April 17, 2014

Unifying our Approach to Mental Health

Andres Barkil-Oteo, MD, MSc, Assistant Professor of Psychiatry, 
Yale School of Medicine 

I was invited to visit Ghana by GHLI to discuss the incorporation of a mental health component, known as the “Psych Corps,” into Ghana’s National Health Service. Ghana graduates 300 psychology students per year who serve one required year posted to clinics across the country. 

This is the second year of the program and we see many issues that still need to be addressed, but largely the feedback was positive and Psych Corps members look forward to expanding the program. Why were my team and I involved? Although none of us had ever been to Ghana, and its culture and customs were foreign to us, somehow the setting felt familiar.  

For the last two years, our group has overseen a student run clinic in New Haven, CT offering behavioral health services to a large, undocumented Latino population in a low income neighborhood. The problems of lack of access, stigma, and lack of professional staff in Ghana’s clinics mirrored many of the problems we face in the U.S. We shared our model with our Ghanaian counterparts, and sought feedback from a group of enthusiastic nurses and psychology graduates on how this could be adapted to their current situation. We, in turn, learned from them how to go about performing outreach and home visits, things we currently lack in our complex, hospital-focused system. 

Our travel to Ghana further illustrated to us that problems of access are universal, as are problems of under utilizing evidence-based therapies, and problems of marginalization and stigma. We need to change our mental perspective to one that assumes that we all deal with similar problems, with differences in intensity, but not in kind. Students wishing to work in the area of global health would be well advised to find a similarly local under-resourced setting, where they could learn skills and practices not taught inside large hospital settings; only then could they approach global initiatives with a mentality of solidarity rather than a mentality of difference. After spending a full day with Psych Corps, exchanging ideas, I came back optimistic about this collaboration, and look forward to continuing the shared learning experience.

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