In most low-income countries less than 1 psychiatrist exists per 100,000 people and national budgets spend less than $1 per person on mental health. But mental illnesses are just as common in low-income countries as they are in high-income countries – and even higher in regions plagued with war, conflict, and displacement. Illustrating the kernel of truth that necessity is the mother of invention, there has been an explosion of innovation in low-income settings to advance desperately needed mental health services.
Columbia University Global Mental Health Program affiliated professor, Richard Negeubauer, recently highlighted important research and clinical work coming from diverse low and middle-income country settings that is changing the way we think about delivering mental health care. The lessons learned are valuable for us all – because better care for more people delivered effectively and efficiently is needed everywhere.
When mental health interventions team up with primary care, good things happen in Zimbabwe. In two different programs, lay health workers are screening for common mental disorders, including depression and anxiety, in primary care in Zimbabwe. That is already innovative, but there’s more. For those who screen positive, a lay health worker delivers problem-solving therapy with education and support. Those who received the intervention improve and still look better at 6 months compared to usual outcomes. These results are being used to advocate for nation-wide scale-up.