Global Is Local: Leveraging Global Mental-Health Methods to Promote Equity and Address Disparities in the United States

Author:

Giusto Ali1ORCID,Jack Helen E.2,Magidson Jessica F.3,Ayuku David4,Johnson Savannah L.5ORCID,Lovero Kathryn L.6,Hankerson Sidney H.7,Sweetland Annika C.1,Myers Bronwyn8,Fortunato dos Santos Palmira9,Puffer Eve S.5ORCID,Wainberg Milton L.1

Affiliation:

1. Department of Psychiatry, Columbia University Irving Medical Center, New York State Psychiatric Institute, New York, NY

2. Division of General Internal Medicine, Department of Medicine, University of Washington

3. Department of Psychology, University of Maryland

4. Department of Mental Health and Behavioural Sciences, College of Health Sciences, Moi University

5. Department of Neuroscience and Psychology, Duke University, Duke Global Health Institute, Durham, NC

6. Department of Clinical Sociomedical Sciences in Psychiatry, Columbia Mailman School of Public Health

7. Department of Population Health Sciences & Policy, Department of Psychiatry, Icahn School of Medicine at Mount Sinai

8. Curtin enAble Institute, Faculty of Health Science, Curtin University; Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town, South Africa

9. Department of Mental Health, Ministry of Health, Maputo, Mozambique

Abstract

Structural barriers perpetuate mental-health disparities for minoritized U.S. populations; global mental health (GMH) takes an interdisciplinary approach to increasing mental-health-care access and relevance. Mutual capacity-building partnerships between low- and middle-income countries and high-income countries are beginning to use GMH strategies to address disparities across contexts. We highlight these partnerships and share GMH strategies through a case series of said partnerships between Kenya and North Carolina, South Africa and Maryland, and Mozambique and New York. We analyzed case materials and narrative descriptions using document review. Shared strategies across cases included qualitative formative work and partnership building; selecting and adapting evidence-based interventions; prioritizing accessible, feasible delivery; task sharing; tailoring training and supervision; and mixed-method, hybrid designs. Bidirectional learning between partners improved the use of strategies in both settings. Integrating GMH strategies into clinical science—and facilitating learning across settings—can improve efforts to expand care in ways that consider culture, context, and systems in low-resource settings.

Funder

national institutes of health

duke global health institute, duke university

grand challenges canada

duke university

Duke Bass Connections

Charles Lafitte Foundation Program in Psychological Research

national institute on drug abuse

university of maryland

national institute of mental health

national institute on alcohol abuse and alcoholism

New York State Representative Espaillat

New York State Office of Mental Hygiene

Publisher

SAGE Publications

Subject

Clinical Psychology

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