Global Mental Health Research for Sustainable Development
The WHO’s global mental health action plan 2013-2020 relies on evidence-based practices. As such, today’s global mental health research is largely focused on the “evidence” to deliver effective mental health interventions in low- and middle-income countries. Although I have no intention to question the need and importance of scientific evidence, we hardly hear about the “sustainability” of evidence-based practice in global mental health despite the fact that “sustainable development” has been a core concept shaping the development agenda since the 1988 Bruntland Commission. Now that mental health and well-being are included in the UN’s Sustainable Development Goals, I would like to explore a question: “How can researchers link global mental health research with sustainable development?”
One answer may be found in implementation science, which provides tools and approaches to integrate evidence into health policy and practices (De Silva & Ryan, 2016). An intervention that is found to be effective in the idealized conditions of a research setting may meet a wide range of barriers in a real world context. The exclusive focus on evidence may divert our attention from the role of culture in a specific setting. In this context, global mental health research should find an answer of not only “what works” but also “how it works” by holistically examining the behavioural, organizational, economic, socio-cultural, and political dimensions of the context where evidence is implemented. Furthermore, researchers have the important role and responsibility to share pertinent individual knowledge available with those at the organizational, community, and society levels (Landry, Amara, Pablos-Mendes, Shademani, & Gold, 2006).
While innovative instruments for knowledge sharing still seem lacking, my past work experience in international development reminds me of the notion of “ownership.” With an understanding that the sustainability of the project outcome results from the beneficial output shared among project participants, development partners generally make great efforts to foster a sense of ownership during the project implementation. In global mental health, community-based participatory research may be one possible approach to generate ownership by addressing the unequal power distribution between researchers and community people.
My initial question is still open for discussion. Meanwhile, the consideration of sustainability and ownership in global mental health research may shed light on the ethical aspects of our research process and application of knowledge.
Sakiko Yamaguchi is in the 2nd year of her PhD program in Division of Social and Transcultural Psychiatry, Department of Psychiatry at McGill. After working on government projects for social development in low- and middle-income countries, including post-conflict countries (Peru, Afghanistan, Sudan), she decided to pursue her PhD to better understand the long-term impact of violent conflict on mental health, and explore how international community can respond to the unmet needs of the affected people. She is currently in Ayacucho, Peru for her research project on alcohol misuse among the Andean highland population, who is still suffering from the consequence of political violence and the daily hardships rooted in poverty and socio-economic inequality.
De Silva, M. J., & Ryan, G. (2016). Global mental health in 2015: 95% implementation. The Lancet Psychiatry, 3(1), 15-17.
Landry, R., Amara, N., Pablos-Mendes, A., Shademani, R., & Gold, I. (2006). The knowledge-value chain: a conceptual framework for knowledge translation in health.Bulletin of the World Health Organization, 84(8), 597-602.