The World Health Organization estimates that untreated mental disorders account for 13 percent of the total global burden of disease, and that by 2030, depression alone will be the leading cause of disability around the world—outpacing heart disease, cancer, and HIV.

Almost half the world’s population lives in countries where, on average, there is one psychiatrist to serve 200,000 or more people. And it’s likely that in these places people are poor and suffer other diseases, which can create and worsen mental health problems. They might also have lived through wars or natural disasters. To make matters worse, stigma against disorders such as depression, schizophrenia, bipolar, and epilepsy often goes unchecked, discouraging people from seeking care and sometimes leading to inhumane treatment.

PIH’s response

Our mental health programs are delivering care and growing at nearly all of our global sites. Given common co-morbidities between mental health and other areas—HIV, tuberculosis, noncommunicable disease, cancer, substance abuse, domestic violence, and poverty—our priority is to make mental health care a central part of our primary care package across our sites and systems.

Soon after Haiti was struck by a devastating earthquake in 2010, PIH began building a system for mental health care to serve an area of 1.3 million people. Over the past three years, we have created a community-based model that is integrated into our primary care system in rural Haiti—11 hospital sites in the country’s Central Plateau and Artibonite departments. Read how one man's life was changed, and hear his doctor's perspective on the importance of mental health care. You can also learn more about this program at the Mental Health Innovation Network.

In Rwanda, the focus of our mental health program has been a health center nurse training model called MESH (Mentoring and Enhanced Supervision at Health Centers). The work focuses on providing affordable, community-based care in the public primary care system, and increases the use of effective treatments of non-specialists through the mentorship program. Read about how Sifa Dorcas played a vital role in helping Hategekimana Bashar receive treatment for schizophrenia.

In Peru, we work in Carabayllo, one of the poorest districts of the capital city, Lima, where we have been a global leader in modeling community-based approaches to successful treatment of multidrug-resistant tuberculosis. Our mental health program has evolved from a strong psychosocial program for patients living with tuberculosis, to delivering care for depression, and developing safe houses for people living with psychotic illness. 

In Mexico, we serve 10 clinics staffed by pasantes (physicians) and acompañante (community health workers). The pasantes receive ongoing monthly trainings on best clinical practices, mental health diagnosis, and treatment. The acompañantes provide basic psychoeducation, monitor treatment adherence, and refer patients to care. Eudeli Velasquez is one such acompañante—read how she helped Rosemberg Lopez rejoin his family and community after being treated for schizophrenia. You can also learn more at the Mental Health Innovation Network.

We are developing mental health programs in Navajo Nation and Rosebud Sioux Tribe, Malawi, Lesotho, Liberia, Sierra Leone, and Russia. In partnership with the Program in Global Mental Health and Social Change and the Dr. Mario Pagenel Fellowship in Global Mental Health Delivery at Harvard Medical School, PIH is building platforms for the delivery of safe, effective, evidence-based and culturally sound mental health services across its sites.