The World Health Organization estimates that untreated mental disorders account for 13 percent of the total global burden of disease, and that by 2030, depression alone will be the leading cause of disability around the world—outpacing heart disease, cancer, and HIV.

Many places, especially poor countries, lack trained mental health care providers and comprehensive mental health care services. Almost half the world’s population lives in countries where, on average, there is one psychiatrist to serve 200,000 or more people, according to the WHO. Furthermore, stigma against disorders such as schizophrenia, bipolar disorder, depression, and epilepsy goes unchecked, discouraging people from seeking care and sometimes leading to inhumane treatment.

PIH Response

In partnership with the Program in Global Mental Health and Social Change and the Dr. Mario Pagenel Fellowship in Global Mental Health Delivery at Harvard Medical School, PIH is training mental health care providers in poor settings. We’re teaching them how to conduct mental health evaluations and give social assistance, psychological support, and medication to patients in a safe and culturally appropriate way.

We began providing mental health services in 2005 in Haiti, where our team of psychologists and social workers support impoverished patients diagnosed with HIV, tuberculosis, or both.

One year later, we took our experience gained in Haiti to Rwanda, where PIH collaborates with the Ministry of Health to bring mental health care into rural communities. We mentor and train clinicians and non-specialists to improve the care they deliver in villages and homes.

After the 2010 earthquake and the onset of the cholera epidemic in Haiti, the need for formal mental health care greatly increased. At the request of national health authorities and with the support of international funders, PIH started expanding the mental health program across the country to help patients dealing with depression, epilepsy, post-traumatic stress disorder, and other mental illnesses.

In 2014, we began expanding to all 10 of our sites in collaboration with national governments, identifying local experts who could lead the incorporation of our mental health program into the primary care system.