
Global Health
Global, Community & Public Mental Health Innovation
I’m committed to finding innovative ways to provide mental health care to communities throughout the world, strengthen health systems, and remove obstacles to care. Working in Rwanda, Haiti, Peru, Chiapas, Malawi, Lesotho, Liberia and Sierra Leone over the past fifteen years has taught me much about how to think about building teams and systems. Since 2010 I‘ve led and supported the implementation and integration of mental health programs as founding Director of Mental Health at Partners In Health, an international health care delivery organization working in ten countries. In this capacity, I’ve supported local teams dedicated to catalyzing comprehensive health system strengthening that is inclusive of mental health. The main focus of this work is to replace institutional care in locked psychiatric facilities with free care delivered by collaborative teams of community members, non-specialist health care providers, and specialists who work in integrated ways close to where people live. I engage in this work because this kind of care is needed in all global contexts, including the US. Working to promote the development of innovative models of delivery of mental healthcare for people without access to services, and learning about ways to strengthen the resilience of communities enhances my practice. My work building teams to develop sustained models of community-based mental health care delivery in places where services are difficult to reach has contributed to an emerging field of global mental health delivery.








(Prevention and Promotion)

(Psychiatry)

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Basic helping skills and social support
Psychosocial interventions
Psychological and psychiatric care
Safe and effective use of technology
Examples:
What America can learn from Rwanda to solve its mental health crisis. National Geographic. 2024
Sierra Leone not long ago still chained mental health patients. A transformation is underway. 2024
This Psychiatric Hospital Used to Chain Patients. Now It Treats Them. 2022
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Specialists
Non-specialists in the workforce and in schools
Community members
Examples:
MGH/McLean Community and Global Psychiatry Program
Sierra Leone Psychiatric Teaching Hospital Residency
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Effectiveness studies of interventions
Qualitative and quantitative assessment of the experience of care
Adaptation to context
Examples:
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Engagement with policymakers
Examples:
A global scope for global health—including mental health. Lancet. 2011.
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Development of a continuum of care from health care facilities to the community
Safety and quality improvement
Effective use of technology
Examples:
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Best practices in engaging members of the community in delivery of support and care
Examples:
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Best practices in mental health and psychosocial response (MHPSS)
Engagement with crises
Examples:
The 2010 Haiti earthquake response. Psychiatry Clinics of North America. 2013.
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Approaches that see mental health along a continuum from:
Health promotion (“well-being”)
Prevention (“distress”)
Treatment and care (“disorder”)
Support for rehabilitation and recovery (“disability”)
Examples:
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High quality evaluation, diagnosis and treatment of disorders
Examples:
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Bringing institutions and organizations together for the benefit of public mental health
A person-centered, human rights-based approach to improving care and systems to serve people’s well-being
Examples:
The Chester M. Pierce MD Division of Global Psychiatry at Massachusetts General Hospital