Columbia University spring semester started this week. How lovely and hopeful that the semester that starts in the dead of winter, is called spring semester. I started teaching the course “Priorities in Global Mental Health” in 2014. In recent years my colleague, Professor Tahilia Rebello has joined me in co-teaching the course.
Tahilia and I and our teaching assistants welcomed students on Wednesday morning at 8:30 AM to our first class. We began with a question: “What do you think of when you hear the term Global Mental Health?” This is the same question we have asked at the start of the semester for 7 years. What has changed are the replies. Using an online texting interface, students submitted one word. In a matter of seconds, their collective replies generated the word cloud above. The size of the words reflect how frequently the word was submitted by different students.
1. Dignity and Human Rights. Only seven years ago, in response to the same prompt, the biggest word (most frequently submitted) was stigma. How remarkable that this year’s class most frequently thought of dignity and human rights. Focused on where we are going and how we will get there. For me, this is like calling our current semester the spring semester. There is no doubt that stigma is still a major issue related to mental illness around the world. Just as there is no question we will have some cold, snowy days this semester. But the idea that global mental health is about human rights and dignity is like the coming of spring after a long, cold winter.
2. Everyone. Cultural. Societal. Transnational. Mental illness is the leading cause of disability in the world. Every sixth or seventh person experiences one, which means all of us are impacted in some way by mental illness. And mental illness does not discriminate. No culture or society is immune. From Bollywood star Deepika Padukone to BBC’s Editor Fergal Keane to unknown millions, mental health matters to everyone. The emerging field of global mental health is all about improving understanding, building systems, and increasing access to appropriate and effective care across communities, cultures, societies, and transnationally.
3. Inadequate. Underfunded. Invisible. Global mental health is about making visible the burden of mental illness and shining a light on the lack of resources devoted to mental health interventions. We have successfully made the case that untreated mental illness is a big problem around the world. But problems don’t get funded. Solutions get funded. The exciting news is that effective interventions exist, and even for those conditions with symptoms that don’t fully resolve, we have programs that can dramatically enhance quality of life and recovery for all.
4. Partnership and Community. The causes of mental ill health are varied, complex and multifactorial. At first glance, some significant factors that contribute to increased risk for mental illness might not seem to be about mental illness at all – like gender inequality, poverty, diet, and air pollution. But the data are rapidly evolving to demonstrate the links between these and many other social determinants of health and mental illness. Far-reaching and enduring solutions will depend on partnerships and communities committed to addressing these dimensions of human experience and systemic change.
5. Wellbeing and Opportunity. The World Health Organization’s definition of health is “…a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” This year’s students recognized that when we talk about global mental health, we need to aspire not only to resolve the clinical symptoms of mental illness but also to promote wellbeing for all. For students in search of a career that promises the opportunity for impact, look no further.
Our Priorities in Global Mental Health class is comprised of students from diverse areas of study, including public health, law, medicine, journalism, and social work. Students hail from all continents (except Antarctica). Their energy and optimism have not been snuffed out but rather tempered and informed by real-world and first-hand experiences related to mental health and illness. Compared to where the field of global mental health was in 2014, and compared to the associations that students had only seven years ago, at the end of class on Wednesday, it felt just right that we call this the start of spring semester.