Worldwide study identifies top global challenges in mental health

The paper resulting from the study appears in the journal Nature.

Professor Abdallah S. Daar, senior scientist with the McLaughlin-Rotman Centre for Global Health at the University Health Network (UHN) and the University of Toronto, co-authored the historic study, "Grand Challenges in Global Mental Health." The study -- the world's largest of its kind -- brought together more than 400 international researchers, advocates, clinicians and other experts to identify the major obstacles to improving the lives of people with mental illness around the world. The paper in Nature also suggests priorities for research funding agencies.

"Mental illnesses are a problem for the whole of humanity -- globally, they contribute a huge burden, and they are poorly dealt with in almost all countries. This is why we need to develop a global list of challenges and priorities," says Daar, the senior author on the paper.

The study took 18 months to complete, having begun in early 2010. With leadership from the McLaughlin-Rotman Centre for Global Health and the US National Institute for Mental Health, it applied the following criteria in the last round to identify the top global challenges: ability to reduce disease burden; impact on equity; immediacy of impact; and feasibility. It grouped the grand challenges into five goals that span discovery science, prevention, health care delivery, training, and policy.

Among the top grand challenges in global mental health identified:

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

"For the first time ever, we have provided a clear picture on where the greatest needs lie in terms of tackling global mental health problems. This will help scientists, advocates, clinicians and practitioners to focus their efforts and will also help global Ministries of Health and funding agencies to understand the whole picture, prioritize and identify appropriate entry points," says Daar, also a U of T Professor of Public Health Sciences and of Surgery. "Substantial progress in mental health research can be made over the next decade if research funding agencies focus on these priorities."

Dean Catharine Whiteside of U of T's Faculty of Medicine says Canadian researchers will continue to play a lead role in mental health research as they hone in on the study's grand priorities. "Scientific research into mental illness has long been a major focus at the University of Toronto, but a clearer vision for research that will have meaningful impact is emerging, thanks to the work of Professor Daar and his international colleagues. With these goals in mind, our top researchers will continue to work collaboratively with global partners to address the most pressing mental health challenges."

"This research is a remarkable achievement in scope, surveying many participants in different countries and covering such a wide range of illnesses," says Dr. Sidney H. Kennedy, Psychiatrist-in-Chief, University Health Network and Professor of Psychiatry, University of Toronto. "It has the potential to transform how we treat mental illness throughout the world by setting key priorities, researching and establishing the most effective treatment interventions, and building a community of researchers and funders who can cooperate internationally."

"Our previous studies had already identified global challenges and priorities for chronic diseases and infectious diseases. Mental health is the next frontier," concludes Daar.