In the field of global health, where caregivers are often left frustrated when enormous suffering goes untreated, sometimes just getting the world to acknowledge the severity of a problem can feel like an achievement.
When that acknowledgment is coupled with real progress toward identifying and implementing affordable, scalable solutions that have the potential to improve millions of lives, it's cause for celebration.
Earlier this month, the Gairdner Foundation announced it was recognizing Vikram Patel, the Pershing Square Professor of Global Health in the Blavatnik Institute at Harvard Medical School, for his outstanding achievements in research in the field of global mental health by presenting him with the 2019 John Dirks Canada Gairdner Global Health Award.
To celebrate this achievement, widely regarded as one of the most prestigious awards for global health research, Patel was feted at a reception at HMS by colleagues from across the university and around the world on April 23.
“In addition to being the leading cause of suffering in the world today, mental illness is also the least attended problem and perhaps the most stigmatized,” said Paul Farmer, chair of the Department of Global Health and Social Medicine in the Blavatnik Institute at HMS, at the celebration.
Patel said the award was an important recognition of the growing body of scientific evidence by researchers and clinicians around the world of the importance of mental health care and the possibilities for addressing mental illness even in communities with few medical or financial resources. Much of Patel’s work is related to the use of community health workers to deliver care.
“The prize is also recognition of the people who have lived with a mental health problem who have had the courage and commitment to have spoken out, for in my mind there is no better way to address stigma than to talk openly about one’s own private sufferings,” Patel said. “I also want to acknowledge the community health workers who have engaged in our programs in so many countries.”
“These are the true heroes of our field, and I bow my head to them,” Patel said.
In particular he highlighted his long-standing collaboration with the Indian nongovernmental community health organization Sangath, which helped him turn his ideas about health care into reality. He also acknowledged the vibrant global health and mental health research communities at Harvard.
Challenges and misconceptions
For many serious mental illnesses, effective treatments are well-known, but the vast majority of people affected by mental health problems are not able to receive the care that can transform their lives.
One obstacle to providing mental health care has been a number of common misconceptions that stand in the way, including that mental health is a trivial problem in low- and middle-income communities compared to more pressing health issues, and that mental illnesses are too complicated to treat in underresourced communities because they require expensive, specialized care.
Patel has dedicated himself to gathering evidence that demonstrates that mental health problems are universal forms of human suffering that cause great harm and to showing that it is possible to deliver relief to those suffering from mental illness with resources that are plentiful and affordable in every community.
Janet Rossant, the Gairdner Foundation's president, cited Patel’s “world-leading research in global mental health, generating knowledge on the burden and determinants of mental health problems in low- and middle-income countries and pioneering approaches for the prevention and treatment of mental health in low-resource settings” as the reason he was given the award.
Rossant emphasized that the prize was not only a recognition of Patel’s research, but also an important opportunity to raise the profile of a serious health problem that affects people in all countries, rich and poor, and to bring new resources and innovation to solving the problem.
George Q. Daley, dean of Harvard Medical School, noted that Patel, who is also a professor in the Department of Global Health and Population at the Harvard T.H. Chan School of Public Health, is an inspiring representative for all of Harvard and for the medical community world-wide.
“You have a deeply held ethic of equity, you have a discerning scientific mind, but it is the compassion that you have in your heart, so fundamental to the practice of being a physician, that we are all here basking in and celebrating tonight,” Daley said to Patel. “You have challenged some of the most stubborn and harmful myths about mental health and your efforts have laid a bedrock foundation for the growing sense that mental health must be a priority.”
Building a body of evidence and a community of care
Over the course of his career, Patel has led pioneering studies that quantified the clinical, human and economic costs of mental illness and developed and tested models of care delivery that allow community health workers to deliver the high-quality mental health care described in Patel’s book Where There Is No Psychiatrist. Since coming to Harvard two years ago, Patel has led the creation of a Harvard-wide global mental health initiative.
Farmer said he was delighted by Patel’s award not just because it recognizes Patel’s excellent research, but also because it highlights the exemplary way that he has addressed the challenges of mental health, noting that Patel has “moved forward what is really a novel field: how do we address ranking social problems and learn from it when we’re doing it?”
Patel’s approach, which ties care delivery to research to continually improve the way care is delivered, serves as a model for how members of a university should conduct themselves in a world riven by inequality, environmental disaster and ruinous health systems, Farmer said.
Ashish Jha, dean for global strategy at the Harvard Chan School and faculty director of the Harvard Global Health Initiative has worked closely with Patel on the Global Mental Health at Harvard initiative. Jha said that Patel is an important role model for another key reason.
“All of the important, easy stuff has been done,” Jha said. “One thing that Vikram has taught us is how important it is to do the hard work. If we're going to move the needle on global health, there's no substitute.”
Celebrants included university leaders, faculty and students, along with Patel’s family, friends and other colleagues. Patel will receive his award at the annual Canada Gairdner Awards Gala in Toronto on October 24.