Global Health
Global & Community Mental Health Innovation
My clinical expertise and interest in high quality systems of care has informed my engagement in public and global health innovation. I’m committed to finding new ways to provide mental health care to communities without access to care, strengthen health systems, and remove obstacles to care.
For more than fifteen years 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.
This work entails support of local teams strengthening public health systems to include mental health services. The main focus of this work is to replace institutional care in locked psychiatric facilities with 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. 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. This work is also being translated to the US context to address our ongoing national mental health crisis.
Delivery of Care
Training and Education
Research
Advocacy for Policy Change
Systems of Care
Humanitarian Crisis Response
Task Sharing
Dimensional Approaches(Prevention and Promotion)
Categorical Approaches(Psychiatry)
Health Equity, Collaboration and Partnerships
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Basic helping skills and social support
Psychosocial interventions
Psychological and psychiatric care
Safe and effective use of technology
Partners In Health, Mental Health
Partners In Health, Mental Health Storymap
Examples:
What America can learn from Rwanda to solve its mental health crisis. National Geographic. 2024
This psychiatric hospital used to chain patients. Now it treats them. The New York Times. 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 Program
University of Global Health Equity Psychiatry Clerkship and Residency Program
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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 partnership for mental health globally. Lancet Psychiatry. 2019.
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 age of trauma. Harvard Public Health. 2021.
Mental health of communities during the COVID-19 pandemic. Canadian Journal of Psychiatry. 2020.
10 ways to manage the effects of social distancing. NPR. 2020.
The 2010 Haiti earthquake response. Psychiatry Clinics of North America. 2013.
In Haiti, mental health system is in collapse. The New York Times. 2010.
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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
The University of Global Health Equity, Rwanda