Mental health is so broad. Why not focus on a single diagnosis?
Fundamentally, we believe that mental health is influenced by a variety of social and economic determinants. In Latin America where we currently work, these broader factors include violence, migration, and drug trafficking, and what we see on the surface are trauma-related behaviors such as domestic violence and substance abuse. It is common to also find anxiety, depression, and other related challenges underlying these behaviors.
So in the spirit of civil rights activist Ruby Sales, we ask, “Where does it hurt?” Instead of exclusively addressing a particular expression of mental illness, we listen to our local partners to understand where there is a high demand for services, training, and education. That is our starting point, and the best way to ensure community participation in the solution.
How do you know people are demanding mental health support?
Many in the space get hung up on stigma. This doesn’t mean they are wrong. However, people are still demanding support for the negative outcomes associated with mental health such as domestic violence in our Ecuador partnership. The Lancet Commission on Global Mental Health defines mental health as, “Mental health can be defined as an asset or a resource that enables positive states of wellbeing and provides the capability for people to achieve their full potential.” When defined so broadly, we don’t have to worry as much about whether someone is demanding “trauma therapy” but can respond to the full range of demands that are connected to mental health and unlocking potential.
Why is mental health so heavily under-resourced in these contexts?
For reference, as little as US$0.25 in mental health spending is available to individuals in low-income countries each year. Meanwhile, prevalence rates in these contexts are estimated to be twice that of high-income countries.
We believe that this mental illness treatment gap is both a result of, and a contributor to, the poverty experienced in these communities. Part of the challenge is that traditional mental health education and training are expensive, and much of it is developed in the West. Additionally, the one-on-one clinician/patient approach to psychological services is difficult to scale. The fact that there are only a few professionals per 100,000 people in under-resourced contexts further contributes to the treatment gap.
Additionally, mental illness is both universal to the human experience and deeply unique to local contexts. Efforts to develop sustainable, effective mental health care must recognize this tension. We are hopeful that as development and humanitarian organizations become more collaborative, we will see more co-designed solutions that are locally driven and sustained.
Are you planning to use technology components in the solutions you design? What about mobile applications?
Yes. As a clinician, Aaron loves incorporating technology to aid the recovery and growth of clients. However, we remain skeptical of relying too heavily on technology to actually deliver the education and services needed in the vulnerable populations we are reaching. Local capacity needs to be built—and while some of that training can be done digitally, we believe are greatest resource against mental illness is the individual who cares enough about her community to act on it.