Stand up straight. Plant your feet. Now imagine drilling from your toes, straight through the exact center of the earth and across to the other side. When you reach the point on the earth diametrically opposite to where you are standing, you will have reached your antipodal point.
Most of us will probably never visit our antipodal points. So when it comes to the people, the climate, the conflicts, the mental health issues going on halfway around the world, should we care? Should the United States spend any of its foreign aid on mental health in places so far away? Doesn’t the U.S. have real mental health needs at home? These are good questions and often asked when we talk about global mental health. Here are some reasons why I respond to all these questions with a resounding, “Yes!”
“Houston, we have a problem.” This famous alert from the Apollo 13 moon mission reminds us that we cannot solve problems if we fail to recognize them. But if we call in the right resources, lifesaving solutions are possible. Mental disorders are the leading cause of disability around the world, and our estimates are probably low. We need to recognize the burden of mental illness globally; we need to say it aloud and put resources to work.
Nobody has a monopoly on innovation. Some of the most significant advances in mental health in the past decade were developed and tested in low and middle-income countries across the globe. Remember the adage, “necessity is the mother of invention”? Resource constrained circumstances breed ingenuity. And low-income environments have other assets to bring to the table. Global partnerships unleash complementary resources that facilitate scaling up and disseminating services around the world.
“Reverse innovation.” Increasingly, new procedures, instruments and technologies in mental health are being developed in lower-income settings and then flowing to higher-income settings. Take, for example, two innovations that started in Africa that have found their way to Europe and North America – the Tree of Life Trauma intervention and the model of community health workers in Harlem. When you consider that 48% of the US population lives in the “low-income” range, focusing on under-resourced communities has huge potential in so-called high income countries, too.
And then there’s equity. More than half of the people who suffer from mental illness around the globe are not receiving treatment that would significantly improve their lives. From a simple moral imperative, it behooves us to work toward relieving mental suffering where we can. While moral ambiguity may be on the rise, the principles of fairness and shared humanity still must hold some currency.
Return on investment. Treatments for mental disorders have proven effective even in the most challenging settings. Focusing on mental health translates to improved quality of life for the individual, enhanced quality of life for families and communities, and reduced burden on health systems. For every $1 invested in mental health, we can expect a $4 return.
So, when we consider investing in mental health – whether we do so at the points on earth that we call home or near our antipodes halfway around the earth, let’s say, “yes.”