Breaking the Glass

The most iconic moment of a Jewish wedding follows many beautiful and symbolic prayers and gestures that culminate in the much anticipated crescendo when the couple standing before their community break a glass – stomping on it and shattering it to pieces. It is then that their marriage is sealed. But marriage is a time of great joy and optimism. Why would we burden it with a thousand shards of broken glass?

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There are as many interpretations of the breaking of the glass as there are shards. At their essence, they all share the same truth. Even at times of great joy, let us not lose sight of the ways in which the world around us is broken.

That is how I feel about the extraordinary milestones for mental health that we have to celebrate this week. They are true. And so are the many shards of glass.


Mental Health at the United Nations General Assembly. Many New Yorkers wish they could skip town during UN week. It is impossible to get around. Impossible to get a taxi or even an Uber. Impossible to make a restaurant or hotel reservation. This year it was worth staying around to support the high-level UN event, Time to Act on Global Mental Health: Building Momentum on Mental Health in the SDG EraDr. Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization, championed an increased focus on mental health around the world. Converting his words at the pulpit to actions in practice have the opportunity to promote health, save lives, and grow economies.


United for Global Mental Health Launched. Founded by Elisha London, a tireless champion for mental health, United for Global Mental Health officially launched this past week with the ambitious agenda of mobilizing and supporting organizations and individuals around the world to ensure that everyone, everywhere has someone to turn to who is trained to support them with their mental health needs. The special session hosted by United for Global Mental Health at the United Nations was a standing room only event. It has the audacious goal of raising millions of dollars to improve the lives of millions of individuals in need of greater mental health services.


Wellcome Trust makes a big investment in mental health. The largest charitable foundation in the world after the Gates Foundation, Wellcome Trust has a laudable track record of addressing pressing public health issues, including advancing work on drug-resistant infections, vaccines, science education, among others. Just recently, Wellcome Trust announced that it was expanding its commitment to mental health. The aim is to “shape a new super-discipline of mental health science, in which scientists and clinicians work with a common purpose, using standardised measures and approaches.” Focusing on psychological treatments for anxiety and depression, and focusing on youth, this initiative has the potential to dramatically reduce the associated burden of these conditions which afflict over 615 million people worldwide.


World Psychiatric Association (WPA) Meeting in Mexico City. Beginning today, the 18th WPA World Congress opens with delegates from every region of the world. The sweeping range of topics include forced migration, suicide, violence, new addictions, poverty, discrimination, toxic environments, gender, neuroscience, aging, early intervention, diagnosis and classification, and dissemination of evidence-based treatments. It is my first time in Mexico City, and I am thrilled to have the opportunity to attend and contribute. The energy and commitment of the many thousand participants is what has made it possible to realize the recent milestones in mental health noted above.

US House and Senate Reach Agreement on Opioid Bill. In rare show of bipartisanship, the House and Senate have reached agreement on a big package of measures to address the opioid epidemic. The bill is 653 pages and contains measures focused on public health interventions as well as law enforcement. Among the many aims contained in those 653 pages, the bill specifically articulates strategies to block deadly fentanyl from being imported by mail and also proposes an increase in nurses’ capacity to prescribe medications for opioid addiction. It also should make inpatient care more accessible for Medicaid recipients.

So why the broken glass? Because with all the momentum and progress highlighted by the five great milestones noted above, the events unfolding in the US this week related to the supreme court nomination remind us that as much as we are making progress, there is still much that is broken. Our mission must be to heed the wisdom of the broken glass – celebrating these milestones for mental health while redoubling our efforts to address the enduring brokenness that needs repair.

Kathleen M. Pike, PhD

Kathleen M. Pike, PhD is Professor of Psychology and Director of the Global Mental Health WHO Collaborating Centre at Columbia University
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