Where is the global in global mental health? A call for inclusive multicultural collaboration

• Published in: General psychiatry Vol. 33; no. 6; p. e100351
• Main Authors: Osborn, Tom L, Wasil, Akash R, Weisz, John R, Kleinman, Arthur, Ndetei, David M
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 05.11.2020; BMJ Publishing Group
• Subjects: Authorship; Child & adolescent mental health; Collaboration; Community; Correspondence; Developing countries; Intervention; LDCs; Medical research; Mental depression; Mental disorders; Multiculturalism & pluralism; Neurosciences; Research methodology; Researchers; Stigma; Kenya; adolescent; clinical; psychotherapy; psychology; adolescent health services
• ISSN: 2517-729X; 2096-5923; 2517-729X
• DOI: 10.1136/gpsych-2020-100351

Common mental health disorders, like depression and anxiety, account for 45% of the global disease burden on youths aged 15–29.1 This challenge is particularly significant in low and middle-income countries (LMICs) where risk factors such as poverty, limited treatment options and stigma restrict access to care and exacerbate the burden and magnify the impact of mental disorders.2 3 Given these barriers, there is an urgent need for research dedicated to expanding mental healthcare for young people in LMICs. Because of the global public health challenge characterized by adolescent mental health disorders, there have been increased efforts over the last two decades to expand treatment options for youths in LMICs. Researchers from high-income countries (HICs) may bring assumptions about diagnostic classification, aetiology and treatment that may not be appropriate for LMICs.4 To address this risk, and enhance cultural validity, some investigators have emphasised the value of collaborating with colleagues from LMICs in designing and implementing interventions for these settings.5 Without such collaboration with community partners, well-intentioned efforts may risk relying on false assumptions about the generalisability of Western-derived intervention development and research methods across diverse populations in LMICs.4 A possible consequence of the status quo is that mental health interventions in LMICs may fail to adequately consider and address salient features of adolescent mental health in LMICs. Besides this, we also considered—in the cases in which the first author was affiliated with an LMIC-based institution—whether the author’s affiliation was from the same LMIC population as that being studied. The inclusion of LMIC researchers in intervention development efforts may lend local credibility to mental health interventions in LMICs and increase their adoption.12 Change that privileges the inclusion of LMIC researchers and experts in global mental health research is needed and feasible.