goal of “establishing mental health as a global public good.”
Dr. Patel presented several critiques of mental health in a global development setting, especially pertaining to the motives of practitioners bringing mental health diagnoses into developing countries. He cited personal experience in response: he has met healers in Zimbabwe, priests in India, and non-Western practitioners throughout the developing world who, thought they might have other names for the disorder, all recognize symptoms of depression.
“Depression is a real, genuine, universal cause of human suffering across cultures,” said Dr. Patel.
And, though it is the people who are socially disadvantaged by poverty that are also typically disadvantaged from depression diagnoses, Dr. Patel cited research that shows mental health intervention can address social conditions as well and help people rise out of poverty. The bottom line in providing the “right to care and right to life with dignity” through mental health, he said, is the importance of sensitivity to global mental health within social, economic, and health care system contexts and constraints.
“When it comes to mental health, there are no developed countries. All countries are, in some way, still developing,” said Dr. Patel.
The first panel, chaired by Dr. Laurence Kirmayer of the McGill University Global Mental Health Program, continued the discussion surrounding “Context and Mental Health: Culture, Poverty, and Religion.” The next three panels discussed how we conceptualize mental health, chaired by University of California at San Diego professor Dr. Janis Jenkins; how we provide services to marginalized populations, chaired by Dr. Patel; and opportunities and challenges in policy and finance in the developing world, chaired by Dr. Pamela Collins, Associate Director for Special Populations at the National Institute of Mental Health.
The closing keynote address given by Dr. Arthur Kleinman, a psychiatrist and the Esther and Sidney Rabb Professor of medical anthropology and cross-cultural psychiatry at Harvard University, introduced a conversation surrounding growth and change in global mental health in both the developed and developing worlds.
He discussed a newly emerging trend in the social science world that turns its back on humanitarianism due to criticisms of NGOs operating in a political space rather than a moral, scholarship-based one. In return, he called for “a much more settled, refined, and thoughtful humanitarianism.”
To make this change, Dr. Kleinman proposes humanitarianism better incorporates academia while scholars remain honest about what they can and cannot do, all with the goal of collaboration and, ultimately, action.
“The most important thing is to be out there doing things. So many people are doing great work: clinicians, people in supporting roles, engaged in a new form of social care that has not yet been fully conceptualized,” said Dr. Kleinman. He also emphasized how new models of care need to harness a new kind of reciprocity in which researchers and clinicians have much to learn from the people they study and treat. “Those in need are giving us their stories, experiences, and lives,” Dr. Kleinman said.
Though we don’t have to do everything at once, he said, we are “all in this together.” Dr. Kleinman advocated for collaboration between the academic community of psychiatry and the development agencies with focus on the specific issues of those who are most vulnerable to mental health disorders in the developing world.
At the close of the symposium, Professor Mendenhall felt that the goals of the day—to challenge and engage in a dialogue around the field—were met.
“I think that every time you engage at this level with these kind of phenomenal people, you move forward. The two keynotes were exceptional—I think they both were really challenging us to think critically about where global mental health fits in development, but also what it means to do global mental health and what it means to make a difference with it,” said Professor Mendenhall.
The symposium was supported by Georgetown’s Global Futures Initiative, the School of Foreign Service Office of the Dean, the Science, Technology, and International Affairs (STIA) Program in the SFS, The Corp, the Graduate School, and the Georgetown Department of International Health.