Depression, anxiety, and other mental illnesses are among the leading causes of death and ill health around the world, contributing both to human suffering and to lost opportunities for economic development and prosperity, according to numerous studies. And, in recent years, researchers have tracked a disturbing increase in mental health disorders.
A growing recognition of the global impact of mental illness has led to a movement to find solutions, a movement with deep roots in the Department of Global Health and Social Medicine in the Blavatnik Institute at Harvard Medical School.
In one of five symposia exploring the evolution of social medicine at Harvard over the past 150 years, GHSM faculty members this year explored how the department has addressed mental health care delivery challenges around the world through the legacy of Paul Farmer, the former head of the department who died unexpectedly on Feb. 21 from a sudden cardiovascular event.
A Look Back
History of Global, Social, Mental Health at HMS
1975 – 1976 Culture, medicine, and psychiatry
Culture, Medicine and Psychiatry, a seminar that took place at Harvard in academic year 1975–1976, led by Arthur Kleinman, Leon Eisenberg, and Byron Good, attracted faculty and graduate students from across the University, including scholars from the fields of anthropology, sociology, political science, and the history of medicine. This was the beginning of a deepening of the relationship between the social sciences in the University’s Faculty of Arts and Sciences and the medical school.
1980 The relevance of social medicine
In The Relevance of Social Science for Medicine, co-authors Eisenberg and Kleinman argued for social science’s importance in medicine:
“The key task for medicine is not to diminish the role of the biomedical sciences in the theory and practice of medicine, but to supplement them with an equal application of the social sciences to provide both a more comprehensive understanding of disease and better care of the patient. The problem is not ‘too much science,’ but too narrow a view of the sciences relevant to medicine.”
1984 – 2008 Culture and Mental Health
For more than two decades, the National Institute of Mental Health Training Program in Culture and Mental Health Services, co-directed by Mary-Jo DelVecchio Good and Byron Good, brought postdoctoral trainees in medical and psychiatric anthropology to Harvard.
1996 Mental health as a global development issue
In one of the foundational documents for the modern approach to global mental health care delivery, World Mental Health Report authors Robert Desjarlais, Eisenberg, Good, and Kleinman laid the groundwork for a biosocial approach to mental health that takes into account social, cultural, economic, historical, environmental, and clinical contexts when tackling mental health challenges on the individual and population levels, a hallmark of scholarship and service in the department.
2001 Advanced training at HMS for international scholars
The launch of the International Mental Health Training Program, funded by the Fogarty International Center, brings psychiatrists from China and Indonesia to HMS for advanced training in mental health services research. Directed by Byron Good.
2009 Partnerships for care delivery
Since the launch of programs in post-genocide Rwanda in 2009, and post-earthquake Haiti in 2010, HMS faculty members have worked with international care delivery nonprofit Partners In Health to develop comprehensive, community-based mental health services. These services are integrated with community-based primary care and clinic-based acute and chronic care for diseases such as HIV, tuberculosis, Ebola, and COVID-19, and with referral hospitals as needed. These comprehensive services for both common and severe mental health challenges reach hundreds of thousands of people in some of the most underserved areas around the world.
2012 Mastering global health
In 2012, the department launched a new master of medical sciences in global health delivery program designed to give global health practitioners the diverse set of tools necessary to envision, manage, and deliver more equitable health care. Participants have included both HMS medical students interested in pursuing careers in global health and working practitioners from more than 30 nations who have taken their new skills back to serve their home communities. Many of the students have focused on delivering mental health care services and on a social medicine approach to mental health care, for example, incorporating support for family members of people with mental illness.
2018 Global mental health expands throughout Harvard
GlobalMentalHealth@Harvard is an interdisciplinary initiative that aspires to elevate the profile of mental health care as a fundamental public good and universal human right, working across all the schools at Harvard University.