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Journal article review

Dr Katrina Bannigan‘Grand challenges in global mental health’  reviewed by Dr Katrina Bannigan, Director of RCOMH.

The ‘Grand challenges in global mental health’ (Collins, Patel and Joestl, 2011) reports the findings of an extensive Delphi study involving 422 researchers, advocates, programme implementers and clinicians from 60 countries. There were three rounds which involved asking the question “what are the grand challenges in global mental health?” (round 1), Selecting the top 40 challenges to identify the top 25 challenges (round 2) and ranking each challenge on a four point scale for: ability to reduce disease burden; impact on equity; immediacy of impact; and feasibility (round 3).The top five challenges ranked by disease-burden reduction, impact on equity, immediacy of impact and feasibility were:

  • Integrate screening and core packages of services into routine primary health care
  • Reduce the cost and improve the supply of effective medication
  • Provide effective and affordable community-based care and rehabilitation
  • Improve children’s access to evidence-based care by trained health providers in low- and middle-income countries
  • Strengthen the mental-health component in the training of all health-care personnel.

From an RCOMH perspective we need to be cognisant that these challenges have been identified when thinking about our work, particularly when shaping our research activity. However, it also important to be aware that service users were not included and that other analyses may highlight different global challenges. For example, in The Spirit Level, Wilkinson and Pickett (2010), contest that reducing inequality would improve  mental health in society in terms of reducing disease-burden, impact on equity, and an immediacy of impact. However, in terms of feasibility, Collins et al (2011) fourth criterion, reducing inequality may seem more like a pipe dream.

If you would like to read this article the full reference is

Collins PY, Patel V, Joestl SS, (2011) Grand challenges in global mental health. Nature, 475, 27-30. [The mental elf link has access to the article].

These other information sources may also be of interest: