Mental Health

Five Questions

A conversation with Vikram Patel

You are an advocate for global mental health equality. Where does this passion stem from?

head-to-toe portraint of Vikram Patel, smiling, hands lightly clasped in frint
Vikram Patel, Pershing Square Professor of Global Health and Social Medicine at HMS and professor, Department of Global Health and Population, Harvard T.H. Chan School of Public Health

As a medical student, I was interested in neurology. I was fascinated by the brain and diseases of the brain. However, I found neurology rounds disappointing. The focus seemed to be almost entirely on the art of diagnosis. Once a diagnosis was made, there seemed to be little further interest in the person or their suffering. I found this to be disheartening. In psychiatry, by contrast, the first questions a consultant would ask a patient were about their personal circumstances such as, who do you live with? and what do you do for a living? I found psychiatry to be a more humane, more person-centered, more dignified, and more interesting way to approach problems of brain health.

If you could change one thing about our understanding of mental health today, what would it be?

The idea that mental health care is the domain of mental health specialists only is one that I would like to see revoked altogether. Mental health is important to each and every one of us, and we all need to be equipped early on with skills and knowledge of how to protect and promote our mental health and how to deal with mental health problems. Mental health is everyone’s business.

What developments are poised to transform mental health globally?

One innovation that has been demonstrated and is becoming increasingly mainstream is that anyone who is sufficiently trained and supervised to deliver a specific mental health intervention can be a mental healthcare provider. Another is the use of digital technologies in almost every aspect of mental health care—from prevention and promotion through treatment and recovery. A third is the increasing convergence between our understanding of the functions of brain circuits and networks with psychological interventions designed to target these brain circuits and networks. I foresee the real prospect of neuroscience, psychological science, and clinical science converging, something I don’t think we could have even imagined a decade ago.

What is the most dramatic change in the field of mental health you have witnessed in your lifetime?

The acceptance of mental health problems as universal forms of human suffering that have been described in very similar ways across cultures, across societies, and importantly, across time. Different cultures and different societies have evolved different ways of dealing with mental health problems, but there are surprising similarities across the approaches used. The belief that the nature and care of mental health problems is highly culture specific was once a dominant idea. Today, I think we know this is not the case.

Good mental health is impossible without …

Good mental health is impossible without recognizing its central value in your life.

Image: John Soares